If you've ever experienced the pain of childbirth, you know that epidurals can be absolute miracle workers. When administered properly, this popular form of anesthesia can turn birth from an utter nightmare into a manageable (even enjoyable) experience. But the unfortunate truth is, epidurals aren't always administered properly — and when they're not, moms and babies can experience serious complications. So what are some things that should not happen when you get an epidural?
If you've been keeping up on trending news, you might have heard the recent (horrifying) story of a mom who discovered that a portion of the needle used to give her an epidural was stuck in her spine for 14 years — 14 years! — after giving birth. Unsurprisingly, this poor woman suffered through over a decade of severe pain, and now she has permanent nerve damage (meaning her pain will likely never go away). Of course, this type of injury doesn't happen often, as Dr. James Lozada, Obstetric Anesthesiologist at Northwestern University Feinberg School of Medicine, tells Romper.
“In general, it is extremely rare for a spinal or epidural needle to break, and even more rare for fragments to remain in the body," he says. "That has been reported less than 5 times in medical literature.”
“Labor epidurals have greatly improved the safety of obstetric care and provide excellent pain relief for millions of women each year. The chances of a broken needle being left in your back are exceedingly low and should not deter you from having an epidural if that’s your desire.”
Indeed, statistics show that epidurals are usually safe. A study analyzing data from the Anesthesia Quality Institute's National Anesthesia Clinical Outcomes Registry found that out of 80,000 women who received epidural or spinal anesthesia during childbirth, the rate of complications was just under 3 percent, reported WebMD.
So the majority of the time, it would seem, epidurals do what exactly they're supposed to do: Relieve pain without causing any significant adverse side effects. Still, there's always a risk that something could go wrong. Hopefully that won't be the case for you, but in the interest of preparing for anything and everything, these are some of the possible problems you might encounter.
1. Inadvertent Dural Puncture ("Wet Tap")
Sadly, this very uncommon snafu is one that I have personal experience with (but more on that in a minute). An inadvertent dural puncture, also known as a "wet tap," is what happens when the epidural needle accidentally punctures the membrane covering the spinal cord, allowing spinal fluid to leak out. While this only occurs in about 1 percent of deliveries with epidurals, according to the American Society of Anesthesiologists, when it does, it can cause unbelievably intense headaches that often need to be treated with a procedure called a "blood patch" (in which your own blood is injected into the hole so that when the blood clots, the hole closes up and the fluid stops leaking).
This happened to me with my third baby, apparently due to a slight curve in my spine. The anesthesiologist told me what happened right away, and warned me that I would probably start having the craziest headache of my life within hours of giving birth. They would try to treat it with painkillers, caffeine, and fluids, he explained, but if none of that worked, he would perform a blood patch.
He wasn't kidding about the headaches. As someone who had migraines for years, I thought I knew what a "bad headache" was like — but nothing could have prepared me for feeling like an elephant was stepping on my skull every time I tried to sit up (lying flat prevents the spinal fluid from leaking out more). Thankfully, the blood patch worked quickly enough. But my experience just goes to show: You never know when that "1 percent" is going to include you!
This is another potential complication that isn't at all common, says Dr. Lozada. That's because the needle used to administer an epidural is sterile, and a large area of your skin is cleaned with antiseptic before insertion. Still, whenever any type of opening is made in the skin, there's a risk that bacteria will find its way inside and cause an infection (and the last place you want an infection is your spine, which is pretty much a direct pathway to your brain). This can lead to an epidural abscess or other type of issue; in 2006, Dateline reported on one woman who allegedly developed meningitis after contracting an infection from an epidural given during childbirth. The new mom died within hours.
Terrifying, yes — but again, infections are exceedingly rare. One study found that spinal epidural abscess formation after catheter insertion for pain relief during labor and delivery happened in just one out of 506,000 cases (according to the British Journal of Anesthesia).
3. A Drop In Blood Pressure
This is a side effect that's more likely to occur than the first two on this list, and one that Dr. Lozada says he "always" discusses with his patients — that's why your blood pressure is checked so frequently during labor. Epidurals can cause your blood pressure to drop suddenly, which can in turn compromise blood flow to your baby. If this happens to you, you'll likely be treated with IV fluids, oxygen, and possibly medications, according to the American Pregnancy Association.
Labor can take quite a while, as you probably know, and if an epidural is in place for six hours or more, mothers can develop fevers.
"With first births, about 20 percent of mothers have an elevated temperature, because the first birth is usually the longest," William Camann, M.D., director of obstetric anesthesia at Brigham and Women's Hospital in Boston, told Fit Pregnancy.
If you develop a fever during labor, you'll likely be subjected to testing and you and your baby might both receive antibiotic treatment.
5. Nerve Damage
Okay, so "nerve damage" sounds really, really scary. And it is really scary, especially if it's permanent, but in the case of nerve damage caused by an epidural, it generally doesn't last.
"There's a very small chance of nerve injury," says Dr. Lozada, adding, "This is almost always temporary, lasting a couple weeks."
Naturally, one could argue that even a couple weeks of nerve damage is a couple weeks too many, but usually a small area is affected and it will pass (in very, very rare cases, of course, it doesn't pass, but this happens so infrequently it's difficult to even find any statistics on the subject).
There are other side effects that moms might experience from epidurals during labor too, says Dr. Lozada, such as itchiness and nausea, but these aren't necessarily a sign that anything is "wrong," just passing sources of discomfort. (And it's worth noting that a little itchiness is a lot less unpleasant than full-on contractions!)
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