Many women know that epidural treatments exist as a form of pain management during labor, but few understand how they really work. This is what you should know.
An epidural refers to any medication a doctor injects into the epidural space near the spinal cord. It may also refer to a combined spinal-epidural (a CSE, or “walking epidural”) in which a physician may target the spinal fluid, itself, and the epidural space for a combination of fast-acting and long-term/low-dose pain management.
The type of injection a physician uses depends on the application. In addition to the nerve-blocking anesthetics and pain-dulling narcotics typically used during labor, physicians may administer steroids or other medications in the epidural space to reduce inflammation and control chronic pain in non-pregnant patients.
For labor and delivery purposes, a doctor will insert a small tube into the space to administer a constant flow of medication to numb or dull the pain. The medication generally kicks in within 20 minutes of administration. CSEs start to act much faster. Epidural injections target the experience of pain, not sensation in the lower body. Women giving birth will still feel sensations and maintain limited mobility after receiving an epidural, but few actually end up walking after receiving the initial injection.
The medication administered with an epidural can reach a baby, but the amounts are very small. So far, the industry has not definitively connected epidural injections with any adverse infant health outcomes. If you worry about the potential side effects of an epidural for your child, we strongly encourage you to speak with your doctor and/or an anesthesiologist about your concerns..
The risks of epidural injections vary depending on an individual’s unique physiology. Some women do not experience any side effects. Others may experience a drop in blood pressure, headaches, soreness around the injection area, or difficulties with pushing. Epidurals are not one-size-fits-all injections. Your delivery team will choose medications and dosages based on your specific medical history and physiology to minimize the likelihood of adverse outcomes.
Epidural injections do make the birthing process less painful for many mothers-to-be, but not all women want or should receive this type of treatment. For those with low platelet counts and other conditions, the practice is often too risky.
Talk with your obstetrician early and often about your delivery plans and preferences. Together, you and your doctor can determine the right pain management strategy for your birthing experience.