Alternatives to the epidural would be IV pain medication, nitrous oxide not in use at all US hospitals yet , local anesthetics or natural pain management. The epidural is most often used for vaginal births, and spinal anesthesia is used for cesarean deliveries I have a whole post on cesarean anesthesia. BUT the epidural can be used during an emergent cesarean to help provide adequate pain relief as well. It does take a few minutes for it to have full effect. The other risk would be moving during the placement as you are in so much pain and that can have more serious consequences.
First time mothers — 7 cm still gives you quite a lot of time to enjoy the benefits of the epidural. One of the big benefits is that if you were to need an emergency c-section more likely on your first time they can dose-up the epidural for that procedure and keep you very comfortable.
I would hope so, and they should. Honestly, at whatever point my patient requests an epidural, I try to make it happen. I think most nurses do. Even 10 centimeters, if you really want it and it is your first baby, they should make it happen. So, there you have it. No, 7 cm is not too late to get an epidural. Be sure to check out all my content on labor pain management I have a lot.
SO, if your doctor says you can get it at any time, you CAN get it at any time! Most often this is too early to get an epidural. It would be better if you had your full movement to help your cervix open, but sometimes it is appropriate. Angeliki A et al. The effect of epidural analgesia on the delivery outcome of induced labor: A retrospective case series. Obstetrics and Gynecology International. Anim-Somuah M et al.
Epidural versus non-epidural or no analgesia for pain management in labor. Gimovsky AC et al. Prolonged second stage in nulliparous with epidurals: a systematic review. Journal of Maternal- Fetal and Neonatal Medicine Johns Hopkins Medicine. Epidurals for Labor Fact Sheet. March of Dimes. Narcotics for labor pain. Epidural block — pregnancy. Managing labor pain. Office on Women's Health.
Join now to personalize. Photo credit: Thinkstock. What is an epidural? What is the epidural procedure like? How long does an epidural last? Does an epidural hurt?
Pros and cons of an epidural Epidural side effects The best time to get an epidural during labor Is it ever too late to get an epidural? Other pain medication during labor Can anyone have an epidural? The medication delivered by the epidural is usually a combination of: a local anesthetic this blocks sensations of pain, touch, movement, and temperature a narcotic this blunts pain without affecting your ability to move your legs Used together, the anesthetic and narcotic provide good pain relief at a lower total dose than you'd need with just one or the other, while allowing for more sensation in your legs.
Here's a step-by-step guide to what happens when you have an epidural: Injection prep: You lie curled on your side or sit on the edge of the bed while an anesthesiologist cleans the injection site, numbs the area, then carefully guides a needle into your lower back — into a small space outside your spinal cord.
Catheter insertion: The anesthesiologist then passes a catheter a small, soft tube through the needle, withdraws the needle, and tapes the catheter in place. At this point, you can lie down without disturbing the catheter, and medication can be administered through it as needed. Test dose, full dose, and monitoring: First you're given a small "test dose" of medicine to be sure the epidural was placed correctly, followed by a full dose if there are no problems.
Your baby's heart rate is monitored continuously , and your blood pressure and heart rate are taken every five minutes or so for a while after the epidural is in to make sure it isn't causing any concerning changes in these vital signs.
Medication takes effect: You'll start to notice the numbing effect about 10 to 20 minutes after the first dose of medication, though the nerves in your uterus will begin to go numb within a few minutes. You'll receive continuous doses of medication through the catheter for the rest of your labor. Adjusting your medication: You may also have the option of patient-controlled epidural analgesia PCEA , which means you can control when you get more medication through a pump that's connected to the catheter.
The amount of medication you can give yourself is limited, so there's no chance of overdose. After you deliver your baby : The catheter will be removed. If you've had a c-section , sometimes the catheter is left in to administer postoperative pain medication. Pros and cons of an epidural Advantages of having an epidural: It provides a route for very effective, safe pain relief that can be used throughout your labor. The anesthesiologist can control the effects by adjusting the type, amount, and strength of the medication.
This is important because as your labor progresses and your baby moves down into your birth canal, the dose you've been getting might no longer be adequate, or you might suddenly have pain in a different area. The medication only affects a specific area, so you'll be awake and alert during labor and birth. And because you're much more comfortable during labor, you can rest or even sleep as your cervix dilates and conserve your energy for when it comes time to push.
Unlike systemic narcotics, only a tiny amount of medication reaches your baby. Once the epidural is in place, it can be used to provide anesthesia if you need a c-section or if you're having your tubes tied after delivery. Sources BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world.
Featured video. Natural childbirth: Benefits and risks of unmedicated birth. You can get an epidural any time you want. The local numbing agent alleviates most of the pain you may feel during the epidural. Most women feel pressure and a stinging sensation as the epidural medication is injected through the needle. It was thought that if an epidural was placed before 4 centimeters dilated, it would cause a woman to need a C-section for delivery. Recent randomized studies over the past few years have not found the epidural to be correlated with the mother needing a C-section.
These studies were so profound that it encouraged The American College of Obstetricians and Gynecologists ACOG to change their guidelines in to reflect these findings. If labor does slow down after your epidural, you may be given Pitocin , a synthetic version of oxytocin which is a natural hormone that helps your uterus contract during labor.
Speak with your doctor about your different options for epidural medication and your dosage. However, an epidural does change the game when it comes to pushing. This is where the nursing staff can help. Epidurals can last for several hours after delivery. Depending on the dosage and type of epidural, the lower half of your body may still be numb after birth.
You will most likely need assistance to walk and to use the bathroom while the medication is wearing off.
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