For some mothers, it's an incredible, blissful experience they'd do again and again. For others, it's a nightmare – one they don't wish to repeat. No, these moms aren't referring to childbirth, but to their encounters with epidurals. Women who have opted for this form of pain management have notably mixed results and responses. But how can one shot render such drastically differing opinions? And what's the magic behind this highly debated needle?

Technically speaking, epidural analgesia is a type of regional analgesia used for pain relief, says Dr. Ferne Braveman, a professor and section chief of Yale Obstetrical Anesthesia in New Haven, Conn. The shot allows a small dose of medication to be directed to a specific region of the body,

"In the case of an epidural, this medication is administered into the epidural space – the space just outside the space containing the spinal fluid in the area of the spinal cord," Dr. Braveman says. "The medication bathes the nerves and prevents the pain message from being transmitted up the spinal cord to the brain. Unlike systemic analgesia, which may lead to a sedated mom and a sedated newborn, moms receiving epidural analgesia are awake, with little or no discomfort, and can enjoy their child's birth."

According to most reports, the use of epidurals is on the rise. But despite how commonly epidurals are administered, they don't always have the same effect on women. In fact, moms report widely different levels of pain with its use. The reason? Just as every labor experience is unique, so are reactions to an epidural.

Dr. Pamela Berens, an associate professor in the department of obstetrics and gynecology at The University of Texas Medical School at Houston, Texas, knows firsthand just how unique one epidural is from the next. "I've had four children, four very different labors and four epidurals – all of which were different," she says. "Different experiences are common, both related to epidural pain relief and also labor pain. There may be a difference in the pain that's associated with a normal labor compared to the pain involved with a longer or more difficult labor. There are also different medications preferred by different anesthesiologists, and some women may have different responses to different medications."

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