When do you choose an epidural or spinal anesthesia?

Also read: Pain relief during labor: what are the options?

When to ask for an epidural?

• Don't wait until you are completely exhausted to ask for an epidural. First, an IV with fluids must be administered to prevent a sudden drop in blood pressure during epidural anesthesia. Furthermore, the anesthetist is not always immediately available, depending on the time and the workload in the operating room. Moreover, not every hospital has an anesthetist available 24/7.
• It takes some time (10-20 minutes) after the epidural is placed before you experience adequate pain relief.
• Towards the end of labour, insertion becomes more difficult and you will of course enjoy the pain-relieving effect for a shorter period of time.
• In the final stages of labor, epidural anesthesia can no longer be initiated.

Also read: Process, advantages and disadvantages of a water birth

When is it best not to have an epidural?

In some cases an epidural anesthesia is recommended.

• If the risk of a caesarean section is high for health reasons of the mother or child, or in the case of multiple births or a breech presentation. If a caesarean section is decided upon during delivery, the epidural catheter in the back can usually be used for anaesthesia.
• When the gynecologist expects a prolonged labor or a difficult delivery.
• If it concerns premature labor.
• When dilation stagnates in a pregnant woman who has difficulty coping with contractions.
• In case of a prolonged dilation phase, for example because the baby's head is in the wrong direction and needs to turn first.
• In case of high blood pressure or pre-eclampsia.
• In the case of a stillborn child.

Also read: Everything about the episiotomy during childbirth

When not an epidural?

Sometimes an epidural anesthesia is not possible.

• In women with an increased tendency to bleed due to a clotting disorder.
• In case of a local infection of the skin of the back or in case of a very serious generalized infection.
• In case of a proven allergy to the anesthetic used.
• After certain back surgeries, it may not be possible to use an epidural. Abnormalities of the back, such as scoliosis or a herniated disc, can make inserting a tube difficult, but do not rule it out.

Also read: Contractions: the different types and how to recognize them

Sources:
www.zol.be
www.gynaecologiebrugge.be
www.uzgent.be
www.knov.nl