Childbirth, Medication in

The Epidural

There are different classes of medications used during childbirth. One class is anesthetics, which act directly on the body's nerves. The epidural, also known as epidural anesthesia, is a regional anesthesia, so it affects only one part of the body. Medications administered through epidurals fall into a group of drugs known as local anesthetics. Commonly used anesthetics are chloroprocaine, bupivacaine, and lidocaine. Typically, a narcotic or opioid such as fentanyl and sufentanil is also used to lessen the amount of local anesthetic that is needed. An epidural is administered through a flexible narrow tube that is inserted in the epidural space of the spine. Essentially continuous pain relief is delivered to the lower part of the body while the individual giving birth remains fully conscious and mentally aware. Epidural anesthesia is the most popular form of pain relief used during childbirth in the United States. Over 50 percent of women who have hospital births use an epidural. The use of the epidural may provide women with a method of dealing with fatigue and exhaustion so that they can be more active participants during the stage of delivery where pushing is required.

One side effect of the epidural is that depending on the amount of medication given, the legs may become numb and the ability to stand may be temporarily lost. Another main effect is that an epidural may slow labor, which increases the likelihood that another drug named Pitocin would be used. Pitocin serves to speed the labor. The use of the epidural also tends to lengthen the amount of time that a birthing mother must spend during the pushing stage of labor. This is due to the weakening of the bearing-down reflex caused by the lack of sensation in the lower extremities. The use of the epidural has been linked to increases in the use of forceps deliveries and vacuum extractions, which increase the risk of lacerations for the baby, and is also linked to an increase in the rate of caesarean sections. Medication used in the epidural may also temporarily slow the birth mother's blood pressure, thereby reducing the flow of blood to the baby, which, in turn, lowers the baby's heart rate. The use of a catheter is often needed because of the decrease in the ability to feel the need to urinate that is associated with an epidural. Other noted side effects include itchiness of the skin and nausea.

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