Raise Vegan September 2018 Raise Vegan (2) - Page 47

Wondering What To Expect During An Epidural? I n labor, the word epidural refers to an ‘epidural anesthetic.’ Its name is derived from the way in which the anesthetic is administered; it is injected into the epi- dural space - the space around (epi) the dura mater, which is the outermost layer of tissue that surrounds the spinal cord. Epidurals are used in several scenarios where pain relief to the lower half of the body may be required. It is most commonly used during labor and childbirth, when the loss of sensation beneath the waist may be wanted . An epidural can be used for pain relief during a vaginal delivery, or for anesthetic during a C-section or an instrumental delivery, which is a vaginal delivery using forceps or ventouse. Many people know whether or not they will want an epidural early on in their pregnancy and it is worth discussing this with your midwife or obstetrician as soon as possible if you’re considering it. Early planning means that, hopefully, your birth will run smoothly, and the timeframe to receive an epidural won’t be missed. Labor needs to be established before an epidural can be given, as it can slow contractions down, and similarly, it cannot be given too late as the insertion of the epidural can interfere with delivery. Pain-relieving medication is admin- istered throughout the delivery via the catheter, and you should receive intravenous (IV) fluids through a cannula in your arm at the same time. Numbness will be maintained throughout the delivery, and will last for a few hours after the epidural is removed. While an epidural is gener- ally a safe procedure, there is, as with any medical treatment, the possibility of side effects and complications. Common side effects include low blood pressure, but you should be re- ceiving IV fluids to maintain your BP. You might also lose control of your bladder, as the nerve supply is also numbed, but a catheter can be insert- ed to drain your urine. Nausea and itching can occur due to the medi- cations that are used in the epidural, but your medical team can prescribe medications to counteract this. A rare, yet more serious complication occurs when the needle from the in- sertion of the epidural goes through to the next layer of membranes lining the spine, which can cause fluid from around the brain and spine to leak, resulting in a headache. This can be resolved by your anesthetist with a procedure called a ‘blood patch’. A small sample of your own blood is injected into the area, and when it clots, it seals the leak. Epidurals are generally safe, and used every day during labor. However, they are not for everyone, and some people will opt to give birth with al- ternative forms of pain relief or none at all. Some people feel they would prefer to be aware of every sensation during labor and pushing can be tougher when you are numb below the waist. If you think that an epidur- al might be the right option for you during your labor, be sure to have a chat with your midwife or obstetri- cian early on in your pregnancy. Once the decision is made to have an epidural, an anesthetist will be called to administer it for you. Although you can receive an epidural lying on your side, most of the epidurals that I have seen put in for laboring women are done with them sitting forward, leaning over a table. The area surrounding the epidural site is injected with a local anesthetic, and then a small tube, called a catheter, is inserted with a needle into the small space between the vertebrae of the lower back. When the catheter has entered the epidural space, the needle is withdrawn and the catheter is left in place. This is how the pain-killing medica- tion is delivered, which will numb you below the waist. Insertion of an epidural should not be painful, however, you will feel a small scratch when the skin is anesthetized and then a sensation of pressure when the needle is inserted into the epidural space. RAISEVEGAN.COM Raise Vegan 47