Advantages and Disadvantages of Epidural Anesthesia for Child Birth

FMST 316

John Cringan

David Wai Yeung Tai #64358062

The Advantages and Disadvantages of Epidural Anesthesia for Child Birth

Childbirth is a great event because it brings new life into the world. However, it is often accompanied by severe and prolonged pain which many women are afraid of. Therefore, more and more women are looking for ways to minimize or eliminate discomfort during childbirth. Some women hire doulas, who give non-medical support during childbirth (Wikipedia, 2010). Other women turn to medical drugs which physically reduce their pains during contractions and labor. Epidural anesthesia has been commonly used in the past 50 years to reduce pain in childbirth (Simkin, 2010). This medication is very popular because the mother remains awake during the whole labor process, so that she can still participate during the birth of her baby (Weiss, 2010). However, like many other medications, it carries risks (Weiss, 2010). Many women are still willing to take the risks because of the pain relief effect.

Position one supporters contend that epidural anesthesia is advantageous to women during childbirth. Whereas supporters of position two believe that epidural anesthesia is disadvantageous because of the health risks associated with it.

Epidural anesthesia has many benefits. It effectively reduces labor pain and allows the mother to relax or sleep during contractions (Simkin, 2010). Some women become very anxious during labor because of the pain they get. This can lead to prolonged labor because anxiety increases stress hormones such as epinephrine and norepinephrine which slow down contractions (Simkin, 2010). Research has shown that the use of epidural anesthesia during labor reduces the levels of epinephrine by 50 percent (Shnider, Abboud, Artal, Henriksen, Stefani, & Levinson, 1980). It also reduces the levels of norepinephrine by about 25 percent. Therefore, epidural allows mothers to stay calm as it reduces their physical and psychological stress during contractions (Shnider et al., 1980). As a result, epidural sometimes speeds up the first stage of labor. In addition, epidural is also beneficial to the mothers who have hypotension because it often lowers blood pressure (Simkin, 2010). Inadequate pain relief during labor can have a negative effect on the woman (Halpern, Leighton, Ohisson, Barrett, & Rice, 1998). Women are more likely to have postpartum depression if her delivery was very painful or stressful (Halpern et al., 1998). Therefore, the satisfaction that a woman gets from epidural can reduce her chance of getting posttraumatic stress disorder. Some women are worried about that the use of epidural anesthesia in labor will cause postpartum low back pain. A prospective follow-up study was done to show whether epidural anesthesia was associated with postpartum low back pain one year after delivery (Macarthur, Macarthur, & Weeks, 1997). The study has shown that the women who received epidural during labor did not have more back pain problems than the women who did not. Furthermore, this study has also shown that women who received epidural during labor did not have more interference with activities than the women who did not. Another advantage of epidural anesthesia is that it reduces labor pain without reducing the movement of the mother (Simkin, 2010). The mother can move easily and change to comfortable positions during contractions while not feeling any pain (Simkin, 2010).

However, epidural anesthesia carries risks to the mother and the infant. Sometimes the use of epidural anesthesia might accidentally cause spinal block, which leads to spinal headache (Simkin, 2010). The mother then needs to stay in bed for days and sometimes a blood patch is needed. Epidural also causes retention of urine (Simkin, 2010). As a result, the mother needs a bladder catheter to urinate which could be very painful. In addition, epidural may lead to prolonged labor; this is because the woman does not feel pain anymore, she does not know when to push the baby through the birth canal (Rathus, Nevid, Rathus, & Herold, 2009). Furthermore, the pelvic muscles will be less powerful (Bawngarder, Muehl, Fischer, & Pribbenow, 2003). This is why vacuum extractor and forceps are often used when epidural is given to the mother (Simkin, 2010). Moreover, epidural anesthesia crosses the placental membrane, so it affects the newborn as well (Rathus et al., 2009). Studies have shown that there is a decrease in muscle strength and tone in newborns whose mothers had received