Having an epidural can make your experience in labor much less painful.
If you opt for epidural analgesia you will have a local anesthetic injected into your lower back, near the spinal cord and nerves. The injection will prevent the nerves from carrying pain messages to your brain, so you should be able to bypass the worst of labor pains by opting for an epidural.
Epidural analgesia is among the most effective pain relief methods available for use during labor. If you opt for an epidural you will be put on a drip first, and will then have a local anesthetic injected near your spine to numb the area in preparation for the epidural. The epidural pain medication is administered through a catheter inserted into your spinal area with a needle. It can be a bit uncomfortable having the catheter inserted but it isn't as uncomfortable as labor pains with no anesthesia can be! The pain relief should come into effect within half an hour.
As it is a local anesthetic, you will be awake for the insertion, but should hardly feel it. The effects of epidural analgesia can last several hours and you may feel tingly as sensation returns to the area post-delivery. This form of pain relief poses no harm to your unborn baby, and the average hospital is more than capable of preventing serious negative health consequences for mother and baby during epidural insertion and removal.
While an epidural is amazing at managing pain during labor, there can also be complications, the most common of which is back pain which can linger for some time after giving birth to your baby. Read on to find out more about the potential side effects of epidural analgesia in childbirth.
Why do some women report severe back pain after an epidural? Lower back pain after childbirth epidural analgesia is a common complaint, but there is no conclusive data to suggest that epidurals cause chronic back pain post-delivery. Though long-term back pain after epidural analgesia is common, some think that this is actually caused by postural issues and injuries resulting from overexertion post-delivery. Back pain may also result from pressure placed on the pelvis during pregnancy. However, ask many mothers suffering from lower back pain after epidural analgesia and they will tell you that they feel the back pain is definitely linked to having the epidural.
So how can an epidural cause back pain and how long does back pain last after epidural analgesia? It is rare for an epidural itself to cause back pain. Studies have found that the same proportion of women experience chronic back pain after epidural analgesia as those who had no pain relief during labor. Back pain after delivery is most often caused by your pelvis shrinking back to size and misaligning, placing uncomfortable pressure on your sacroiliac joints. Pregnancy can place a huge strain on the bones and ligaments of your back and the resulting pain can last weeks or months after having your baby.
So, how to relieve back pain after epidural analgesia? The best way to relieve lower and upper back pain after epidural analgesia or just after pregnancy and birth, in general, is to book in for a session or two with a chiropractor who can realign anything that has been pushed out of place and relieve the pressure on your joints.
It is also important not to overexert yourself after delivery. Your body will need time to rest. Take it slow and don't do too much heavy lifting or carrying kids around for too long in the first few months after giving birth. If you have tried holistic methods of relieving your back pain and nothing has worked, consult your doctor or physiotherapist.
While studies have provided little evidence that the epidural procedure itself causes chronic back pain, there is a very low risk of other side effects, which may manifest as back pain.
Inadequate Pain Relief
An epidural might not block out all the pain of labor and delivery. In fact, around 12% of epidurals are ineffective at reducing pain during childbirth. Causes include poor placement of the catheter in the epidural space, existing inflammation in the area preventing optimum diffusion of the anesthetic, and labor progressing faster than expected.
If the catheter is misplaced it can miss the nerves altogether, meaning that there is no anesthesia taking place at all. This could be due to the epidural catheter being too short for the epidural space, the practitioner confusing the epidural space for intercostal space or another cavity, and the epidural catheter migrating during labor. Don’t worry though, an epidural catheter won’t get lost inside you! If you feel the epidural hasn’t worked, demand that someone check it and sort it out.
Epidural anesthesia is relatively short-lived, providing pain relief for around two hours. If your labor lasts longer than that you will have more epidural medication administered during the course of your labor.
Studies show that women with a history of chronic back pain are more likely to suffer complications with their epidural. In women with sciatica, for example, epidural medication takes longer to reach the nerves affected by sciatica due to inflammation. Scoliosis can also make finding the epidural space more difficult. However, most women presenting with chronic back pain prior to delivery do have positive results from their epidural.
