What Is Epidural Anaesthesia And How Is It Administered?

The birthing room is the final frontier; after all the preparation, classes, and waiting, here you are.  The decisions you’ve made during the course of your pregnancy have been put into action.  Choosing the method of delivery and the drugs to use before, during, and after delivery are topics you have already discussed with your doctor.

No matter what drugs you may need for childbirth, choosing to use them is not a decision that any mother makes lightly.  Many mothers opt for natural (drug free) delivery with a back up plan of anesthesia.  Some mothers may be able to stick with that plan while others may need to go to Plan B and choose anesthesia.

Trying to hang in there and tough it out with the contractions is a noble cause, but it is one that you and your doctor will have to face together.  There are times and situations when strength alone will not prevail. That force of will can break down even the strongest of women, and there can be medical reasons why epidural anesthesia may be the best course of action.

Your doctor should discuss anesthesia with you ahead of delivery time so that you have the necessary information and the anesthesiologist can be standing by when your delivery time comes. The most common form of anesthesia used in childbirth is the epidural.

Administering the Medication

Just what does an epidural entail? In medical terms it is a form of regional anesthesia or block. This means that only certain areas of your body will be affected by the medication.

The epidural is given in the lower back, blocking pain below the waist. This may already sound grim.  How will they get to your lower back when contractions have rendered you rather unapproachable? The doctor will probably ask you to roll on your side and curl up in the fetal position. This “curling up” increases the amount of space between your vertebrae so the doctor can administer the medication safely.

Because you are hooked up to a monitor, the doctor can see when a contraction is happening. Once one contraction has passed, the doctor can begin the procedure. It is very important that you don’t move. Have your partner assist you by holding your shoulders, your hand, and offering a pillow to squeeze or whatever it takes so you remain still.

A long needle is inserted into your back in the space above the spinal cord (epidural space) in which a long tube is then inserted to administer the anesthetic. If you feel anything other than the pin prick of the needle it will be pressure as the medicine goes in. Once the procedure is finished, it may take a few minutes for the drug to take effect.

Women who have been in labor for extended hours can now rest until it is time to push. An epidural takes away the pain below the waistline. Your monitors will let the doctor track your contractions and let your and your doctor know when it is time to push.

Epidural anesthesia is one option when natural childbirth doesn’t seem to be working out to the advantage of the mother or baby. It eases the pain and gets the mother ready for the final push to bring her baby into the world.

Water Birth – Is This Alternative For You?

Water birthing is a relatively new concept in the United States. Basically, a mother gives birth to her baby while being partially immersed in warm water. Water births have more typically been done during home deliveries, but have now entered the mainstream birthing hospitals.

What to Expect – Preparation

Proponents of water birth say that it is a more natural process. A baby has been living in water for nine or ten months already. Coming into this world in the same kind of medium is believed to be less traumatic and an easier transition.

The mother will use a pool or tub that is partially filled with water. The water must be maintained at a certain temperature. Ideal temperature is equal to the internal environment of the body (98.6 degrees Fahrenheit). Keeping the water at body temperature prevents the mother’s temperature from rising too high and endangering the baby.

The water is also continually changed to keep it crystal clear. The doctor or midwife needs a clear view of the cervix and the baby as it passes out of the birth canal so that any potential problems can be detected early and resolved.

The water level is also important. The mother’s lower half is submerged in water when she sits, but her body needs to remain stable, not buoyant, so that she can push when the time comes. Too much water will cause her to float and lose her position.

What to Expect – Birth

According to experts in water birthing, immersion in water eases the pain of the contractions. Any mother would love that. The body begins to relax somewhat so the mother’s cervix can dilate without as much pain.

Doctors who advocate the water birth method don’t recommend that a mother enter the birthing pool until after early labor. Immersion before five centimeters of dilation is too early. When you first enter the water, contractions seem to speed up due to natural oxytocin in the body. This increased flow can last for a couple of hours, long enough to dilate to delivery size. If a woman sits in the water too long, the surge stops and labor is stalled. Getting closer to full dilation makes a better use of that oxytocin spike.

Many mothers believe there are advantages to letting their baby emerge from water in the womb to water in the birthing pool. For women who want an alternative to the delivery bed, water birth may offer the calm, quiet delivery she is hoping for.

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