What are advantages and disadvantages of epidurals?

Dr. Juan Reina explains the advantages and disadvantages of having an epidural. Click play to watch the video or read the transcript.

What are advantages and disadvantages of epidurals?

The disadvantages of the epidural are that the patient has no control over the actions she will have during the birthing process because she’s going to be numb. Some patients don’t like that. They want to have full control of their extremities and their legs and they want to feel the urge to push that comes along with having the baby’s head in your pelvis. But we have the nursing staff and the capability of coaching the patient with an epidural with the same gestures and efforts to deliver the baby. All these disadvantages are at a smaller scale; they don’t happen all the time, they do happen like anything you do in life, but they happen on a smaller scale and usually we have counter measures for any of these disadvantages. Sometimes epidural will slow down the laboring process, the contractions might mellow down, but we have again we counter measures for that. We use pitocin to enhance the contractions at all times if we need to whether you have the epidural or not because ultimately we want to deliver the baby. Also, by placing the epidural we basically numb from the waist down and that can cause certain dilation or expansion of the blood vessels from the waist down which causes a drop in the blood pressure that will sometimes happen after an epidural. Again, we have counter measure for that. We usually give the patients enough fluids beforehand and if the blood pressure drops abruptly or suddenly then we have some medication to counteract that. As far as the husbands or the father of the baby is concerned the epidural brings a positive edge . . . and now we’re going into the advantages of it. Once he’s in there with his wife waiting for the big moment. That could be just a few hours or many hours . . . 12, 18, 24 hours of laboring until you finally deliver your baby. During that time the epidural gives the advantage of having a comfortable laboring process in which I tell my patients you could be playing cards with your husband, talking to your family who came to visit from out of town, watch movies (there’s free pay-per-view in the hospital) and have a relaxed atmosphere and sensation while you wait for your baby to come to the world. That also helps the family and father of the baby to feel comfortable. They are in a home environment while they wait for the baby to be born. It creates less anxiety and less stress. In some patients who have lower pain threshold it enables an emotionally positive experience. The other advantages of the epidural are that it also helps relax the muscles in the pelvis which when you’re in pain you try to contract everything in your body. By relaxing it creates that additional space so to speak for the baby to come down. Also while you are in the delivery process if there is a complication, the heart rate goes down in the middle of delivering the baby, we can act quickly to get the baby out.

 

Epidurals allow a mother to remain awake and alert during pre-labor and labor, according to the U.S. Department of Health and Human Services Office on Women’s HealthOff Site Icon (HHS). This type of anesthesia can be advantageous for childbirth because the level of numbness can be adjusted during the labor process, and pain relief comes in a short amount of time after the medicine is delivered, according to HHS.

According to the National Institutes of HealthOff Site Icon (NIH), some risk factors of epidurals may include:

  • Allergic reaction to the anesthesia used
  • Bleeding around the spinal column
  • Difficulty urinating
  • Drop in blood pressure
  • Headache
  • Nerve damage
  • Spinal infection

An epidural may prolong some stages of labor, and may hinder the mother’s ability to push, according to the NIH.

For more information about the advantages and disadvantages of epidurals, talk to your doctor.

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