Loss Of Bladder Control
One of the best parts of having an epidural is that you get a catheter meaning you don’t have to get up to pee 10 times an hour as you did in the last weeks of pregnancy! One of the side effects of your epidural is that you will not be able to tell when you have a full bladder until after the effects of the medication have worn off. This is why you will have a urinary catheter inserted when you have the epidural administered. It shouldn’t be removed until the anesthesia has worn off.
Rarely, complications can arise from clumsy insertion of a urinary catheter. This could result in damage to the urethra, or a urinary tract infection. The risk of infection is higher the longer the catheter is left in place, however, and if it is only in place during labor, you shouldn’t be left with a UTI. If you do develop an infection you will be treated with antibiotics and the symptoms should lessen rapidly.
Long term, urinary incontinence shouldn’t be a problem directly related to having had an epidural. Urinary incontinence is common in the days following delivery, however. You might lose some sensation for a short time afterward which makes identifying when you need to urinate more difficult. This should be short-lived, however, and should resolve itself fairly quickly after birth.
One weird complication of epidural medicine is that it can give you itchy skin for a while! When you suppress pain reception, you often see an increase in itchiness. The use of opiates in epidurals can also lead to itchy skin, though this can be remedied with medicine or a change in the epidural medicine itself.
Low Blood Pressure And Nausea
One of the most common epidural side effects is a lowering of blood pressure in the patient. This is not dangerous, and your blood pressure levels will be monitored carefully by your doctor throughout your labor. If your blood pressure drops too much your doctor will give you fluids and medication to stabilize it.
One of the symptoms of low blood pressure is nausea, so you might feel a bit sick if your blood pressure starts to drop. This should be easily remedied if you tell your doctor as soon as you start feeling nausea set in. They can then give you medication to raise your blood pressure and quell the nauseous feeling.
Temporary Nerve Damage
This sounds scary but is rare, and, above all, temporary. When inserting the epidural, nerves can be damaged. Temporary nerve damage usually results from the needle or tube damaging a single nerve and this can result in a numb patch around where the epidural was administered to the patient. You might get a pins and needles sensation in the area around your lower spine, near where the injection was given. This can be uncomfortable and disconcerting but is only temporary. Your spine won’t be damaged from the epidural and these symptoms should only last a few hours.
Permanent Nerve Damage
This is exceedingly rare, and the minuscule risk of this happening to you shouldn’t put you off opting for an epidural if it is the best option for you. Remember that anesthetists are highly trained and accidents resulting in permanent health issues are as rare as one in 50,500.
Very rarely, a patient can suffer from permanent damage to nerves due to poor administration of the epidural. If an anesthetist somehow punctures the spine itself with the epidural needle, this could lead to permanent health issues and paraplegia.
An uncontrolled infection in the area could also lead to permanent damage to the spinal cord and nerves, but hospital doctors and anesthetists are highly trained to minimize the risk of infection and should immediately put you on antibiotics if they suspect any kind of infection resulting from the epidural.
The risk of spinal injury is low because epidurals are administered below the bottom of the spinal cord. Nerve injury is rare too because epidurals are usually given when the patient is awake. If you feel any pain due to a nerve having been touched by the needle or epidural tube, you will be able to let the doctor know and they will be able to adjust the needle before permanent damage is done.
As with any medical procedure, there is always the risk of unforeseen complications arising which can result in negative health outcomes. However, there is no evidence to suggest that epidurals can harm your baby during labor, and there are usually enough resources at the hospital to solve any health issue that could present itself during or after your epidural.
The risk of death from a spinal epidural is about six in a million. In the incredibly rare event of a death related to childbirth epidural administration, there are likely to be other factors involved such as compromised overall maternal health, and substandard patient monitoring. The very small minority of mothers experiencing long-term side effects of an epidural may be entitled to some form of compensation.
If you are ever worried about the effects of your epidural either during or after the procedure, seek medical help.
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