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Using Epidural Anesthesia During Labor: Benefits and Risks

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Using Epidural Anesthesia During Labor: Benefits and Risks

Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body and it’s the most popular method of pain relief during labor. Women request an epidural by name more than any other method of pain relief. The goal of an epidural is to provide analgesia, or pain relief, rather than anesthesia, which leads to a total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments. More than 50% of women giving birth at hospitals use epidural anesthesia.

Types of epidurals?

Regular Epidural

After the catheter is in place, a combination of a narcotic and anesthesia is administered either by a pump or by periodic injections into the epidural space. A narcotic such as fentanyl or morphine is given to replace some of the higher doses of anesthetic.

Combined Spinal-Epidural (CSE) or “Walking Epidural”

An initial dose of narcotic, anesthetic, or a combination of the two is injected beneath the outermost membrane covering the spinal cord, and inward of the epidural space. This is the intrathecal area. The anesthesiologist will pull the needle back into the epidural space, thread a catheter through the needle, then withdraw the needle and leave the catheter in place. This allows more freedom to move while in the bed and a greater ability to change positions with assistance. With the catheter in place, you can request an epidural at any time if the initial intrathecal injection is inadequate. 

With the use of these drugs, muscle strength, balance, and reaction are reduced. CSE should provide pain relief for 4-8 hours.

Benefits  of Epidurals During Delivery

  • Potential for a painless delivery. 
  • Allows you to rest if your labor is prolonged.
  • By reducing the discomfort of childbirth, some women have a more positive birth experience.
  • Required in cesarean delivery. will allow you to stay awake and also provide effective pain relief during recovery. 

Risks of Epidurals During Delivery

  • Low blood pressure: About 14 percent of women who get an epidural block experience a drop in blood pressure. Although it’s usually not harmful. Your blood pressure will be closely monitored. If necessary, fluids and medication can be passed through a drip to keep your blood pressure normal.
  • Loss of bladder control: After having an epidural, you may not be able to feel when your bladder is full because the epidural affects the surrounding nerves. You may have a catheter inserted to empty your bladder for you. You should regain bladder control once the epidural wears off.
  • Nausea and vomiting: Opioid pain relievers can sometimes make you feel sick to your stomach, a ringing of the ears, backache, and soreness when the needle is inserted
  • Fever: Women who get an epidural sometimes run a fever. About 23 percent of women who get an epidural run a fever, compared to about 7 percent of women who don’t get an epidural. The exact reason for the spike in temperature is unknown.
  • Permanent nerve damage: In rare cases, an epidural can lead to permanent loss of feeling or movement in, for example, one or both legs.

Other complications

Other very rare complications of an epidural include:

  • fits (convulsions)
  • severe breathing difficulties
  • Death
  • Seizure

When can an epidural NOT be used?

  • You’re Taking Certain Medications
  • You’re Bleeding Heavily
  • Have low platelet counts
  • Are hemorrhaging or in shock
  • Have an infection on or in your back
  • Have a blood infection
  • If you are not at least 4 cm dilated
  • Epidural space cannot be located by the physician
  • If labor is moving too fast and there is not enough time to administer the drug
  • Your Blood Work Isn’t Just Right
  • Labor Restrictions

Before deciding to have an epidural, you should discuss the procedure with your anesthetist about the advantages and disadvantages of each technique. Medication provides the greatest pain relief, but it can cause side effects. Make the decision based on your personal preferences and ability to tolerate pain.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://www.healthline.com/health/pregnancy/natural-birth-vs-epidural

https://www.healthline.com/health/pregnancy/pain-risks-epidurals

Stages of Pregnancy

Stages of Pregnancy

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Stages of Pregnancy

Within 24 hours after fertilization, the egg that will become your baby rapidly divides into many cells. By the eighth week of pregnancy, the embryo develops into a fetus. Pregnancy is counted as 40 weeks, starting from the first day of the mother’s last menstrual period. These weeks are divided into three trimesters. Your estimated date of birth is only to give you a guide. Babies come when they are ready and you need to be patient.  

Pregnancy is divided into three trimesters:

  • First trimester – conception to 12 weeks
  • Second trimester – 12 to 24 weeks
  • Third trimester – 24 to 40 weeks.

The moment of conception is when the woman’s ovum (egg) is fertilized by the man’s sperm to complete the genetic make-up of a human fetus. At this moment (conception), the sex and genetic make-up of the fetus begin. About three days later, the fertilized egg cell divides rapidly and then passes through the Fallopian tube into the uterus, where it attaches to the uterine wall. The attachment site provides nourishment to the rapidly developing fetus and becomes the placenta.

When does pregnancy start?

Medical professionals measure pregnancy week 1 from the first day of a woman’s last menstrual period. This is called the gestational age, or menstrual age. It’s about two weeks ahead of when conception actually occurs. Although a woman is not actually pregnant at this point, counting week 1 from the last menstrual period can help determine a woman’s estimated pregnancy due date. Your healthcare provider will ask you about this date and will use it to figure out how far along you are in your pregnancy.

