The Epidural Cocktail

Roughly 60% of women receive an epidural at birth, despite the popularity there are many misconceptions about receiving an epidural. One common misbelief is that every epidural is the same, or better yet, that there is only one type of epidural. Epidurals vary depending on the patient, anesthesiologist, and hospital protocol. Some hospitals even offer a somewhat ‘watered down’ combined spinal epidural (CSE), often referred to as a “walking epidural.”

Another difference is the insertion method and contents. A common epidural consists of a high dosage of anesthesia and is inserted through a needle and catheter into the epidural space. The epidural space is the outermost area surrounding the spinal cord. A spinal block is placed closer to the spinal cord, in an area called the “subarachnoid space,” however no catheter typically remains. Both a spinal and epidural are utilized in a CSE. A CSE and contains a low dosage of anesthesia as well as opioid or “pain killing” medication. With a CSE some moms claim to have more mobility and faster onset of the intervention. Nonetheless, some studies found no differences in mobility and increased pruritis, also known as itching with the use of low dosage anesthetics.

Some benefits of an epidural include potential rest if labor is prolonged, reduction of discomfort, and the ability to stay awake if having a cesarean section. Some downfalls to receiving an epidural may include a drop in the heart rate for both mother and baby, a higher possibility for the use of additional interventions, and rare, more serious occurrences such as irreversible nerve damage. Side effects to the medication such as shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, and difficulty urinating can also be seen. As you prepare for “labor day” it is important to ask, research, and understand the pain management options given at the facility you choose to deliver at. Other options might include non-pharmaceutical comfort measures or medications that can be administered through an IV. Being informed can help in establishing and implementing guidelines for a birth plan most suitable for you.

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