I'm kinda sleepy but I'll try not to forget to much
Risks of Epidural
- Biggest risk is that it won't be effective or will only be partially effective
- Itchyness
- Increased need to augment labour (use oxytocin to boost contraction strength and frequency - artificial oxytocin increases risk of fetal distress and subsequently c-section)
- Increased risk of prolonged 2nd stage (pushing stage)
- Increased risk of instrumental delivery (vacuum or forceps)
- Risk of spinal headache occuring afterwards
- The procedure can hurt, but labour hurts too
- Increased incidence of breastfeeding difficulties, including getting baby to latch and breast engorgement issues. (epidurals require increased IV fluid intake in order to ensure a stable temp. Receiving lots of IV fluid in labour increases the chances of suffering from really bad (wore then physiological) engorgement and increases the risk of mastitis)
- Level of anesthesia may rise too high impairing ability to breathe
- Abnormal drop in blood pressure can occur
- Continuous monitoring not required but is generally used anyways
- Very very rare risk of neurological injury causing paralysis
And although risks exist most people who have epidurals end up perfectly fine and there are instances where epidurals can be benficial such as times when there is a pre-existing labour progress issue as sometimes the woman's tension can prevent adequate progress to occur. In this situation, an epidural can potentially relax the pelvic floor enough to encourage fetal descent and cervical dilation which can subsequently reduce the odds of requiring a c-section for progress... Best to try other things first like position changes to avoid the epidural having the opposite effect. Epidurals can also be beneficial in labours that are already at high risk for requiring a c-section, such as twins. An epidural can easily be topped up to provide adequate anasthesia for a c-section which allows the woman to be awake during the procedure. If it is a true emergency situation then often there is not enough time to insert a spinal for the c-section so general anesthesia would be used and when it is used you are put to sleep and your partner is generally not allowed to be in the room either.
Nitrous (Gas & Air) Risks
-Can cause dizziness, lightheadedness, nausea
-In rare cases can cause hallucinations
-Memories of labour and birth may become unclear or dreamlike
-Doesn't give full relief (but does take the edge of for many women)
-Not recommended for preterm births (
2 weeks) as it increases risk of intracranial hemorrhage
-Not recommended for women with vitamin B12 deficiencies (not sure why??)
The benefits of nitrous is that it is Very shortlasting, if you don't like how it makes you feel you stop using it and the effect is gone in a few short minutes if not seconds. It has not been shown to affect labour progress. It has not been associated with fetal or newborn distress. It has not been shown to influence newborn breastfeeding behaviours. An IV is not required nor is continuous monitoring required
Risks of Narcotics (such as demoral, but there's lots of different types)
- Can cause nausea and lightheadedness
- Been described as producing a "stoned" feeling
- Doesn't completely take pain away but changes your perception on what you think about the pain.
- Can also impair memories of the birth experience
- Longer acting than nitrous
- It's an injection and needles hurt, but labour hurts too.
- Baby is at risk of respiratory depression (being unable to breathe on their own) if born within 4 hours of the mom getting narcotics. This is reversable by giving the baby another drug called Narcan but if this occured baby would still be required to stay in NICU for post-resus observation.
Narcotics can be very very useful in managing early/prodromal/latent/false labour. False labour contractions CAN be just as painful as "real" contractions and can go on and on in some unfortunate women. In these women, a dose of narcotics can be just what they need to get a few hours of sleep and when they wake up the contractions will either be gone and they will enter labour later one when their body is ready or they will wake up in full fledge labour and be well rested to continue the labour with no further meds.
Anyways, every labour and birth is different and while it is good to plan for a natural birth with minimal intervention and most women commited to do this are in fact capable of doing so, it's definitly good to know what your pharmacological pain relief options are because as I mentioned above there are situations when they can do good... The key is determining when those situations are. It's also very very very good to be well versed in several non-medical pain relief options as well including water therapy and hypnobirthing.
im hoping to have a drug free birth (in hospital but in a very lovely hospital i may add!) and im just wondering if anyone has any info on the effects of pain relief and epidurals on baby? does gas and air have any effect?
) and myself in the end. i had horrific back ache for months.
