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The perception of pain during labour and delivery varies between individuals. Specially, the first-time mothers need a proper antenatal counselling regarding good nutritious diet, antenatal exercises and physiology of labour pains. Here we shall only be dealing with labour & delivery.

Epidural anaesthesia is an advancement in pain management during labour, which ensures that a pregnant woman has a comfortable labour. It is a regional anaesthesia in which an anaesthetic drug is injected near the spinal cord in the spinal canal. Epidural analgesia is the introduction of small doses of medicines into the lower back spine through a fine plastic tube. The procedure is carried out in the room itself.

The back is cleaned with an antiseptic and the area where the catheter is to be introduced is numbed with a local anaesthetic. The needle is then passed into the epidural space and one does not have to enter the spinal canal as feared by some. The tubing is then strapped to the back with tape and kept in place. Other than the prick of the local Anaesthesia there is generally no other discomfort. Once the tube is in place medicines are introduced into the catheter, which are enough to block your pain, but you will be able to push the baby. Drugs are introduced at regular intervals depending on the requirement and intensity of the pain. It numbs the body below the waist, but the movements are not impaired. It is administered when the patient is in active labour. It can be given as a single injection or in multiple doses through a special epidural catheter by a skilled anaesthetist.

Advantages

  • Pain relief. Most of the mothers dread the pains and spend sleepless nights visualizing themselves at that time and even resort to suggestions like opening ones hair to decrease pains and other vague things.
  • No stress or anxiety on the part of the mother.
  • As no pain is felt she can concentrate on pushing the baby
  • Allows time for rest, exhaustion does not set in.
  • Good for hypertensive patients as they feel relaxed and thus there is no further increase of blood pressure.
  • Does not prolong labour, in fact labour is hastened in some cases.
  • Post labour recovery is faster; hence she can feed her baby early. Mother ? infant bonding comes earlier.
  • Can participate in the joyous moment of the new arrival.
  • Psychologically she is in an upbeat mood.
  • Almost complete relief from pain with the patient being mobile.
  • No postpartum headache as in spinal anaesthesia.
  • Mother is conscious and alert throughout the labour.
  • An instrumental delivery can be performed under the same anaesthesia, if need arises.

If the patient has to be taken for caesarean section, the effect can be topped up through the epidural catheter.

Side effects.

  • Less than 1% of patients complain of headache / Itching at the site.
  • Bleeding disorders.
  • Infection at the injection site.

Disadvantages

  • Sudden drop in the blood pressure.
  • Because of pelvic floor relaxation, baby’s head may not rotate and forceps application may be required.
  • Slight increased rate of instrumental and caesarean deliveries.