Epidural: Advantages, Disadvantages, and Solutions

(By Keren Giber Segev)

An epidural is one of the most commonly used pain relief methods—not just for childbirth. First, it’s important to clarify that the epidural is actually a space—the epidural space—into which the anesthetic is administered.

The epidural procedure typically takes 15-30 minutes. Beforehand, you’ll usually receive IV fluids to reduce the risk of a drop in blood pressure following the procedure. The epidural can be administered while you are either sitting or lying down, depending on the anesthetist's preference. Both positions are equally effective, so it’s up to what feels more comfortable for you.

After the procedure, you’ll be asked to lie on your back for 20-30 minutes to allow the medication to distribute evenly to both legs. From there, you're ready to smile through the journey ahead!

Advantage 1: Pain relief.

Disadvantage 1: Labor delay.Pain serves as a guide during childbirth. When we feel pain, we naturally move to ease it. With an epidural, you are confined to the bed and often remain in the same position, which can stall labor progression.

Solution 1: Incorporate intentional movement. Even with an epidural, you can change positions every 20-30 minutes or whenever someone enters the room. Try rocking your pelvis while seated upright, lying on your side with gentle pelvic tilts assisted by someone else, or performing hip rotations. Simply shifting positions can work wonders.

Advantage 2: Muscle relaxation.When we experience pain, stress, or excitement, our muscles can tense up, making it difficult for the body to relax and progress. An epidural relaxes the muscles, potentially allowing labor to advance if tension has caused a stall.

Disadvantage 2: Uterine muscle relaxation.This can make contractions less effective, which may delay labor.

Solution 2: Consider taking the epidural during active labor, ideally at 5 cm dilation or more. However, if you choose to get it earlier due to severe pain, pay close attention to the monitor about 30 minutes after administration. If contractions decrease in frequency or intensity, you can start implementing gentle induction techniques to encourage contractions.

Disadvantage 3: No release of endorphins to assist the baby during delivery.Endorphins, the body's natural pain relievers, are released in response to contraction pain. These hormones cross the placenta and help the baby cope with the birthing process. Without pain, endorphin release is reduced.

Solution 3: Try to postpone the epidural as much as possible.

Side Effects:

• Itching.

• Uncontrollable shaking.

• Blood pressure drop.

  
  

Solutions for Side Effects:

• For itching, apply almond oil to soothe the skin.

• For shaking, focus on nasal breathing and try redirecting the shaking to the pelvic area. Don't fight or stress about it; these tremors often pass within minutes, reappear, and then disappear completely.

• For blood pressure drops, there's little you can do as pre-epidural fluids are typically administered. Blood pressure is closely monitored during the first 30 minutes and periodically thereafter.

Just know that the best thing to do when taking an epidural is to go to sleep!

When you sleep, your body releases a lot of oxytocin. It's not like you'll sleep for 5 hours now, it's about half an hour to an hour

, but it can do wonders because your body will be relaxed and the birth will be able to progress. Just remember to be in an advanced position (on your side, asymmetrical...)

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