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July 23, 2019 | Family Medicine
Myths surrounding pain management during labor and childbirth—particularly epidural injections—can cause confusion and unnecessary concern for expecting mothers. Clearing up some of these misconceptions can help women make informed choices about this popular and reliable method of pain relief.
Before we get to work on dispelling some of these myths, however, let’s take a look at the way doctors most commonly use epidurals in childbirth today.
Since the early 1940s, doctors have used some form of epidural to help relieve the pain of labor and delivery. Since that time, however, medical science has improved the safety and effectiveness of epidurals.
The anesthesia method most people refer to as an epidural is technically known today as a combined spinal-epidural (CSE), also known as a “walking epidural,” according to the American Pregnancy Association. This procedure produces an analgesic effect, rather than full anesthesia. In other words, the treatment reduces labor and delivery pain without causing a complete lack of sensation.
During this procedure, a doctor injects an initial dose of medication below the outermost membrane of the spine and then inserts a tiny tube (catheter) into another part of the outer spine, through which medication can be delivered as needed throughout the childbirth process.
You will have relative freedom of movement (with assistance), and you can request more medication whenever you feel it’s necessary. You will be able to rest, and you may have a more positive birth experience due to the increased comfort level you experience, the American Pregnancy Association reports.
Fact: Every medical treatment poses some risk for complications under certain circumstances. For the mother, epidural injections can produce side effects, including infection and nerve damage, but the incidence of complications is low, according to the American Society of Anesthesiologists (ASA). You may experience some discomfort at the site of the catheter insertion, but this discomfort often goes away within days, if not hours.
Further, no scientific research supports any increased risk for the baby, according to the ASA.
Women participating in the study also expressed concern that an epidural could cause cerebral palsy and other birth-related conditions. However, no evidence supports these claims. In fact, the ASA states that the baby receives too little medication from an epidural to pose any harm.
Fact: No scientific evidence supports the myth that having epidural anesthesia increases the risk of having to deliver your baby by cesarean section.
Fact: Medical science has perfected this method of anesthesia so that it relieves pain without impairing your ability to walk, push or participate in the birth experience. In fact, having an epidural increases your chances of being awake and aware of your contractions, enabling you to push and participate fully.
In the study cited by the American Society of Anesthesiologists, almost half the participants mentioned the internet as their primary source of information about pain management for labor and delivery. Unfortunately, many online sources often lack scientific support.
The best way to understand the potential benefits and risks of any pain management method is to talk to your doctor. Your healthcare provider can explain your options and advise you based on your personal medical history and risk factors. Once you have all the facts and your doctor’s recommendations, you can make the best possible decision about epidural injections and pain management for childbirth.
“Epidural Injections.” RadiologyInfo.org, by the American College of Radiology and the Radiological Society of North America.
“Laboring under misconceptions: Epidural myths may keep women from reliable pain management.” American Society of Anesthesiologists.
“Epidural Anesthesia.” American Pregnancy Association.
“The Present Status Of Continuous Caudal Analgesia In Obstetrics.” Waldo B. Edwards & Robert A. Hingson.
“Patients’ preferences for labor analgesic counseling: A qualitative analysis.” Paloma Toledo MD, MPH et al.
Jedidiah Oldham, DO
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This information is not intended to replace the advice of a medical professional. You should always consult your doctor before making decisions about your health.