Labour pain management: Regional Anesthesia

When it comes to labour pain, women generally experience and tolerate it differently from one another. For some women, focusing on their breathing and relaxation techniques is all they need to get through labour and childbirth while others may need (or think they need) every pain-managing medicine available to help them cope. One of the most popular pain management methods happens to be Regional Anesthesia. These can be in forms of epidurals or spinal anesthesia. However, do keep in mind that your pain relief options may also be governed by certain circumstances of your labor and delivery.

Regional anesthesia is administered by an anesthesiologist who will numb an area on your lower back with a local anesthetic. The anesthesiologist will then insert a special needle into the numb area to find the exact location to inject the anesthetic medication. After injecting the medication, the needle will be removed. In some cases, a tiny plastic tube called an epidural catheter stays in place after the needle is removed to deliver medications as needed throughout labor. The procedure can be done while you are either sitting up or lying on your side. These medications do not completely stop pain, but they do lessen it. Because they affect your entire body and may make both you and your baby sleepy, these drugs are mainly used during early labor to help you rest and conserve your energy.

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FAQs

When during labour can I get it?

The best time to administer regional anesthesia varies depending on you and your baby’s response to labor. Your health care provider will determine the best time for you to receive it.

Will it affect my baby if I get one?

Research has shown that regional anesthesia both epidural and spinal, has no adverse affects on baby or mother.

How long will it take for the medicine to kick in?

Spinal anesthesia starts working immediately after the medication has been injected and the relief lasts about two and a half hours. If your labor is expected to last beyond this time, an epidural catheter will be inserted to deliver medications to continue your pain relief as long as you need it.

In the case of an epidural, you will feel the affects 10 to 20 minutes after the medication has been injected and can be topped up through the catheter whenever needed.

Will my labour slow down because of a regional anesthesia?

Labor and contractions may slow for a short period of time for some women who are on regional anesthesia. However, many women have also found that the anesthesia helped them to relax and actually improved their contraction pattern while they got some much-needed rest.

Will I be able to push my baby out when I’m on anesthesia?

Yes, you will, for your cervix will still dilate while you rest comfortably! It should not affect your ability to push; instead, it will make pushing more tolerable and less uncomfortable.

Will I feel any sensation after having an anesthesia?

While the relief from pain will be significant, you may still feel mild pressure from your contractions, especially during the active stages of labour. You may also feel pressure whenever your doctor or midwife examines you.

Do I have to remain in bed after an anesthesia?

Not necessarily. According to your situation, the anesthesiologist may be able tailor the anesthesia to allow you to walk about. Ask your anesthesiologist about a “walking epidural if you’re interested to know more. Do keep in mind, however, that it depends on your personal situation and how your labour progresses.

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Differences between a Spinal Anesthesia and an Epidural

With a spinal anesthesia, the medication is injected inside the dura, the tough coating surrounding the spinal cord, where else with an epidural, medication is put inside the spinal column just outside the sac that surrounds the spinal cord. Less medicine is needed with a spinal anesthesia and it works faster than an epidural too, but it may cause a headache or low blood pressure in some women.

Possible side effects

While it is the duty of anesthesiologist to take special precautions to prevent complications, there may be some side effects and these include:

• Lower blood pressure. For this, you will be given intravenous fluids. Your blood pressure will be carefully monitored and treated to prevent this from happening.
• Mild itching. This may occur for some women during labor. If itching becomes bothersome, let your midwife or anesthesiologist know.
• Headache. Drinking fluids and taking pain tablets can help relieve headaches after regional anesthesia. If the headache persists, tell your anesthesiologist and additional medication can be ordered for you.
• Local anesthetic reaction. While local anesthetic reactions are rare, they can be serious and should not be taken lightly. Be sure to tell your anesthesiologist if you become dizzy or develop ringing in your ears so that you can be treated swiftly.

One should never feel reluctant or ashamed of requesting pain-relief, as giving birth is not a competition of who can do it without drugs. The most important is the outcome of your baby and you. One also need not worry about the safety of pain relievers given or administered by medical professionals as they are trained in providing both mother and baby with what’s best for them.