The question of whether or not to get an epidural during childbirth is one many moms-to-be agonize over. Some women have their hearts set on a natural childbirth, preferring to explore such medication-free labor pain management options as hypnobirthing or The Bradley Method; others are worried that getting an epidural will slow their progress down or somehow harm their baby (even if they're not so keen on the pain thing). Plus, the idea of a giant needle to the spine sounds pretty painful all on its own! But your epidural needle won't actually hurt, as unbelievable as that might sound. How is this even possible?
First, a little background on how epidurals magically turn labor from a nightmarish hell ride to a relatively tolerable (if not 100 percent enjoyable) experience. As the American Pregnancy Association definds it, "epidural anesthesia is a regional anesthesia that blocks pain in a particular region of the body." Medications including a combination of local anesthetics (such as lidocaine) and opioids or narcotics (like fentanyl) are administered, sometimes along with another drug like epinephrine to stabilize the mother's blood pressure or prolong the procedure's effect, via a catheter in the lower back. The meds are pumped through the catheter for the duration of your labor, hopefully providing sustained relief. It's an extremely popular choice, the APA reports, with over 50 percent of women who give birth in hospitals choosing epidurals.
Now, back to that "catheter in the lower back" thing. That's where the giant needle comes in, right? Yes, but first there's another needle — a smaller one used to numb the area where the big needle is going. That injection might not be comfortable, exactly, but it's definitely small (tiny!) potatoes compared to the labor pain that would follow without it.
"The worst part is an injection of lidocaine in the back, which numbs the area, which will burn for 10 to 15 seconds, then go away," Dr. James Lozada, an anesthesiologist at the Northwestern University Feinberg School of Medicine, told SheKnows.
"After that, you’ll probably just feel pressure when the epidural catheter is inserted," he added.
The whole process should only take about 20 to 30 minutes, and can apparently be given at any point during labor, though many hospitals traditionally waited to administer an epidural until a woman was at least four centimeters dilated for fear of stalling labor. Depending on when it's administered, Lozada said, an epidural can actually shorten labor (though it can also add an average of 20 minutes, too).
Generally, the process goes like this, according to the APA: You're told to either lie down on your left side or sit up with your back arched, and you're instructed to remain very, very still. (As a mother of three, I can tell you from experience that the "very, very still" thing is one of the hardest parts, particularly when a contraction kicks in mid-procedure!) Your lower back is swabbed with antiseptic, and a small area is numbed with local anesthetic. A needle is inserted into the anesthetized area, then a small catheter is threaded through the needle into the epidural space, after which the needle is removed and the catheter is left in its place. Then the catheter is taped to your back, where it remains until you don't need the meds anymore.
As with most things having to do with the human body, it seems that every woman's experience with an epidural is slightly different. But as Richard Siegenfeld, M.D. wrote in The Epidural Book: A Woman's Guide to Anesthesia for Childbirth (excerpted in Fit Pregnancy), "Although some women fear getting epidurals more than they fear childbirth, after getting one, most say that the procedure is less uncomfortable than an IV or even one contraction."
Getting an epidural wasn't particularly uncomfortable for me, though it was somewhat stressful because I was so freaked out about accidentally moving while the anesthesiologist was trying to stick a giant needle into a very delicate part of my body. (I had a natural childbirth with my first, but opted for an epidural the next two times, if that tells you anything about natural childbirth.) But honestly, I don't remember feeling the epidural needles at all — and I definitely remember how much the contractions hurt before the epidurals kicked in, so I would probably recall if the injections had been painful.
Basically, if you're worried about the pain involved in getting an epidural, don't be. Even if you did feel the needle, the discomfort would still pale in comparison with full-blown labor.
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