Hospital birth with epidural
Name: Hospital birth with an epidural
What it is and how it works:
An epidural is an injection administered into the small of the back with a slightly terrifying-looking needle, which numbs the abdomen, pelvic area and (sometimes) legs.
Epidural analgesia is a commonly-used method of pain relief in labour in the U.K. and hospitals here tend to use low-dose epidurals - also known as mobile epidurals - so that sensation in legs and feet remains and the labouring mother can change positions.
What are the benefits:
It’s considered the most effective form of pain relief during childbirth. Also, an epidural works fairly quickly (20 minutes prep time and another 20 minutes to kick in), plus top-ups are administered as necessary. Epidurals don’t cloud judgement and have the added benefit of lowering blood pressure.
What are the negatives:
They don’t always work according to plan, so only part of your tummy might get numb. More monitoring of both the fetal heartbeat and mum’s blood pressure is required, and other side effects include itching, shivering, headache and fever.
According to the Royal College of Midwives, other potential negatives include a longer second stage of labour, a higher chance of fetal malpositioning (which makes an instrumental delivery with forceps or vontouse more likely), the retention of urine during labour (requiring a catheter) and post-natally, perineal trauma. Finally - and this is very rare - there is some risk of either temporary or permanent nerve damage.
Are there cost implications?:
Epidurals are free on the NHS but can cost hundreds of pounds in private clinics (For example, at London’s Portland Hospital, epidurals are £750, plus £50 per top-up, which covers the cost of the anaesthetist and the drugs).
Available on private/NHS/both?:
Yes, but epidurals are unlikely to be available in birth centres, aren’t available at home and are also not an option in midwife-led maternity units of hospitals (you have to transfer to obstetric-led units).
Caroline Flint, midwife, The Birth Centre
'It’s a very good form of pain relief, but it can slow labour down and does have an effect on the body. It can affect the muscles of the lower pelvis which increases the need for a c-section and forceps. But, it may be worth it on the day because it is the most effective form of pain relief.'
Dr. Pat O’Brien, obstetrician, University College London Hospitals
'It’s the best form of pain relief, takes the pain away completely and is also safe for the baby. Nowadays many hospitals are using the mobile epidural, which means you can still walk around and push well.'
Image © Polka Dot