Here midwife Anne Rickley explains what an epidural is and how it can provide pain relief in labour as well as giving details about the potential risks there are of having one...
What is an epidural?There are two types of epidural: traditional and mobile. Also known as a low-dose epidural, a mobile one is similar to an ordinary epidural except that some women are able to walk around, with help. For others, it just means that they're able to move their legs and change position on the bed.
If a woman has feeling in her legs, it may mean she can pass urine without needing a catheter (a tube inserted into the bladder to drain off pee). Traditional epidurals use a strong anaesthetic that numbs the lower half of the body, leaving little muscle control. Because of this, labour can be longer and may require more medical intervention such as forceps. Whether you have a mobile or traditional epidural will depend on what your hospital offers.
How is an epidural given?
A mobile epidural is given in the same way as a traditional one. Anaesthetic is injected through a hollow needle into the space just outside the outer membrane around the spinal cord. A plastic tube is fed through the needle, then the needle is removed and the anaesthetic continues to be administered through the remaining tube. The midwife can top this up as the effects wear off, or it can be given continually through an infusion pump.
Some hospitals offer PCA (patient-controlled analgesia), so the mum-to-be can press a button to automatically top up the epidural as she needs it. It's controlled so that the mum-to-be can't give herself too much.
Initially, your doctor will want you to lie on your left side with your knees curled up towards your chest or will ask you to sit on the edge of the bed, with your feet resting on a chair and your chin tucked onto your chest.
It's very important that the injection goes into the right space, so it's essential for you to keep still as it's being administered (easier said than done if you're having contractions). Your midwife will be with you and will make sure that the anaesthetist doing the procedure is aware of when you have a contraction so that he can pause.
The main difference between a mobile and traditional epidural is the drugs used. Mobile epidurals use a much lower dose of anaesthetic in combination with a pain-killing medication.
The nerves to the bladder, abdominal and leg muscles aren't totally blocked, but it does work in different ways on different women, some can sit up and shift their position, while others can walk around with supervision.