Pain can be lessened by the injection of morphine or demerol. These medications will allow for relaxation, especially between painful contractions. Because these medications can make the baby sleepy when he or she is born, they are not recommended if the baby will be born soon.
Epidural analgesia is the most effective method of providing pain relief in labour. An anesthetist inserts a small plastic tube into the mother's back, and a mixture of local anesthetic freezing drugs and a powerful painkiller is injected. By using a pump, a slow continual stream of these medications runs into the mother's back and gives pain relief. While this is generally very safe, and has been used at O.S.M.H. for many years without serious problems, we need to inform you of the possible risks and complications.
Common side-effects:
Your legs will feel heavy and you may have difficulty moving or passing urine. If necessary we will help you move and put a small tube (catheter) into your bladder to empty it.
Your blood pressure may drop. This will be checked and treated with intravenous (I.V.) fluids and medication, if necessary.
Possible problems:
Some studies have suggested that epidurals in early labour may increase the risk of forceps delivery or caesarian section. Other studies have not confirmed this.
Many women suffer backache during pregnancy and after labour. Current research suggests that this is not worsened by epidurals. Some women have an area of numbness which lasts for several days.
Serious problems:
These are rare.
The epidural catheter can be put in the wrong place. About 5% of the time it goes into a blood vessel in the back, and has to be pulled back or reinserted. Very rarely a dose of local anesthetic is injected into the blood vessel and the patient notices a metallic taste in her mouth, becomes dizzy, and may go on to have a convulsion or even a heart attack. With prompt treatment, complete recovery from this complication is possible.
About 1-2% of epidurals enter the fluid which surrounds the spinal cord. This frequently causes a severe headache, which may need further treatment. Very rarely a large dose of local anesthetic is injected, causing serious complications.
Other complications include the introduction of infection into the area around the spinal cord.
Exceedingly rarely, epidural analgesia can cause death or permanent paralysis. However, even "natural" childbirth has risks.
Anesthetists are specially trained to know these risks, and avoid or treat complications.
Effect on baby:
Epidural analgesia has little or no effect on the newborn.
Effectiveness:
Epidural analgesia works well, providing about 9 women out of 10 with complete or nearly complete pain relief. Sometimes it is necessary to add more medication, adjust the tubing, or even reinsert the epidural in order to achieve good pain relief. Epidural analgesia often avoids the need for a general anesthetic, which is much more risky than epidural analgesia.
Availability:
Unfortunately, there are some days when there is not an anesthetist available at O.S.M.H. who can provide epidurals for pain relief.
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This section to be signed during pregnancy: I have read and understood the above. My questions have been answered to my satisfaction. |
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This section to be signed when wanting epidural:
I request an epidural. I am aware of the risks, benefits, and alternatives. |
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