I'm not going to lie, I bow at the altar of the epidural. After having one unmedicated labor and delivery and juxtaposing it against the delightful occasion that was my delivery with my daughter, I would make out with a cat for an epidural. Because for me, that medicine was some Hogwarts magic brought to New York City. But there are risks, as there are with any medical procedure. In the interest of fairness and objectivity, there are some epidural side effects after giving birth that you should be aware of so you're fully prepared.
It's important to note that in general, epidurals are a very safe form of pain relief. Well over half of women will get an epidural during their labor, according to the Centers for Disease Control and Prevention (CDC). And, according to an enormous study published in the British Journal of Anesthesia, the risks are lower than ever. Somewhere between 1 in 6,000 and 1 in 80,000 (yes, 80,000) women will experience either temporary or permanent problems related to anesthesia.
I spoke with Dr. Gary Schwartz interventional pain physician and Director of Acute Pain Management at Maimonides Medical Center in Brooklyn, New York. Schwartz is board-certified in both Pain Management and Anesthesiology, and he tells Romper, "The most common problems aren't dangerous, but instead disappointing." Meaning, they're not deadly, but you're not getting the pain relief you thought you would. Thankfully, many are repairable.
1. You're Only Getting Pain Relief On One Side
Schwartz says that occasionally, the placement of the catheter is askew or it moves during the course of your labor, and you end up getting relief on only one side. He says if you notice this happening, speak up — it's possible that it can be moved.
2. No Pain Relief At All
Yep, it could happen that your epidural isn't even giving you the relief you want, especially in the case of severely obese patients. Schwartz says that the catheter may be accidentally placed in the subcutaneous tissue, not the intended area, leading to a lack of pain relief. Again, tell your anesthesiologist or OB-GYN if you're not getting pain relief.
3. You Get A Headache
Occasionally, you might end up with something called a PDPH, or postdural puncture headache. This is a postural headache, meaning it intensifies upon sitting or standing, which occurs when an inadvertent dural puncture happens during epidural. This causes the cerebral spinal fluid to leak into the dura mater, which alters fluid levels and can create a headache days later. Schwartz says there is treatment for this type of headache including what is known as a "blood patch."
4. You Get A Metallic Taste In Your Mouth
Lightheadedness, dizziness, ringing in the ears, or a metallic taste in your mouth are all potential symptoms of anesthetic toxicity, according to the Western Australia Department of Health. But Schwartz says that doctors administer something called a "test dose" of epinephrine and lidocaine before administering the epidural medications to check for placement and assure it's not gone intravenous and caused toxicity.
Schwartz says that any remaining numbness, fever, or non-postural headache should be mentioned to your OB-GYN as they might be symptoms of an infection.
6. Your Active Labor Might Hurt More Than You Thought It Would
There are several phases of childbirth, and between the early moments of active labor and transition, different nerves are affected. Schwartz says you might notice a differing amount of pain relief between the early labor and post-transition because the upper nerves are more easily and predictably treated with epidural than the lower, sacral nerve group that is active during transition and beyond. Yes, it sucks. Talk to your anesthesiologist, but it's likely you will feel something in that period, if only so you can feel when and how you need to push.
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