Epidural for normal births
Your epidural will be performed by the consultant anaesthesiologist.
An intravenous infusion will be set up first. After this has been running for some time, a catheter will be introduced through a needle into the space around the spinal cord and left in place throughout labour.
A local anaesthetic is then introduced through this catheter to produce pain free labour. You will experience a numbness extending from your legs to your abdominal wall.. Many people also experience a degree of muscle weakness in their legs.
Should you feel faint during the onset of the epidural do not panic as this is not uncommon. Your nurse will ask you to turn on your side and administer oxygen for you to breathe.
The effect will start to wear off after 3-4 hours at which time the anaesthesiologist or the gynaecologist might decide to administer a top-up dose to prolong the effect. A pump may be used to give a continues infusion of the local anaesthetic which results in fewer top-ups being necessary.
Occasionally the anaesthesia may only occur on the one side, and very occasionally a small area does not become anaesthtized at all. Should this happen your anaesthesiologist will attempt to overcome the problem. If the problem can not be solved you will be offered another means of pain relief. A nurse will be with you throughout your labour, your gynaecologist and anaesthesiologist will be nearby at all times.
Due to the decrease in muscle power it is sometimes necessary for the gynaecologist to assist with the delivery of the baby by using a suction apparatus ofr forceps. The epidural will enable you to be relaxed throughout your labour and make it an enjoyable experience for you.
After the birth of the baby do not hurry to get out of bed. Due to the muscle weakness and lack of sensation you could fall over. There is also the risk of fainting if a top-up dose had been given just before the delivery.
Complications after an epidural are rare. One is a severe headache. This can be relieved. Another is a loss of sensation in the outer thigh. Return of normal sensation may take 3 months or so.
Epidural during caesarean births
In the event that a baby cannot be delivered "normally" and a Caeserian section is required, the anaesthesiologist will either increase the epidural top-up or convert the epidural to a spinal anaesthetic. This implies the insertion of a extremely fine needle into the spinal fluid. The spinal produces a total block. This means that all sensation as well as motorpower is lost in the abdomen and legs. This effect could last for 3-4 hours.
If a Caeserian section is planned from the outset, some anaesthesiologist might perform a combined spinal / epidural anaesthetic to achieve maximum effect during the caeser and also to prolong the apin relieving effect after the opperation.