Risks and Benefits of Epidural Anesthesia
There is no debate that to the extent that a woman in labor can avoid
interventions and medication, the better off she and her baby will be. All interventions
carry with them some amount of risk. However, sometimes a certain amount of
risk can be tolerated. If the benefits of the intervention outweigh the risks, then
an intervention should be employed. This
decision should be made with maximum knowledge of the risks and benefits.
Benefits of the epidural
As a form of pain relief for labor, epidural anesthesia is considered to be a
safe and efficacious alternative. There is no question that in comparison with general
anesthesia, epidurals appear to be very safe. Since epidurals are administered locally,
there is very little chance that the baby will be exposed to any
of the medication. Often the epidural allows the laboring woman to maintain muscle
power in her legs, and the sensation of pressure in her perineum. This maintenance
of sensation helps her to push her baby out in a natural way. Hopefully, forceps or an episiotomy will not be
needed. However, if an episiotomy is necessary, no additional pain medication is needed.
Safer than a "spinal"
If an epidural is done properly, there should be no severe headache
afterwards. Headaches are much more common after "spinal block" anesthesia. Spinal blocks
are similar to epidurals. The pain-killer is given in smaller doses and to a
different part of the spinal column. When spinals are given, it sometimes happens that a
small amount of the cerebrospinal fluid leaks out, which can lead to severe
headaches. These headaches can sometimes be as bad or even worse than the labor itself.
Epidurals can sometimes help labor progress
Sometimes a woman in labor can become so tired and tense from the pain she is experiencing that she doesn't allow her body to relax enough to deliver the baby. When the pain of labor has been alleviated, very often the woman can
settle down and allow her body to do what it needs to do.
Risks of the epidural
It is very common for blood pressure to drop after the epidural has
been given. If this happens, fluids and sometimes other medications will need to
be administerd to stabilize the blood pressure. The woman's blood pressure should be
carefully monitored throughout labor. Loss of sensation can cause impairmant of the
feeling to urinate. This can lead to urine retention and catheterization to relieve
bladder pressure. Some studies indicate that labor also can be prolonged due to epidurals.
In general, epidurals are considered to be safe for mothers and babies. If epidurals are administered
properly, and the vital signs of the mother and baby are carefully monitored, a positive outcome for mother and baby can be expected.
For more information about epidurals, read the articles entitled "Understanding Epidurals" and "Epidural Anasthesia".
