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Home › Articles › Labor Preparation › All About Epidurals

All About Epidurals

Researching Your Options for Pain Relief

By Catherine S. Moore, R.N., C.N.M.

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The epidural has become the most common method of pharmacological pain relief chosen by laboring women in the United States. An epidural can be used for spontaneous vaginal births, forceps- and vacuum-assisted births, as well as Cesarean births. Women often choose the epidural because they know it claims to offer total pain relief in labor.

But what really is an epidural? Many women make the choice to have an epidural without knowing the answer to that question.

What Is an Epidural?
According Dr. Joy Hawkins, director of obstetric anesthesia at University of Colorado School of Medicine in Denver, "The epidural rate is about 51 percent nationwide, with tremendous variation between hospitals."

There are three types of anesthesia: local, regional and general. Local anesthesia requires an injection of numbing medication that affects a very small area of the body. General anesthesia requires gas and intravenous sleeping drugs that ensure that the patient will not be awake during a procedure (example: major surgery). Regional anesthesia is when medications are used to numb an area (or "region") of the body while allowing the person to remain awake. Spinals and epidurals are examples of regional anesthesia.

The American Association of Nurse Anesthetists says that "the ideal anesthetic should provide enough pain relief to allow you to deliver your baby with minimal pain and anxiety, leaving you free to fully participate in the experience."

How Is It Done?
During a spinal, medication is given through a needle or small plastic tube (catheter) directly into the subarachnoid space, which is the part of the spinal column that contains the cerebral spinal fluid. Numbing medication given via the spinal route is very fast acting, and the patient starts to feel numb immediately.

During an epidural, medication is given through a needle or catheter directly into the epidural space that is the part of the spinal column just outside the space that contains the spinal fluid. Numbing medication given via the epidural route is slower acting than the spinal. It usually takes about 15 minutes for the patient to feel numb.

What Medications Are Used?

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