February 5, 2018

To Epidural or Not To Epidural – Anesthesia and Your Pregnancy

By Mary Leonidas, CRNA

The test is positive – you are pregnant!

Now, a flood of feelings overwhelm you. Excitement! Joy! Boy or girl? How to tell family? Name? Pink or green nursery?

Then, perhaps, after the thrill of the happy news, comes the fear of the unknown. Will my baby be safe? Should I get an epidural? What if I need a cesarean section?

Maybe you’ve never been hospitalized. This may be your first or your fourth pregnancy… You have a friend, or a sister who was pregnant… You heard on TV, or read on Facebook… There are lots of stories out there, but every pregnancy is its own unique experience, including your anesthesia care. Here is what you can count on.

Know that it is your choice.

A birth plan can include several pain-control options, including a labor epidural. At Mission Hospital, a specialized anesthesia care team is available 24/7. This team includes a certified registered nurse anesthetist and an anesthesiologist. When you arrive to the labor and delivery suite on your expectant day, you can speak with your care team when you desire. Benefits and risks of a labor epidural will be explained, and all your questions answered. A labor epidural is always your choice.

What is a labor epidural?

A labor epidural is a catheter that is placed in your lumbar spine (lower back), through which a local anesthetic infuses to numb your sensation to labor contractions and vaginal birth. A labor epidural is intended to help you cope with your labor contractions and better enjoy your birth experience.

How much pain relief can you expect from my labor epidural?

Although we would like to promise you that your birth experience will be completely pain free, there are limitations. Factors such as spine or pelvis malformations or the size and presentation of your baby can affect just how much labor pain you will experience. Labor epidurals can also lower your blood pressure, therefore, we are careful to provide as much pain relief as possible without causing any complications. Ideally, you will feel your contractions but tolerate them well. We use a numeric pain scale of 0-10 to assess your pain level as your labor progresses.

What if you need a cesarean section?

In the event you need to have your baby delivered by cesarean section, your epidural can be dosed in such a way that you can undergo surgery and still be awake for the birth of your baby. If you do not have an epidural, a similar single injection, spinal, can provide the same anesthesia. Lastly, if there is a reason you cannot have an epidural or spinal, general anesthesia (going to sleep for surgery) is always available.

Mary Leonidas is a Certified Registered Nurse Anesthetist at Mission Hospital.

For more information about the maternity services at Mission Health, visit mission-health.org/womens.