time from whenever your cervix is completely dilated to the time that the baby comes out, it can lengthen that amount of time. So overall, yes and no. It can shorten it, or it can extend it, but overall, it’s not a significant thing. 6 What are some of the risks and side effects? Dr. Wiley: Overall, epidurals are pretty safe. There’s a low risk of morbidity and mortality as far as mom is concerned. We think about common side effects with epidurals with things like headaches, some- times we’ll see the baby’s heart rate change, or the baby’s heart rate decrease. Even with the baby’s heart rate decreasing, there’s no increased risk of having a C-section. Itching is also commonly seen. We think about other things like the serious risks that are associated with them; it’s very rare, this is like less than 1 percent. We think about things like blood clots inside the
spine, and that’s where we kind of go back to not wanting people who have low platelets or who’ve been on blood thinners to get them. We also think about infection, so the women who’ve had infections and what- not around their back. And nerve damage, I feel like that’s one of the big, scary ones. Everyone has heard of someone who has been paralyzed from an epidural, and that is so, so rare. A lot of times if we see any- thing like nerve damage, it’s very temporary and resolves within a few days. 7 Can epidurals not work on everyone? Dr. Wiley: That can happen, and that also is one of the more rare things. Things we think about when that needle and that catheter are placed, like let’s say it’s not placed in the right spot, or if it were to move out of place, then that would be a reason for it not to work. Let’s say a woman comes in and her cervix is changing rapidly and she’s headed
towards like a quick delivery, some- times you might not have enough time for the epidural to actually kick in. Sometimes we’ll see, just de- pending on the position of the baby, because the epidural is working to decrease pain in a specific area, some people will talk about if your baby’s coming out sunny side up then you might feel like more pres- sure in back and more pain from the epidural because it may not work as well. 8 Are there other options for pain relief? Dr. Wiley: Some data says over 60 percent of women currently in the U.S. get epidurals. We know that is the most effective method of pain control, and it is overall safe. Other than epidurals, there are some other options, like IV pain medicines, and nitrous oxide, like laughing gas. There’s some local blocks we’ll do in the vagina, that’ll kind of help, but we know overall, epidurals are the most effective form of pain meds.
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