Progress of Labor Initially, in some women, the epidural may slow the occurrence of contractions. If this occurs, time and/or medications will increase the strength and frequency of contractions. In other women, the administration of labor analgesia allows relaxation that may actually improve the progress of labor.
Effect on Baby Epidural analgesia is very safe for mothers and babies and research has shown little or no effect on the baby.
Contraindications to Regional Anesthesia Some women are not candidates for epidural or spinal anesthesia because of co-existing medical conditions. Women who have bleeding disorders should not receive regional anesthesia because the procedure can cause bleeding into the epidural space, which may cause nerve injury. Women with severe infection can also develop nerve injury after regional anesthesia because of the introduction of bacteria into the epidural space. Complicated back surgeries such as Harrington rods and spinal fusion can present unique challenges for the anesthesiologist and should be discussed in advance whenever possible. The anesthesiologist may need to request surgical notes or X-rays in advance of your labor. If you have a concern regarding one of these issues, we will be happy to consult with you on the phone or in person.
Risks of Regional Anesthesia Although uncommon, complications can be associated with regional anesthesia. The occurrence of a headache after epidural or spinal is approximately 1 percent. Sometimes these headaches can become severe, but they are treatable and have no long-term consequences. Nerve injuries from catheter placement, infection, or hematoma are exceedingly rare, but usually resolve spontaneously or with medical intervention. Rarely, an intravascular or spinal catheter may go undetected, which may have serious effects on the mother’s heart or respirations. This unlikely event is avoided by careful observation and use of a “test dose.” Shivering and backache can both be associated with epidural, but occur in laboring and postpartum patients without epidural as well.
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