Epidural Anesthesia in Normal Vaginal Delivery

Risks of Epidural Anesthesia in Normal Vaginal Delivery Outweighs the Benefits

Epidural anesthesia refers to an anesthetic procedure delivered through a catheter (small tube) into a space outside the spinal cord known as the epidural space. The main use of the catheter is to aid in infusing a solution, which usually contains a local anesthetic and a narcotic. The local anesthetics commonly used are bupivacaine and ropivacaine. These anesthetics when mixed with a required dose of the narcotic fentanyl, makes the appropriate solution used in the procedure. When the solution passes through the small catheter, it blocks the nerve roots found in the spinal cord, and the sympathetic nerves in the epidural space. Depending on the placement of where the catheter is, epidural analgesia may help in relieving pain associated with the chest, abdominal, and lower extremity surgery (Akbas, Mert and Akcan, a Baris, 2010 p. 45-49).

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According to Akbas, Mert and Akcan, a Baris, (2010, p. 45-49), the main aim of epidural was to relieve pain for women undergoing the caesarean section for delivery; however, its incorporation in normal delivery is what has raised concern. This means its purpose has lost meaning. There is no need to run away from a normal delivery if a pregnant woman can undergo the ordeal without medical interventions. Epidural as a pain relief is becoming a popular choice for women in the labor ward in the globe today. This procedure is commonly an alternative for women who are to have their first delivery. For those women who give birth through the caesarean section, epidurals are certainly the best option to general anesthetic allowing women to see their born babies, and subsequently breastfeed at that early stage. For women who are willing to practice this procedure during a normal birth, the practice becomes an issue of discussion.

The block caused by the solution used in the epidural procedure increases the risk of urinary catheterization in labor. The mobile epidurals that use the low dose of the local anesthetic in combination with opioid preserve in maternal mobility may reduce the risk of bladder dysfunction. It was clear that women who had epidurals had the ability to void urine spontaneously at any time (Wilson, MacArthur, and Shennan 2009, p. 97-103). Another risk is the drop in blood pressure. Dropping of the mother’s blood pressure during a normal birth will result to a decrease on the availability of blood needed in the placenta and can lead to drop of oxygen gas needed by the baby. This is very risky. When such an important ingredient for a normal delivery to lack or is inadequate during delivery, it only means a loss of life. Awareness is what pregnant women need to comprehend the risks associated in full. Afterwards, every woman will have a decision to make out of knowledge.

According to Epstein (2013, p. 74-93) Pain specialists, including anesthesiologists will continue to perform epidural spinal injections to pregnant women. However, research reveals that these injections expose the women with medical interventions during childbirth or without to significant morbidity and even mortality. In addition, it is not apparent whether the injections may relieve pain, but for those without surgical lesions the injections may delay requisite surgery and result to permanent neurological deficits. It is evident that some risks associated with infectious epidural steroid injections result to fatal meningitis, but those performing epidural do not make pregnant women opting for epidural aware. I feel that such risks are matters of life and death and women must know them before considering epidurals. In addition, there are common risks of these injections. They include; increased neurological deterioration, paralysis, and quadriplegia Epstein (2013, p. 74-93).

All these researches provide information on the risks of epidurals in different aspects. The epidural procedure may also affect the child. The drugs administered to the mother directly enter the child. The levels may be as high as those of the mother may, and because of the immature liver of the baby, the drugs may take a long time to clear from the baby’s body. The baby may experience rapid breathing within the few first hours and prone to low blood sugar levels. Again, some studies have shown that some children develop deficits related to these drugs used in epidurals. This suggests that the drugs have significant effects on the child and may lead to cancer in children (Gwen Lewis 2010, p.30). Having done all this research on epidurals, it is not worth it to practice such a procedure whose risks outweigh the benefits

Another study provided varied information but similar to research on this paper it describes the risks associated with epidurals. This study involved women undergoing epidural anesthesia during labor time, in order to determine whether morbid obesity was in any way associated with increased hypotension, or fetal heart rate abnormalities after epidurals. The study revealed that morbidly obese women had hypotension. In addition, they had prolonged fetal heart rates following epidural anesthesia during labor term. Still health practitioners will proceed with such a practice intentionally although they know the effects associated. There is no greater sin than an intentional one. It is time for these medics to change and preach normal delivery without intervention if the woman is health and okay (Laura et. al 2011, p. 370).

References

Akbas, Mert and Akcan, a Baris, “Epidural analgesia and lactation,” Eurasian Journal of Medicine 43, (2010): 45-49.

Wilson, M. J, MacArthur, C, and Shennan, a. “Catheterization in labor with high dose vs. mobile Epidural analgesia: a randomized controlled trial.” British Journal of Anesthesia 102, no. 2 (2009): 97-103.

Epstein, Nancy, “The risks of epidural and transforominal steroid injections in the spine: commentary and a comprehensive review of literature,” Surgical Neurology International 4, (2013): 74-93.

Gwen Lewis, “Epidurals and child cancer,” Journal of Childbirth and Medical Research, (2010): 30.

Laura K. Vircella, Judette M. Louis, Brian M. Mercer, Norman Bolden. “Impact of Morbid

Obesity on epidural anesthesia complications in labor.” American Journal of Obstetrics and Gynecology 205, no. 4 (2011): 370.


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