What are the benefits and risks of an epidural?
An epidural is the gold standard for labour pain relief and very safe for most people. It uses pain medication like the kind used for dental procedures that help to numb and prevent sharp pain. It can be used for as long as needed (as first time labour can last 14-20+ hours) as a tiny tube is inserted that delivers the medicine. It can be used for both vaginal delivery as well as a C-section birth. Epidural rates in Canada and US are 60-70% of all births. More people have an epidural, especially in hospital (or those who intended a non-hospital birth and then are transferred to hospital because they want an epidural), although you may feel pressure to go without.
An epidural decreases bowel and bladder damage and may help labour progress by relaxing the pelvic floor muscles. It prevents pain and can decrease the intensity of labour, birth, and stitching from vaginal and perineal tears. It can be helpful in case of retained placenta or excessive postpartum bleeding. An epidural may also allow for sleep and rest during labour when preparing to push and for the upcoming 2-3 weeks of sleep deprivation.
You can choose to have an epidural at any time as long as you can sit still for 15-20 minutes. You can change your mind and choose an epidural even if you had originally planned not to have one, without feeling guilty.
Risks of epidural are rare. Here are some possible risks that will be discussed with you at the time you request one: itching, inability to get full pain control (especially near delivery or pushing phase), low blood pressure and/or temporary drop in baby's heart rate, nausea or vomiting, soreness, or fever. The very rare risks include post-epidural headache (1%), nerve damage (1 in 4000 to 1 in 200,000), difficulty breathing, or infection/abscess.
Koble series:
Anaesthesia: pain control and birth by Dr Kelly Fedoruk (Obstetric Anesthesiologist)