Are there more childbirth complications when getting an epidural? It's an important question for expectant mothers who want to make an informed choice about their birth. And because more than 60 percent of mothers use an epidural in their delivery, knowing the risks of having an epidural is more important than ever.
During an epidural, a small amount of medicine is administered in a woman's back, typically after she is 5 centimeters dilated, or in "active labor." The medicine relieves pain by blocking the nerve impulses from the lower half of the body. The small amount of medication absorbed by the baby is "not known to cause harm," Cynthia Wong, M.D., an associate professor of anesthesiology at Northwestern University Feinberg School of Medicine in Chicago, told Fit Pregnancy.
The most common side effect of having an epidural is hypotension, a drop in maternal blood pressure that could affect the baby. "With treatment, hypotension has no consequences to mother or baby," Dr. William Camann, director of obstetric anesthesia at Brigham and Women's Hospital in Boston, said in a Fit Pregnancy interview.
A very real, though not necessarily dangerous, side effect of having an epidural is that it makes labor last longer. A study compared the delivery times of 42,268 women who gave birth to healthy babies vaginally between 1976 and 2008. Half of the women studied had epidurals, and the second stage of labor lasted 5.6 hours for first-time moms who had epidurals, in comparison to 3.3 hours for those who didn't.
Some question the link between C-sections and epidurals. Because epidurals prolong birth, that may result in physicians giving the mother a C-section to shorten her delivery time. Babies born from C-sections are twice as likely to have breathing problems, and mothers have an increased risk of hemorrhage and infection. However, a 2011 analysis of several studies of more than 15,000 women concluded that epidurals do not increase the risk of C-sections, even when given in early labor.
An analysis of several studies of the advantages and disadvantages of having an epidural showed that women who received epidurals had an increased risk of very low blood pressure, fluid retention, and fever. However, the analysis found no difference in whether epidurals left effects on the baby soon after birth.
One 2005 study showed that the babies were in an abnormal position at the time of delivery four times more often in women who used epidurals than in those who didn’t. However, the study could not confirm whether epidurals can actually cause a baby to be abnormally positioned.
Some women report having trouble breathing after an epidural, and 1 in 100 women have a severe headache after receiving the medication.
Generally, epidurals are a very safe procedure, with a complication rate of less than 3 percent. For many expectant mothers, the advantages of a less painful birth outweigh the risks. What's most important is to know your options so you can be prepared in the delivery room — no matter what choice you make.