Epidurals are a form of anesthetic pain relief, often given to women during labor. An epidural is considered a regional anesthesia because it removes a portion of the body's ability to feel pain versus an analgesic which just dulls the feeling of pain (taking a tylenol would be an analgesic).
An epidural is often called a regional or local block because only a portion of the body is numbed and unable to feel pain. This effect is caused by the doctor injecting pain medication directly beside nerves that carry sensations (pain and other sensations) to the brain. Sometimes an epidural does not fully take away the pain below the waist, but just decreases the pain, or only takes away sensation in a portion of the body.
Depending on the amount of pain medication injected, a woman may loose control of the muscles below her waist, in addition to loosing the sensation of pain. These higher doses are more likely to affect the baby, so lower dose epidurals are becoming more common. These are often called "walking epidurals" because the mother can retain more control of the muscles in her legs, although she will likely not be walking around - even to use the restroom.
The medication used for the epidural is injected into a small space near the spinal cord, in the lower part of the back, called the epidural space. The injection of medication into the epidural space is how this form of pain relief got its common name.
To recieve an epidural, a woman must lie on her side, curled into a ball shape to allow the spaces of the spinal vertebrae (back bones) to open up. Many women report feeling very uncomfortable during this procedure, since they often experience contractions, but are not allowed move.
In the standard epidural block a woman will lose feeling in her abdomen, back, buttocks, perineum, and legs. Epidural pain relief can sometimes slow labor, and cause a mother's blood pressure to drop, so most hospitals will only give an epidural after active labor has been reached - approximately 4-5 cm.
Mothers should expect to be given an IV of fluids. to help prevent her blood pressure from dropping, and will likely be asked to submit to constant electronic fetal monitoring as well. She may also have a catheter inserted into her bladder since walking to the bathroom will be difficult, or impossible.
More Resources About Pain Management During Labor: The Pregnancy Book by Dr. Sears
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