What are the benefits and risks of an epidural?

An epidural is a pain relief technique which can be administered by a doctor during childbirth and other medical procedures. There are however benefits and dangers.

This article will look at the pros and cons of an epidural, as well as other possible options.

Benefits

A doctor may suggest an epidural to treat back pain.
A doctor may suggest an epidural to treat back pain.

An epidural is a barrier to the nerves. For a variety of reasons, a doctor can prescribe an epidural, including pain relief during labor, back pain such as sciatica, and chronic leg and arm pain associated with an irritated spinal nerve root.

During labor

An epidural, which reduces the pain between a woman’s belly button and upper legs, will begin to take effect after about 15 minutes, the American Society of Anesthesiologists says.

An epidural doesn’t take away all the pain, and a woman still has some pressure to feel.

Other advantages of an epidural during childbirth include:

  • it is typically safe
  • is it typically effective
  • it allows a woman to remain awake during a cesarean delivery
  • women still have control of their upper body

Back pain

An epidural injection for back pain may have some of the following benefits, including:

  • Effective pain reduction: According to a 2016 systematic review, people who had an epidural for sciatica noted a 50–83% improvement in pain.
  • Decrease surgical intervention: According to the same review, about 80% of people did not need surgery after receiving an epidural injection.
  • Decrease functional disability: An epidural may aid those with a functional disability, which is a long-term disability due to an injury, illness, or condition.

Risks 

Some side effects of an epidural may include:

Serious side effects are uncommon, according to the American College of Obstetricians and Gynecologists (ACOG), but they can include spinal injury, breathing problems, a racing heart, and numbness or tingling.

An epidural can have different side effects during labour. Data about the impact of an epidural on labor duration differ. An epidural can prolong the first and second stages of labor if the doctor administers it too late, according to the Office on Women’s Health (OWH). Many doctors, however, decide on the appropriate time to give an epidural, differently.

Other side effects may include:

  • itching
  • weakness in the legs
  • increased risk of needing the help of forceps or a vacuum
  • skin infection
  • some people may get permanent nerve damage, but this is rare

According to ACOG, the opioids in an epidural can lead to some short-term side effects in the fetus. These include:

  • reduced muscle tone
  • a change in heart rate
  • drowsiness
  • breathing problems

These side effects are usually easy to overcome. If a person is worried about how an epidural might affect the fetus, they should talk with a doctor.

Epidural vs. natural birth

Approximately 60 percent of working women choose an epidural as a form of pain reliever. A woman needn’t have an epidural to give birth, though.

Whether a woman chooses to use an epidural while working is her choice, but women should keep a mind as open as possible. A doctor may need to recommend an epidural or other kind of pain relief sometimes. This could happen if a woman needs a delivery of a cesarean for example.

Alternatives for labor

If an individual chooses not to have an epidural, there may be other strategies for managing pain. Not all hospitals offer all of the services, however, so women can negotiate pain relief options with their health care providers when they present.

Medicinal pain relief

Medicinal pain relief alternatives may include:

Nitrous oxide

Some women prefer nitrous oxide to help them relax when giving birth and during labour. This involves inhaling the nitrous oxide 30 seconds before the start of a contraction. Though it is safe, some people can briefly feel dizzy and nauseous.

Opioids

A doctor may administer, or inject, opioids into the muscle through an IV. They do not affect a person’s ability to push, and thereafter an epidural remains an option. They don’t get rid of the pain absolutely, though, and are short-acting.

Side effects include sense of drowsiness, nausea, and can cause vomiting. The OWH states that there is a time limit for the use of opioids in work. Usually, if a woman is expected to deliver very early, a doctor should avoid the use of opioids, because opioids can delay the baby’s breathing and heart rate.

Pudendal block

An person may want to talk to a doctor about the use of a pudendal block.

A pudendal block is a numbing drug which is inserted into the pudendal nerve and vagina just before the head crowns of the fetus. The numbing medication may help ease pain associated with pushing out the infant.

Not all doctors, however, know how to do a pudendal block as the treatment has usually fallen out of favour.

Non-medicinal

A person who is looking for a completely natural delivery might consider home remedies for labor pain.

Some potential home remedies include:

  • hot compresses
  • cold compresses
  • labor ball
  • adjusting the position to find one that is comfortable
  • massaging the lower back or other areas
  • yoga
  • breathing exercises
  • meditation
  • TENS unit
  • aromatherapy
  • essential oils
  • doula
  • tub bath

Alternatives for other procedures

Some potential alternatives to an epidural for other procedures include:

  • opioids
  • cold or hot therapies
  • spinal anesthetic, which is a single injection of medication into the spine
  • general anesthetic

Summary

An epidural is a safe form of occupational pain relief and for chronic pain management. Although it does have other threats, these are either temporary or very rare.

A person needn’t have an epidural and there are alternatives.

Pregnant women will address what kind of delivery and pain relief they need during childbirth with their doctor or midwife. They should also take the opportunity to address any possible plans and concerns.

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