How early can I know I’m pregnant?

From the moment of conception, the hormone human chorionic gonadotrophin (hCG) will be present in your blood. This hormone is created by the cells that form the placenta (food source for the growing fetus). It’s also the hormone detected in a pregnancy test. While you may get a positive POAS test at 3 weeks, it’s a good idea to wait a week or two and test again to confirm. A blood test also can detect hCG and is more sensitive than a urine test. Pregnancy can detect pregnancy as early as 6 days after ovulation, you could be able to confirm your pregnancy at/around 3 weeks.

Stages of Fetal Development

During the first trimester, your body undergoes many changes. Hormonal changes affect almost every organ system in your body. These changes can trigger symptoms even in the very first weeks of pregnancy. Your period stopping is a clear sign that you are pregnant. 

The developing baby is tinier than a grain of rice. The rapidly dividing cells are in the process of forming the various body systems, including the digestive system. The evolving neural tube will eventually become the central nervous system (brain and spinal cord).

First trimester (week 1–week 12)

  • 1 and 2: Getting ready
  • 3: Fertilization
  • 4: Implantation
  • 5: Hormone levels increase
  • 6: The neural tube closes
  • 7: Baby’s head develops
  • 8: Baby’s nose forms
  • 9: Baby’s toes appear
  • 10: Baby’s elbows bend
  • 11: Baby’s genitals develop
  • 12: Baby’s fingernails form

Second trimester (week 13–week 27)

Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months.

You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move. Fetal development takes on new meaning in the second trimester. Highlights might include finding out your baby’s sex and feeling your baby move.

  • 13: Urine forms
  • 14: Baby’s sex becomes apparent
  • 15: Baby’s scalp pattern develops
  • 16: Baby’s eyes move
  • 17: Baby’s toenails develop
  • 18: Baby begins to hear
  • 19: Baby develops a protective coating
  • 20: The halfway point
  • 21: Baby can suck his or her thumb
  • 22: Baby’s hair becomes visible
  • 23: Fingerprints and footprints form
  • 24: Baby’s skin is wrinkled
  • 25: Baby responds to your voice
  • 26: Baby’s lungs develop
  • 27: At 27 weeks, or 25 weeks after conception, your baby’s nervous system is continuing to mature. Your baby is also gaining fat, which will help his or her skin look smoother.

Third trimester (week 28–week 40)

Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Your baby will open his or her eyes, gain more weight, and prepare for delivery.

  • 28: Baby’s eyes partially open
  • 29: Baby kicks and stretches
  • 30: Baby’s hair grows
  • 31: Baby’s rapid weight gain begins
  • 32: Baby practices breathing
  • 33: Baby detects light
  • 34: Baby’s fingernails grow
  • 35: Baby’s skin is smooth
  • 36: Baby takes up most of the amniotic sac
  • 37: Baby might turn head down
  • 38: Baby’s toenails grow
  • 39: Baby’s chest is prominent
  • 40: Your due date arrives

As you near your due date, your cervix becomes thinner and softer (called effacing). This is a normal, natural process that helps the birth canal (vagina) to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited as the final countdown has begun.

Don’t be alarmed if your due date comes and goes with no signs of labor starting. Your due date is simply a calculated estimate of when your pregnancy will be 40 weeks. It does not estimate when your baby will arrive. It’s normal to give birth before or after your due date.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Preferences:

https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/stages-pregnancy

https://my.clevelandclinic.org/health/articles/7247-fetal-development-stages-of-growth

Most Dangerous Birth Complications

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What is dangerous birth complications?

Childbirth is the process of giving birth to a baby. It includes labor and delivery. The labor and birth process is usually straightforward, but sometimes complications arise that may need immediate attention. Complications can occur during any part of the labor process. It may cause a risk to the mother, baby, or both. It is very important for women to receive health care before and during pregnancy to decrease the risk of pregnancy complications.

A childbirth complication refers to any abnormal obstetrical condition or adverse event occurring during pregnancy, labor, or delivery that can greatly impact a mother or baby. Obstetric complications are ultimate what cause all birth injuries. Some of these complications are relatively benign while others can be dangerous and even life-threatening.

The list below identifies the most dangerous childbirth complications:

