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  • Epidurals: What, Where & Why?

    What is an epiduralAsk any pregnant woman, “What is your primary concern about giving birth?” and she will tell you: THE PAIN! While it is true, there will be some pain involved when delivering a human being into the world, there are pain management options! No one needs to suffer while giving birth; if the woman in labor is no longer coping, new decisions will be made. These decisions often include either pain medication and/or epidurals.

    What is an epidural?

    An epidural is a form of pain relief used during labor, numbing the body from the waist down.

    An anesthesiologist or nurse anesthetist performs this form of anesthesia; the procedure starts with a local anesthetic, followed by the insertion of a long needle (used to guide a thin catheter) between two of the lower lumbar vertebrae in your low back. The medication is typically delivered continuously, replacing pain with a sense of pressure.

    Is an epidural safe?

    First and foremost, an epidural is a medical intervention, and all interventions have some degree of risk involved. Having said that, anesthesiologists and nurse anesthetists are highly trained health care professionals who spend more years perfecting their area of specialty than any other medical professional. Given the length and duration that a woman spends in labor, epidurals have proven to be a very beneficial pain management approach, outweighing the potential risks associated with them.

    When to get it?

    The recommended time to request an epidural is during ‘active labor’ when she is between 3-7 centimeters dilated.  The procedure takes an average of 15 minutes to complete; the labor nurse is there throughout to assist the mom in remaining still.

    Does an epidural affect the baby?

    The short answer is no. The medications used during an epidural, may cross the placental barrier and might cause some delay in the newborn latching at the breast.  Continuous monitoring is used throughout labor and pushing to consistently track the baby’s heart rate.

    Why choose an epidural?

    • In most cases provides much needed pain relief.
    • Dose of medication can be varied for labor vs. pushing
    • It permits further pain medication if you require a cesarean.

    Are there any disadvantages?

    • When given ‘early’ an epidural can slow labor down.
    • Side effects can include an itchy or shivering feeling.
    • You will remain in bed, as your legs will not support you; it takes several hours after the baby is born for the legs to “wake-up.”
    • Some women will report having a “lazy leg” after delivery that can linger for days or weeks. This may or may not have to do with the epidural. Additionally, there are reports of low back pain, sometimes blamed on the epidural. Is this residual pain a result of birth trauma to muscles and ligaments in the low back, or the epidural? The answer remains unknown.
    • Other interventions include: an automatic blood pressure cuff and a urinary catheter to empty your bladder. More interventions may become necessary, particularly in a longer first baby labor, including the medication Pitocin, as epidurals combined with a long labor frequently slow down contractions. Pitocin is frequently used to bring the contractions back to a labor pattern that will better facilitate progress.


    In conclusion, an expectant mom needs to maintain an attitude that ‘giving birth is not a contest.’ You don’t get points for how you deliver your baby. We maintain there is only one goal: “Healthy Mom, Healthy Baby… However you get there.” While it is great to avoid interventions as much as possible while giving birth, it can also be quite helpful to know that there are options available to you to ultimately succeed in getting your healthy baby into your arms.

    sarah mcmyolerGuest Blog by Sarah McMoyler, RN, BSN, and creator of the McMoyler MethodTM

    Sarah McMoyler, RN, BSN, has seen over 25,000 Bay Area expectant parents come through her classroom doors for her signature McMoyler Method™ course. As a Labor & Delivery nurse, mother of two, childbirth educator, and triathlete, she views ‘Birth and Parenting as Extreme Sports!’ Just as athletes prepare for their event, so must expectant parents be ready for the biggest event of their lives.

    McMoyler Method™ was developed based on Sarah’s experience with couples arriving on the Labor & Delivery unit completely unprepared, not knowing how to cope with pain or how to communicate with the healthcare team. She developed the first condensed, childbirth class that is relevant to today’s busy, expectant parents, helping them establish realistic goals necessary to navigate effectively through labor & delivery.

    Her book The Best Birth: Your Guide to the Safest, Healthiest, Most Satisfying Labor and Delivery, brought national attention to her Bay Area classes with individuals and hospitals across the country asking for McMoyler Methodology. The Best Birth Online Class, powered by McMoyler Method™ was produced so that expectant parents can prepare for birth and parenting wherever they live.

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