Today on this Mini-Webinar I give an overview of that most sought-after of childbirth Labor pain relief: The Epidural. So really WHY does it increase the chances of needing a traumatic emergency Instrumental delivery (forceps/ventouse) or dramatic Surgical delivery (C-Section). I overview these common consequences from “Failure to progress”, “Obstructed labor” and “Fetal distress”.
Kathy Fray is an award-winning best-selling parenting author, passionate promoter of mothers-to-be accessing empowering maternity education, holistically-minded Midwife, and thought-leader of Integrative Maternity Healthcare information.
"Hi everybody! Its Kathy Fray here from MotherWise and welcome to another webinar podcast and today I'm gonna talk to you briefly about epidurals. These are obviously very commonly used as part of childbirth anesthesia. The interesting thing about them, well there's lots of interesting things, but epidurals were not designed for childbirth. It was just childbirth adapted a surgical form of anesthesia and spinal anesthesia basically and thought well we could use this for childbirth. I think that's important to just bear in mind. It's not designed for childbirth. It's something we've adapted.
Epidurals definitely do increase your chances of needing an instrumental assisted delivery so that's a one-two soft forcep delivery and they also increase your chances of needing a c-section or surgical delivery because of either failure to progress in the labor dilatation or failure to progress in the descent of the baby with a pushing stage or fetal distress. Now the reason that those things all occur are kind of obviously a little complicated, but to give it in the most simplest of terms, it's really because officially the fetal distress tends to come because the whole labor is lengthened, right. When you start the process of having an epidural by the time it's sort of you get your blood done, and then the obstetrician approves of it and the mother is consented for it, and the anesthetist actually arrives and gets it cited and gets it on board and then she needs her blood pressure down every five minutes for the first little while to make sure that she's okay from hypotension which is a respecter individuals and then it takes a good sort of fun 10, 20, 30 minutes to actually confirm it. When all of that has happened typically you know like an hour and a half has gone by or so and at that point her contractions have petered away. She then needs an oxytocin drop usually to get going again, to get those contractions happening again properly. So now that baby has had two and a half hours of extra labor without actually having extra dilatation of progress of the cervix opening up.
So babies have had a bit more labor than ideally, it would have liked and then what happens is that once you get to that stage when you're fully dilated and you start pushing, because a lot of women on epidurals have been lying horizontally, they have a higher risk of the baby being in a posterior line instead an anterior line just because of gravity being involved. She's lying back instead of leaning forward which is what she will naturally do when she's in labor without an epidural. The baby also often has not flexed the head well, so instead of being like this, they're like that and that's not really conducive to them descending. Often once the woman is fully dilated, then she's given another hour or two for what we call the phase of descent and just allowing that baby just to come down but lower into her pelvis, before she starts to push which would happen a lot quicker. Without an epidural that might only happen within a few minutes.
We give a longer time when there's an epidural on board. Then usually once that woman is what we call it spines or plus one, we get her to start pushing, and the pushing can take longer with an epidural or so that can sort of add up to you know like, where you would say one or two hours for a first baby without an epidural and two to three hours with an epidural would be regarded as sort of normal, once she starts effective pushing.
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