What is an epidural?

An epidural is a type of anesthesia that relieves pain before and during labor by blocking pain signals from the nerves in the lower spine to the brain. The answer to the question of what is a princess birth is one of the most researched topics about childbirth by expectant mothers. During normal delivery with an epidural, the epidural causes a great or complete disappearance of pain (analgesia) in the uterus, vagina, and pelvis area. Painless birth is called princess birth. The level of anesthesia can be adjusted to provide more or less numbness. In this way, the experience of normal births is adjusted according to the patient's preferences. The purpose of the epidural is to provide pain relief before full numbness occurs, to relieve the mother and to ensure that the mother is an active participant during epidural delivery. The mother feels little or no pain during the contractions after epidural injection and can push the baby when the time comes.

Types of Epidural Analgesia

In general, there are three types of epidurals:

Epidural catheter

The anesthetic medication is given through a catheter placed in the epidural space near the spine. Your anesthesiologist will use numbing medication to reduce or eliminate any discomfort you may feel during the procedure. Anesthesiologists are highly experienced in administering epidural analgesia and the risk of significant complications are extremely rare.

Spinal injection

The numbing medicine is administered directly into the spinal fluid, so this method works much faster, but it also wears off more quickly. Anesthesiologists often combine spinal injection with an epidural catheter so that it has an immediate analgesic effect and medication inserted through the catheter into the epidural space can provide sustained pain relief.

Spinal and epidural anesthesia are similar and can be easily confused. Important differences between the two include:

  • A larger dose of medication is required with an epidural than with spinal analgesia (pain relief).
  • With epidural use, the onset of analgesia is slower than with spinal analgesia, resulting in a more gradual decrease in blood pressure.
  • Epidurals can be performed anywhere along the vertebral column (cervical, thoracic, lumbar, or sacral), while spinals are usually performed below the second lumbar vertebral body.
  • It is easier to obtain segmental analgesia or anesthesia by the epidural route than using the spinal route.
  • While a spinal injection is usually given as a single shot injection, medications for the epidural can be adjusted during labor and delivery and continued through the catheter after surgery.

Combined spinal epidural (CSE). This combination of spinal and epidural analgesia is often referred to as a "walking epidural" and is the most commonly used method to provide labor analgesia. Pain relief is achieved very quickly and the analgesia state can be prolonged when needed. Since patients have slightly more sensation in the lower half of the body, the person has more freedom to move and change positions.

Is It Painful During Epidural Procedure?

While some women do not feel any discomfort while taking an epidural, some women say they feel pain. Your anesthesiologist will numb the area with a local anesthetic, so you may feel a stinging sensation for about 5-10 seconds and then feel pain-free pressure when the epidural catheter is inserted.

How Quickly Does the Epidural Work and How Long Does the Effect Last?

The epidural usually takes 10-15 minutes to work, and because the drug is administered via the catheter, it can be given as needed throughout the delivery. This means that you can continue to take epidural pain relievers even if your labor takes longer than normal.

Pros and Cons of Epidural

Every medical intervention has its pros and cons, so if you're considering getting an epidural during a vaginal delivery, it's in your best interest to learn as much as you can about the topic.

Pros of Epidural

  • Pain relief effect. The epidural is a safe, effective, good choice of pain reliever during labor.
  • The ability of the mother to remain active during childbirth. During both a cesarean section with an epidural and a normal delivery with an epidural, the epidural keeps you awake and active.
  • Relaxation. Especially with the birth of your first baby, the process can take a long time and you may feel quite exhausted at the end of the process. The epidural gives you the opportunity to rest, refocus, and regain your energy before it's time to push the baby during normal delivery.
  • It does not have a negative effect on the baby. Unlike some intravenous drugs, such as narcotics, which can cause respiratory distress in newborns, an epidural does not affect the infant.

Cons of Epidural

  • Movement limitation. Although “walking epidurals” allow for greater movement and greater sensation during labor, this effect is limited. Most women will not be able to move excessively after receiving an epidural. When you get an epidural, you have a vascular access and you will be connected to a fetal monitor that further limits your range of motion. 
  • It takes a little longer to give birth. According to a recent study, women who get an epidural spend more time in the second stage of natural labor (the part where the baby is pushed) than those who don't.
  • Postpartum drowsiness. It can take several hours for the epidural to fully wear off, so if you want to get up and walk right after a normal delivery, the epidural may not be the right choice for you.
  • Urine catheter. Because the medicine used in the epidural will numb the lower part of your body, a urinary catheter may be needed if labor lasts longer than a few hours. After the epidural wears off, the catheter will be removed.

Risk and Possible Long-Term Side Effects of Epidural

Making any medical decision can be stressful for you, especially while pregnant. The overall risk of getting an epidural is extremely low. As long as standard care practice is followed, long-term side effects after an epidural are very unlikely.

Risks and side effects include maternal hypotension (a sudden drop in blood pressure), chills, nausea, pain or bruising at the injection site and, very rarely, permanent nerve damage at the site of the catheter insertion. One in 200 births mother may develop a severe, treatable headache called a post-dural headache.

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