ASK DR NOVOA – I was thinking of getting an epidural when I am in labor, but I was told it will increase my chances of a C/S and can cause permanent damage to my back. Is this true?

Generally speaking, NO and NO.

The epidural, short for epidural analgesia, is a procedure where a small catheter is placed in the epidural space of the back. Once placed, both pain medication and anesthesia can be given over a number of hours or even days.

For most women, it can mean the difference between smiling through their contractions or suffering for hours until they deliver their baby.

In general, greater than 95% of women will request the epidural for pain management. Unlike oral, intravenous or intramuscular medication, which will eventually enter the bloodstream of the baby, the epidural does not cause the transmission of these types of drugs to the baby.

Some studies have suggested that the use of the epidural can increase the length of labor and increases the risk of C/S. However, when your OB follows the recommended guidelines for labor management, there is very little risk of complications.

Many women believe that the epidural causes permanent or chronic back pain. This can occur but is not due to the actual placement of the epidural line, but, rather, on back injury sustained when moving or straining while pushing without sensing pain. The easiest way to understand this is that the epidural can allow you to literally put your foot behind your head without feeling pain. When you can do this, there are no warning signs being sent from your back to your brain saying “Don’t Do This”. Therefore, it is very easy to injure your back without even knowing it while the epidural is working.

If you are interested in statistics, the risk of neurological injury or paralysis from an epidural is 1/250,000. The risk of death is 1/100,000.

Despite this, the epidural is extremely safe and is highly recommended in order to help a woman avoid the intense pain of labor and enjoy her labor with a smile.

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Filed under Blog, Obstetrics, Questions of the Day

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