Epidurals: Pros vs Cons

Epidurals

I have been studying the side effects of epidurals and have always wondered if they were harmful for the mother or baby.  Well, after some research, I have been rather surprised by my findings… the list side effects of epidurals is rather long and potentially frightening. Having some sort of complications with your epidural is very common.

I think I have come to the conclusion that if an epidural is used during labor, you essentially trade the pain or discomfort of labor for alot more potential pain and discomfort for hours, days, weeks or even years to come.  Come to find out, some women never get any pain relief from their epidural during labor and then have terrible side effects from their epidural that didn’t work!

Here is a nice article from nursingcenter.com  Learning the essentials of epidural anesthesia

“If the epidural needle or catheter enters the subarachnoid space….can cause high spinal anesthesia, increasing the loss of function in the respiratory muscles. The patient will have trouble breathing, leading to apnea, increasing numbness, or paralysis. This is an emergency. Immediately calm and reassure the patient. Call the emergency response team and the anesthesia provider. Have emergency airway equipment, emergency medications, and suction at hand to maintain the patient’s airway and cardiovascular status. Follow basic life support guidelines to protect and support the patient’s airway, breathing, and circulation.

What Can Epidurals Can Do For You:

Epidurals can be the first step to other complications and interventions:

• Restricted mobility, IV, and EFM (all epidural patients)
• Increased likelihood of needing a catheter, oxytocin, AND/OR internal monitoring
• Increased likelihood of having a forceps, episiotomy AND/OR cesarean (c-section) delivery

Short Term Effects On Mother Who Have An Epidural:

• Dural puncture
• Hypotension (29%) (Low Blood Pressure) – MAJOR risk to baby and baby’s brain because of lack of blood flow to the placenta and baby.
• Nausea, vomiting, shivering (frequent)
• Uneven, incomplete OR non-existent pain relief
• Respiratory insufficiency or paralysis – (no breath!)
• Convulsions
• Slight to severe headaches
• Septic meningitis
• Cardiac arrest – heart attack (serious!)
• Maternal death

Long Term Side Effects Of The Epidural On The Mother:

• Neurological complications
• Backache (weeks to YEARS!) in 20% of women!
• Postpartum feelings of regret, loss of autonomy (click for definition)
• Fecal and urinary incontinence (inability to urinate)
• Loss of perineum sensation and sexual function

Epidural Side Effects On The Baby:

• Direct drug toxicity to baby
• Fetal distress, abnormal FHR – fetal heart rate (can lead to emergency cesarean)
• Drowsiness at birth, poor sucking reflex
• Maternal fever (inability to regulate body temperature from numb skin) leads to fetal hyperthermia and neonatal
  NICU workup (spinal tap, etc.)
• Neonatal jaundice
• Decreased maternal-infant bonding, behavioral problems
• Hyperactivity up to seven years (suspected)

And this is an incomplete list…  Who would sign a consent if it included all the info above?  The degree to which the facts about the risks of epidural anesthesia are hidden from women in labor is astonishing.

I hope that pregnant women will have a more informed explanation of the risks of epidural anesthesia than what is currently given, and I would suspect that many would make other choices if true informed consent was given (before labor, when the woman still has time to prepare to cope with the discomfort or pain of  childbirth in other ways).

For more info on the pros and cons of epidurals, check out the following websites:

http://www.healing-arts.org/mehl-madrona/mmepidural.htm

http://www.gentlebirth.org/archives/episdrgs.html#CaseEpidural