Top Questions to Ask Your Anesthesiologist
What You Should Know about Epidurals, Spinals and Drugs for Labor
Apr 6, 2009
If you are in active labor when you request an epidural, you may not have the time to review all of the pros and cons of every drug with the anesthesiologist and how those medications might affect you. Not to mention, sometimes being in the throes of labor pain leads you to not care about some of those issues until after you are no longer in pain!
If you have the opportunity to talk with the anesthesiologist either prior to labor or in the early stage when you first arrive at the hospital, there are several questions that you should ask prior to giving informed consent for an epidural, spinal or other regional anesthesia.
- Question - What are the risks of this medication to my labor? Medications, especially given too early in labor, can slow contractions and labor progress. Studies also show that pushing is longer in women who have epidurals.
- Question - Will getting analgesia make it more likely that I will have a cesarean? There are mixed results about whether epidurals increase a mother's chance of cesarean, but the most recent research indicates that it does not change the mother's chance of cesarean.
- Question - Are there any similarities between this analgesia and others that I may have had a negative reaction to in the past? It is important to share with your anesthesiologist any prior reactions you have had to any medication. This can be included in your birth plan.
- Question - What are the risks of this medication to me? Research does indicate that one of the side effects of epidurals is that they can cause the mother's blood pressure to drop significantly.
- Question - What are my risks of having complications after birth such as a spinal headache?Some evidence suggests that the risk of spinal headache is about 1 in 100.
- Question - What if this analgesia does not work for me? Research shows that approximately 50% of mothers who receive an epidural needed a top-up dose of medication later in labor. Mothers report that sometimes the epidural only takes effect on one side. In this case, your anesthesiologist would need to administer the epidural again.
- Question - Are there risks to my baby from this medication? Faster-acting regional analgesia such as a combined spinal-epidural, is more likely to affect your baby's heart rate. A Cochrane Review of 21 studies reports that the mother is more likely to need an instrument such as vacuum or forceps during labor after an epidural. Epidural usage may negatively affect breastfeeding as research indicates that mothers who received an epidural were significantly more likely to give their baby a supplement in the first 24 hours of life.
The answers provided here are meant to be a guide for you in your own question-asking. Be sure to verify this information with your own research as well as consultation with the anesthesiologist responsible for your care.
Experts in the UK are now recommending that standardized information be provided to women in order to have informed consent prior to receiving medication during labor (via an informational card). However until anesthesiologists are required to provide this information to every woman in labor, it is important that each mother take the time to ask these and other key questions before consenting to any regional analgesia, including epidurals, spinals, intrathecal narcotics (ITN) or combined-spinal epidurals.
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