Planning on getting an epidural? What does the process entail? Well, get the inside scoop from a Labor and Delivery nurse.
Read the disclaimer.
What is an Epidural? Read here.
Ok so here is the thing. The pain is different. It isn’t the same pain as contractions (if that makes sense). You should feel pressure and some mild cramping. We don’t want you to be a limp noodle. Why? We want you to be able to push and feel when it is time to push. We also would like a little help when we need to turn you. Our backs will thank you! But I promise, it will give you relief.
So what happens after I request an epidural?
The nurse will tell your provider, who in turn calls the anesthesiologist. Time between asking and getting the epidural is very dependent on the hospital. Usually it shouldn’t take more than an hour.
If you don’t have an IV, you’ll be getting one now.
Before the anesthesiologist comes, your nurse should be giving you a bolus of fluid.
Once the anesthesiologist arrives what happens?
A consent should be signed, they’ll go over the risks.
Your nurse will be hooking you up to everything. The fetal heart rate monitor should be on you at all times (if it hasn’t already been), along with the toco (measures contractions), a pulse oximeter, and a blood pressure cuff will be applied.
Make sure to listen to your anesthesiologist and nurse carefully as they will give you instructions on positioning for the epidural (usually a sitting position).
Now, I am not going to sugar coat things. Trying to stay still is hard during contractions. Just be as still as you can be.
Once you are in position they’ll clean your back off. Then they will tell you to push your back out. Sounds odd, but hug a pillow, tuck your chin into your chest, and curl around your baby.
Before the catheter goes into your back they will numb the area. This is the worst part about the whole thing. You may not even notice, as contractions are a lot worse than the little bee sting.
Once numbed up they will feel around to place the needle, it will go into your epidural space.
Then the anesthesiologist will thread a catheter into the epidural space. You may feel a “zing”, a very odd sensation that goes down one of your legs. If you feel this make sure to tell them. This just means it hit a nerve and the anesthesiologist will make an adjustment.
Next is a test dose to make certain that it is in the right spot. They will tell you to let them know if you have any strange symptoms like ringing in your ears or a metallic taste in your mouth.
Once confirmed the needle is removed. The anesthesiologist will tape the heck out of your back. You’ll get a free wax later, but all this tape is needed. This is to make sure the catheter doesn’t move.
Give the medication a few contractions to kick in, about twenty minutes. It isn’t instant (don’t we wish)!
Your nurse will then place a Foley catheter. You won’t be able to get up to pee anymore. Plus a full bladder can inhibit a baby from descending.
About baby descending. When this happens, baby blocks some of the medication from getting to certain nerves. This is a good thing. This means that baby is close to coming. Embrace it. It won’t be awful (not pain free), but we WANT you to feel this pressure. Again, as mentioned before we don’t want all your pain gone. A good epidural gives you some sensation. A bad epidural numbs you to the point where you have NO pressure feeling. Not cool.
What can go wrong?
Not that you know the steps, I will go over what can possibly go wrong. Rather you be informed and educated before you go in.
The catheter can migrate or in some cases pull out
The Anesthesiologist may miss the first try. Sometimes this could be due to how your positioned or the doctor’s skill.
Some people have a “window”. This just means there is an area where the nerves are bundled and the medication can’t get to that area.
Anatomy can play a huge role. Some people’s anatomy is different. One person may get no relief while one may get good pain control
Once your epidural is in communicate with your nurse. If you are still feeling pain after it is placed, speak up. It won’t be INSTANT pain relief. It should start to decrease after a handful of contractions, about twenty minutes.
When you feel that pressure tell your nurse. I am not exaggerating when I say this, but we want to KNOW EVERYTHING.
Do you have any questions regarding the process? Or other questions related to the epidural? Feel free to comment below or e-mail me at firstname.lastname@example.org