Definition
Epidural anaesthesia (PDA) is an anaesthetic of the abdominal and pelvic area, which is used if desired during childbirth, especially in cases of severe pain during birth. Unlike spinal anaesthesia, epidural anaesthesia does not completely eliminate motor functions, i.e. the patient can usually still move her legs, albeit with restrictions. In epidural surgery, the anesthetic is injected into the epidural space, the space between the vertebral bodies and the hard skin of the spinal cord, and thus not directly into the spinal cord or spinal fluid.
When must epidural anaesthesia be given before birth?
The PDA is usually placed at the request of the expectant mother. In most cases, the decision can be made spontaneously if the pain of the contractions is felt to be unbearable for the patient. However, it is advisable to at least inform the doctor about the risks and the procedure before the onset of labor or at the beginning of labor if an epidural is a possibility.
In this way, the information can be explained in a more relaxed environment, questions can be clarified and the anesthesia can be set quickly in case of emergency. A prerequisite for the insertion of an epidural is that the patient can remain still for several minutes despite the contractions. The entire procedure of the epidural takes 10 minutes on average. A pause in labor is used to place the catheter to ensure that the patient is relaxed and does not move. Since the effect occurs after a few minutes and reaches its maximum after about 15 minutes, the epidural can theoretically be placed at any time before birth, as long as the actual birth process (expulsion phase) has not yet begun.
What are the risks for my child?
Like any anesthetic that the patient takes during pregnancy and birth, the anesthetic of the epidural enters the child’s bloodstream via the umbilical cord and placenta. This can cause the child to be more sleepy after birth than children born without an epidural. As a rule, however, the epidural is well tolerated by the newborn baby and has fewer side effects than, for example, a general anesthetic.
However, since births under an epidural take a little longer on average, the birth itself can be more stressful for the child. In addition, an epidural makes it more difficult for some children to turn into the correct birth position, so that more so-called “stargazers” are born, children who are born face up instead of face down. This birth position can lead to bruising of the child and the birth must be supported more often than in the normal position by means of a suction cup or forceps. This can also lead to bruising and swelling, especially in the head area of the child, but in most cases these disappear after a few days.
