How you wish to manage your pain is always your choice. You will not be forced to get an epidural or use IV pain medication. However, some patients have medical problems that make an epidural a safer anesthesia choice if they need an emergency C-section delivery. Depending on your situation, the anesthesia physician who sees you may suggest that it will be safer for you to get an epidural.
Even if you do not want pain relief during labor, someone from the anesthesia team will talk to you about your medical history. They will also do a brief physical exam. This is done for all patients in the Labor and Delivery Unit so that we are prepared in case of an emergency.
Someone from the anesthesia team will talk to you within an hour after you arrive in the Labor and Delivery Unit. The timing of your epidural is up to you and your obstetrician or midwife.
You will get pain medication through the epidural until you have your baby. You will also have a small button that you can press to give yourself more medication if you are having pain. Most patients press the button at least once each hour.
The epidural medication is given through a pump. The pump is set so that you cannot give yourself too much medication.
Your blood pressure will be checked at least every 30 minutes during the rest of your labor.
Even with an epidural, you may feel pressure as the baby moves and you get closer to your delivery. When you feel this pressure, it does not mean that the epidural is not working. In fact, it is often helpful to feel that pressure so you know when and how to push when the time comes.
The anesthesia team is available 24 hours a day, 7 days a week. They will stop by and see you every few hours during your labor. They will also come see you if you feel that your pain is not well controlled.
Many studies have shown that epidurals are very safe for both you and your baby. Like any medical procedure, epidurals have some risks and side effects that you should know about:
- Low blood pressure (common)
- Itching (common)
- Shivering (common)
- Nausea and vomiting (rare)
- Headache (rare)
- Bleeding (extremely rare)
- Infection (extremely rare)
- Injury to the spine or nerves (extremely rare)
Studies have shown that getting an epidural does not raise your chances of needing a C-section. But, it may lengthen the time it takes to push the baby out.
If you need a C-section and have an epidural, the anesthesia physician can usually give you more medicine through the epidural to prepare you for your surgery and allow you to stay awake for the birth of your baby. You will not feel the pain of surgery, but you may feel pressure, especially with the delivery of the baby.
Sometimes, if your obstetrician needs to do the C-section right away (in an emergency), there is not enough time for you to fully feel numb. In that case, you may have to have general anesthesia and be asleep for the C-section.
If you are having a scheduled C-section, you will usually have spinal anesthesia.
The spinal anesthesia procedure is very much like the epidural procedure, but you only receive one dose of medication that lasts for up to two hours. This way you will be very numb for the surgery and be awake when your baby is born. You will not feel the pain of surgery but you may feel pressure, especially with the delivery of the baby.
The spinal or epidural procedures that most patients receive typically provide pain relief that lasts 12 or more hours. IV pain medications are also offered if needed.
On the day after your C-section, you will start to receive pain medications by mouth. Your provider will decide at the time of discharge which pain medicines you will need at home.