  • Fetal distress is a sign that your baby is not well. An irregular heartbeat in the baby happens when the baby isn’t receiving enough oxygen through the placenta. If it’s not treated, fetal distress can lead to the baby breathing in amniotic fluid containing meconium (poo).
  • Shoulder dystocia typically defined as a delivery in which additional maneuvers are required to deliver the fetus, includes changing the mother’s position and manually turning the baby’s shoulders. Shoulder dystocia occurs when the fetal anterior shoulder impacts against the maternal symphysis following delivery of the vertex. An episiotomy, or surgical widening of the vagina, may be needed to make room for the shoulders.
  • Umbilical Cord Prolapse in a normal childbirth, the baby goes through the birth canal first and is followed by the umbilical cord and placenta. Prolapse occurs when the vital umbilical cord drops down into the cervical opening first and ends up in front of the baby as it enters the birth canal. The umbilical cord prolapse must be dealt with immediately so the fetus doesn’t put pressure on the cord, cutting off oxygen.
  • Fetal Macrosomia is the scientific term for a baby that is too big for safe vaginal delivery. Any baby in excess of 9 lbs. at full term is considered macrosomic. Undiagnosed fetal macrosomia is a potentially dangerous complication. Vaginal delivery is not safe for macrosomic babies because they are too big and are very likely to get stuck in the birth canal. It is associated with increased risks of cesarean section and trauma to the birth canal and the fetus.
  • Uterine rupture is rare. It can occur during late pregnancy or active labor. It is spontaneous tearing of the uterus that may result in the fetus being expelled into the peritoneal cavity. Prior cesarean delivery, induction of labor, size of the baby, and maternal age of 35 years or more are some factors. The mother may be at risk of excessive bleeding.
  • Failure to progress or Prolonged labor happens when labor slows and delays delivery of the baby. The cervix may not thin and open as it should. This makes it hard for the baby to move down the birth canal. Fetal Descent Stations (Birth Presentation) The progress of the baby can be progressively measured. Some of the reasons include slow cervical dilations, a small birth canal or pelvis, delivery of multiple babies or emotional factors.
  • Placenta previa is a condition in which the placenta lies very low in the uterus and covers all or part of the cervix. The cervix is the opening to the uterus that sits at the top of the vagina. Placenta previa happens in about 1 in 200 pregnancies. A cesarean delivery is usually necessary.

Can complications be fatal?

Childbirth complications can be life-threatening if there is a lack of proper health care. Appropriate health care can prevent or resolve most of these problems. It is vital to follow the doctor’s advice and instructions regarding pregnancy and delivery and to attend all prenatal visits during pregnancy.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Reference:

https://www.medicalnewstoday.com/articles/307462

https://www.webmd.com/baby/features/childbirth-complications#1

https://www.birthinjuryhelpcenter.org/pregnancy-dangerous-complications.html

Giving birth during COVID-19: What to expect

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Many pregnant women are worried about planning the birth of their baby during the pandemic. If your stress level is rising and you’re becoming overwhelmed with questions, that’s totally understandable. Giving birth is stressful enough. Adding a pandemic to the mix has only increased anxiety among today’s moms-to-be. While it’s true that aspects of labor and delivery may look different than they did prior to COVID-19. To ensure the health and safety of mom and baby remains the goal.

Here are some concerns you may want to address

What health and safety protocols have been implemented to reduce COVID-19 exposure risk?

As COVID-19 spreads through the air and women who are in labor breathe heavily during contractions, everyone in the room with you needs to wear a mask for your safety. Getting the vaccine protects the baby that’s why pregnant women are recommended to get the COVID-19 vaccine. The good news is not only does doing the vaccine protect you, it protects your baby, who will receive antibodies from you. The obstetricians, midwives, physician anesthesiologists, nurses, and other health care providers who care for women in labor have been vaccinated and follow other precautions to ensure safety, such as wearing personal protective equipment (PPE). recommends 

How many support persons can I have by my side in the hospital?

Currently, most hospitals will allow only one or two support people in the room with the laboring mom. If you test positive for COVID-19, safety protocols mean you will not be able to bring anyone in the room with you. After delivery, most new moms leave the hospital sooner, they spend less time in the hospital than they might have before the pandemic. one day (vs. two days) after vaginal birth and two or three days (vs. three or four) after cesarean delivery. The elements of the protocol include providing patient education prior to delivery, promoting breastfeeding and mother-baby bonding, and getting women up and moving as quickly and safely as possible. Rest assured that some things haven’t changed during the pandemic. Health care providers such as physician anesthesiologists will be by your side during your time of need.

Are there any extra precautions I should be taking at home before my baby arrives?

The final weeks before your delivery are an important time to continue social distancing. This means limiting contact with people outside your immediate family. This will lower your risk of getting COVID-19 just before you have your baby.  Hospitals have implemented several additional health and safety measures to make it as safe as possible for you to have your baby during the COVID-19 pandemic. 

Despite the challenges, we need smart ways to promote maternal and infant health during the pandemic.

Choosing where you’ll welcome your baby into the world is an important decision. Plan ahead if you can. Pack any special snacks, drinks, books, toiletries, and anything else you might want during your stay. It’s where you’ll make your first memories together. No matter the circumstances, having a baby is a joyful occasion. Changes in labor and delivery protocols during COVID-19 ensure it’s a safe experience.

Disclaimer

The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. The purpose of this website is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

https://www.healthpartners.com/blog/giving-birth-during-covid-19/

https://uvahealth.com/services/covid19/birth-coronavirus-faqs

https://www.newswise.com/coronavirus/six-facts-women-need-to-know-about-giving-birth-during-the-covid-19-pandemic/?article_id=750200