“Walking” Epidurals

Excerpt from The Birth Book written by William Sears, M.D. and Martha Sears, R.N.

The newest epidural anesthesiologists have in their bag of pain relievers is one that relieves pain yet allows some movement.  This marvel is achieved by mixing a morphinelike narcotic (an analgesic) with an anesthetic, thereby reducing the dosage of anesthetic needed for pain relief.  As a result, the pain pathways are blocked but the motor nerves are partially spared.  Dubbed the “walking” epidural (though women are seldom able to walk during an epidural), this technique makes it possible for mothers to feel the urge to push and retain the ability to do so while still experiencing varying degrees of pain relief.  You and your doctor negotiate a balance:  how much pain relief you need versus how much movement you need.  Adding narcotics to the magic potion means that the onset of pain relief is more rapid (five to ten minutes versus ten to twenty minutes without the narcotic), lasts longer, and is better than the anesthetic agent alone.  With this new combination mothers supported by their birth partner can stand, squat, kneel, and push.  When only a narcotic analgesia is given, some mothers can even stand and walk with support.  However, epidurals using only narcotics are seldom effective in eliminating pain associated with labor.  And with anesthetic agents (those that numb sensations and take away the ability to move), mother must remain horizontal until her body has adjusted to the epidural, because of the danger of falling blood pressure if she is upright.  With the added narcotic analgesia there seems to be no more effects on baby than wil the anesthetic agent alone.  With these new combinations you get the best of both worlds:  pain relief and more active participation in birth.

~ by cmb0414 on August 3, 2010.

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