Epidural Side Effects
How to Avoid Complications from Regional Anesthesia During Birth
The majority of mothers today use an epidural for labor. While epidurals are known to provide excellent pain relief, they come with a variety of potential side effects that mothers may not be aware of. Giving birth with an epidural is not just about avoiding the pain, but also it is imperative that mothers are informed about possible side effects to prevent complications.
Epidurals Can Cause a Drop in the Mother's Blood Pressure
One of the most common epidural side effects is a drop in the mother's blood pressure. This is also known as hypotension and can occur any time regional anesthesia is given since the blood vessels become dilated. One of the main reasons the labor nurse gives a mother IV fluid is to prevent her blood pressure from dropping after an epidural.
If the hypotension is prolonged or drops too low, the anesthesiologist may administer an amphetamine that constricts the blood vessels, called a vasoconstrictor in order to bring the mother's blood pressure back to a normal range.
Epidurals Require the Use of a Urinary Catheter
Since regional anesthesia blocks sensation, the mother will not be able to tell if her bladder is full. A urinary catheter is placed to keep her bladder empty. In some cases, the labor nurse may leave the catheter in, or in some situations, she may place the urinary catheter in just long enough to empty the mother's bladder and then take it out.
Research shows that walking epidurals may allow the mother to void on her own without using a urinary catheter. However, be sure to ask if walking epidurals are offered since they are not routinely available at every hospital.
Epidurals Will Limit the Mother's Mobility
It will be nearly impossible to have enough motor ability to bear your own weight after receiving an epidural in order to walk around. She will need to remain in bed with a pillow propped against one hip and then shift to the other side. The only type of epidural that allows for some mobility is a walking epidural.
Epidural Side Effects Include Possibly Slowing Labor Progress
Some research shows that epidurals can lengthen labor, especially the pushing stage. A mother's labor is much more likely to slow down if she gets an epidural before contractions are well-established. It is also possible that the lack of mobility due to being in bed can make it harder for the baby to rotate and descend, thereby slowing labor progress. Mothers may want to try to wait until active labor prior to getting an epidural to reduce the chance that labor will slow down.
Epidurals May Increase the Use of Vacuum or Forceps Since Pushing is Affected
Just like trying to chew something when your mouth is numb from dental work, another epidural side effect is having more difficult pushing. When your lower half is "numb", it can make it harder for you to feel an urge to push. It is also more likely that a vacuum or forceps will have to be used when an epidural is used. However, not pushing right away as soon as you are fully dilated, but instead waiting for your body to "labor down," otherwise known as passive descent, can reduce the likelihood of instruments being used.
Talk to your care provider in your birth plan about your desire to not push right away and have as much time to push as possible before resorting to using an instrument such as vacuum or forceps. Be sure you know all of the pros and cons as well as all of the epidural side effects so that you know how to avoid the complications.
References:
Wilson, MJ., "Urinary Catheterization in Labour with High-dose versus Mobile Epidural Analgesia," Br J Anaesth., Jan 2009 Vol. 102
Brancato, RM., "A meta-analysis of passive descent versus immediate pushing in nulliparous women with epidural anesthesia in the second stage of labor," Journal of Obstetrics and Gynecology and Neonatology Nursing, Jan-Feb 2008.
Epidural Side Effects Causes Blood Pressure Drop
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