Laboring under misconceptions: Epidural myths may keep women from reliable pain management
(June 4, 2014)
It’s one of the most effective, safest and widely used forms of pain management for women in labor, yet there are misconceptions about epidurals, a recent study shows. From fears of permanent back pain to allegations of potential harm to the baby, many women still harbor mistaken beliefs about epidurals.
“My own mother didn’t want me to have an epidural because she thought it would hurt my baby,” says Paloma Toledo, M.D., M.P.H., lead author of the study. “But when I showed her the overwhelming scientific evidence that it was safe for me and the baby, she felt good about my decision.”
More than 60 percent of women in labor use an epidural, spinal or combined spinal-epidural anesthesia for labor, according to the National Center for Health Statistics. It is becoming increasingly rare to use spinal anesthesia for delivery alone, but combined spinal-epidurals are becoming quite common, according to the American Society of Anesthesiologists (ASA). To administer an epidural, a physician anesthesiologist inserts a needle and tiny tube (catheter) in your lower back and delivers medication to continuously relieve pain below your belly button. Spinal anesthesia is a one-time injection of pain medication.
Toledo, an obstetric physician anesthesiologist and assistant professor of anesthesiology at Northwestern University Feinberg School of Medicine, Chicago, frequently hears concerns and misconceptions about epidurals. With the ASA, she offers the truth behind some common myths:
Myth: Epidurals can cause permanent back pain or paralysis in the mother.
Fact: Serious complications from an epidural, including paralysis, are extremely rare. Some women have discomfort in the lower back (where the catheter was inserted) for a few hours or days after the epidural, but it doesn’t last.
Myth: Epidurals can harm the baby.
Fact: In Toledo’s study, published last year in the “International Journal of Obstetric Anesthesia,” women expressed concern that an epidural could cause cerebral palsy or be harmful to the baby. No evidence or research corroborates these concerns. Additionally, the amount of medication that reaches the baby from the epidural is so small it doesn’t cause harm.
Myth: Epidurals can slow down labor or increase the risk of having a cesarean section (C-section).
Fact: There is no credible evidence that an epidural slows down labor or increases your risk of having a C-section. If a woman has a C-section, other factors usually are at play, including having a very large baby or slow progression of labor due to other issues. In fact, there is evidence that epidurals can speed the first stage of labor for some women.
Myth: An epidural can interfere with the birth experience.
Fact: Some women express fear that their legs will be numb and they won’t be able to walk, feel a contraction or push properly. In fact, your legs should not be so numb that you do not feel them. You may be able to walk after an epidural, depending on the hospital’s policy; however, walking generally is not recommended immediately after the epidural is placed. Epidural procedures have improved significantly in the last 20 years, and you’ll receive enough medication to relieve the pain without taking away your ability to move. Furthermore, the epidural medications will not cause you to be groggy or tired. In other words, you’ll be able to feel contractions – they just won’t hurt – and you’ll be able to push effectively.
Myth: There’s a limited window of time when you can get an epidural.
Fact: You can get an epidural any time during your labor – in the beginning, the middle or even toward the end.
THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.
For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGYTM 2014 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES2014.