What you should know about epidural anesthesia during the delivery?
Epidural anaesthesia (lumbar puncture) is a very effective method of pain relief during childbirth.
Advantages of an epidural
- It typically offers tolerable pain relief.
- An epidural will not generally affect your baby.
- If a caesarean section proves necessary, the anaesthetic can be strengthened via the epidural.
Preparations for the epidural
- Check-up of the baby through a cardiotocogram (CTG) (registration of the fetal heart rate and uterine contractions)
- The pregnant woman is given extra fluid via an infusion.
Insertion of the epidural
- The epidural is inserted either in the recovery room or the maternity suite.
- After numbing the skin with an injection, the anaesthesiologist will insert a needle into the woman's back in order to insert a thin tube (an epidural catheter).
- The pregnant woman is not allowed to move while the epidural catheter is being inserted and must warn the anaesthesiologist when she has a contraction.
- Inserting the epidural catheter usually takes 20 minutes. It takes another 5-15 minutes before the anaesthetic takes effect.
- A pump with local anaesthetic is connected.
- Afterwards, the pregnant woman (blood pressure and oxygen level) and the child (heart recording) must be continuously monitored.
- After administering an epidural, a tube will be inserted into the bladder.
- In some cases, the epidural may not work properly and must be either adjusted or replaced.
Potential issues of an epidural
- An epidural increases the chance that the baby has to be delivered with the aid of vacuum extraction (suction cup).
- The woman may develop low blood pressure, itching and/or a fever during the epidural.
- If the pregnant woman develops a fever, the baby must be observed after the delivery. If the baby shows any signs of an infection, the paediatrician will prescribe a 7-day course of antibiotics.
- The insertion site for the epidural can be sensitive. However, this usually fades after a few days.
- If a woman develops severe headaches after giving birth, she must contact the birth centre.
See below for information on the most important risks of receiving an epidural.
The risks of epidural or spinal anaesthesia pain relief during childbirth
Type of risk |
How often does this occur? |
How common is this? |
|---|---|---|
Significant drop in blood pressure |
1 in 50 woman |
Occasional |
There is insufficient pain relief during the |
1 in 8 woman |
Common |
There is insufficient pain relief during |
1 in 20 woman |
Occasional |
Severe headache |
Epidural anaesthesia: 1 in 100 woman
Spinal anaesthesia: 1 in 500 woman |
Infrequent |
Nerve damage: a numb spot on the |
Temporary: |
Rare
Rare |
Epidural abscess (infection) |
1 in 50,000 woman |
Very rare |
Meningitis (inflammation of the membranes |
1 in 100,000 woman |
Very rare |
Epidural haematoma (blood clot) |
1 in 170,000 woman |
Very rare |
Sudden loss of consciousness |
1 in 100,000 woman |
Very rare |
Serious damage, including paralysis |
1 in 250,000 woman |
Extremely rare |
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