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Last Updated: Jan 10, 2023
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Epidurals - Know The Benefits & Disadvantages!

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Dr. Poonam Patel VasaniPain Management Specialist • 18 Years Exp.MBBS, MD - Anaesthesiology, FIPM, Fellowship in palliative medicine, certificate in interventional pain management, Multidisciplinary pain management course
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Modern women want to have it all, in personal and professional life. They want to experience the joy of motherhood but not the pain associated with normal delivery. For such women, epidural analgesia during labour is a blessing. Epidural analgesia/anaesthesia is given to pregnant women during childbirth. Epidural painkillers stop the pain signals transmitted nerves from uterus. This stops the pain sensation of labour. For epidural analgesia, a catheter (small tube) is inserted into the epidural space in the spinal cord. It is through this tube that the drugs (painkillers) reach the desired nerves. 

Types of Epidurals: 

Epidurals can be 

  1. Injection with top-ups: Once given, epidurals help to relieve the pain that arises due to contractions. When the epidural starts to wear off, top-ups or refills are used. The refills can last for 1-2 hours. 
  2. Combined Spinal Epidural: Compared to the regular epidurals, the combined spinal epidurals are powerful, quick, and more effective. Here too, epidural painkillers are made to pass through the catheter, once the first injection wears off. It is also known as Walking Epidural. 
  3. Continuous infusion (patient-controlled epidural analgesia): Here, the other end of the epidural catheter is attached to a pump. This pump continuously infuses the painkillers into your back. For an effective response, top-ups may be used. Many hospitals allow patients to control the pump. 

Merits and demerits of having an epidural--

Merits: 

  1. Epidurals make the delivery smooth and hassle free. 
  2. Epidurals are relatively safe as only a small fraction of the medicine reaches the baby. 
  3. Women stay fully awake and experience no pain during the cervix dilation. This enables them to push the baby out with more energy.
  4. Depending on the requirement, the dosage of epidurals can be adjusted. 
  5. Epidurals help to lower the cases of C-section delivery. 

Demerits: 
Though epidurals make childbirth easy, one cannot overlook its demerits. 

  1. Infections can sometimes occur. 
  2. Sometimes epidural analgesia can have a patchy effect, causing some pain to persist. 
  3. Though rare, epidural can result in nerve damage. 
  4. Epidurals bring about a fall in blood pressure. At times, this can be risky for the baby. 
  5. Nausea, headache, itchiness, backache, soreness are the common side effects of epidurals. 
  6. Epidurals relax a woman, thereby reducing their urge to push the baby out. 

Thus, they may take longer than usual to push the baby. If you wish to discuss about any specific problem, you can consult a Pain Management Specialist.

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