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By Amanda Miller Demystifying Epidurals 8 Common Questions Answered
brain lesion, like a brain tumor or something like that, where entering into that space of place, an epidural would cause increased pressure. 3 Can it be “too late” to receive an epidural? Dr. Wiley: I usually tell my patients, as long as you can sit still, you can get an epidural. So, if you can’t sit up and sit still because the baby’s coming out, it’s a little too late, but you could be any dilation to get an epidural. 4 How long will epidurals last? Dr. Wiley: When epidurals are placed, the anesthesiologist puts the needle in, they put the medicine in, and they leave a little catheter in the back, and basically, that continues to infuse medicine. An epidural can last the entire length of a woman’s labor. 5 Will epidurals slow down labor? Dr. Wiley: Overall, no. There is some evidence that says that getting an epidural can actually shorten the time from when your cervix starts dilating to the time when you’re complete. An epidural can actually make that length of time shorter, because you’re more relaxed. The time from whenever your cervix is
W hen it comes to putting together a birth plan, many moms-to-be opt to factor in an epidural. For those moms who are still undecided and want to learn more about epidurals, Dr. Lorene Wiley, OB/ GYN and Medical Director for OB/ GYN at Baton Rouge General and teacher with the Family Medicine Residency Program, provides insight into common questions and concerns when it comes to epidurals. 1 What does an epidural do? Dr. Lorene Wiley: An epidural is a form of regional anesthesia, or neuraxial anesthesia, in which a needle is placed through the vertebrae or the bones in your back, and medicine is administered through that needle to deliver pain relief in labor. The medicine that’s in the epidural is a combination of a local anesthetic and usually an opioid. This acts to give pain relief to a woman in labor.
2 Can anyone receive an epidural? Dr. Wiley: Yes and no. Epidurals are appropriate and should be offered to laboring women, regardless of how many babies they’ve had, how far dilated they are, or how high up in the birth canal the baby is, unless there’s a true contraindication to it. Commonly, contraindications are rare, but the things that are really important are women who have bleeding disorders. We also think about women who have coagulopathies, low platelets, and there are cut-offs for how high your platelets or blood counts have to be to be able to get an epidural. If a woman’s recently taken blood thinners, those blood thinner injection theories on why a woman wouldn’t be able to get one depending on the timing of when she’s had one. If someone were to have a big infection, like over the back or in the area where we will want to place the epidural, that will also be a contraindication. If someone had some type of
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PINK&BLUE | SPRING 2024
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