How can epidural affect baby

However, labor is inhibited by very high CA levels, which may be released when the laboring woman feels hungry, cold, fearful, or unsafe. However, a reduction in the final CA surge may contribute to the difficulty that women laboring with an epidural can experience in pushing out their babies, and the increased risk of instrumental delivery forceps and vacuum that accompanies the use of an epidural see below.

On average, the first stage of labor is 26 minutes longer in women who use an epidural, and the second, pushing stage is 15 minutes longer. When an epidural is in place, the baby is four times more likely to be persistently posterior POP or face up in the final stages of labor—in one study, 13 percent compared to 3 percent for women without an epidural. In one study, only 26 percent of first-time mothers and 57 percent of experienced mothers with POP babies experienced a SVD; the remaining mothers had an instrumental birth forceps or vacuum or a cesarean.

Anesthetists have hoped that a low-dose or combined spinal epidural would reduce the chances of an instrumental delivery, but the improvement seems to be modest. In one study, the Conventional Obstetric Mobile Epidural Trial COMET , 37 percent of women with a conventional epidural experienced instrumental births, compared with 29 percent of women using low-dose epidurals and 28 percent of women using CSEs.

For the baby, instrumental delivery can increase the short-term risks of bruising, facial injury, displacement of the skull bones, and cephalohematoma blood clot under the scalp. Women laboring with an epidural in place are almost three times more likely to be administered Pitocin. In one Australian survey, about half of first-time mothers who were administered both an epidural and Pitocin had an operative delivery. The impact of epidurals on the risk of cesarean is controversial; differing recent reviews suggest no increased risk 31 and an increase in risk of 50 percent.

Note that the studies used to arrive at these conclusions are mostly randomized controlled trials in which the women who agree to participate are randomly assigned to either epidural or non-epidural pain relief. Non-epidural pain relief usually involves the adminstration of opiates such as meperidine pethidine. Many of these studies are flawed from high rates of crossover—women who were assigned to nonepidurals but who ultimately did have epidurals, and vice versa.

Also, note that there are no true controls—that is, women who are not using any form of pain relief—these studies cannot tell us about the impact of epidurals compared to birth without analgesic drugs. These range from minor to life-threatening and depend, to some extent, on the specific drugs used. The most common side effect of epidurals is a drop in blood pressure.

This effect is almost universal, and usually preempted by administering IV fluids before placing an epidural. Hypotension can be treated with more IV fluids and, if severe, with injections of epinephrine adrenaline.

Other common side effects of epidurals include: inability to pass urine and requirement for a urinary catheter for up to two-thirds of women; 38 itching of the skin pruritus for up to two-thirds of women administered an opiate drug via epidural; 39 , 40 shivering for up to one in three women; 41 sedation for around one in five women; 42 and nausea and vomiting for one in 20 women.

Epidurals can also cause a rise in temperature in laboring women. Fever over Opiate drugs, especially administered as spinals, can sometimes cause unexpected breathing difficulties for the mother, which may come on hours after birth and may progress to have serious effects. Many observational studies have found an association between epidural use and bleeding after birth postpartum hemorrhage.

An epidural gives inadequate pain relief for 10 to 15 percent of women, 55 and the epidural catheter needs to be reinserted in about 5 percent. More serious side effects are rare. If the epidural drugs are inadvertently injected into the bloodstream, local anesthetics can cause toxic effects such as slurred speech, drowsiness, and, at high doses, convulsions.

This occurs in around one in 2, epidural insertions. Later complications include weakness and numbness in 4 to 18 per 10, women, most of which resolve spontaneously within three months.

Some of the most significant and well-documented side effects for the unborn baby fetus and newborn derive from effects on the mother. These include, as mentioned above, effects on her hormonal orchestration, blood pressure, and temperature regulation.

For example, epidurals can cause changes in the fetal heart rate FHR that indicate that the unborn baby is lacking blood and oxygen. This effect is well known to occur soon after the administration of an epidural usually within the first 30 minutes , can last for 20 minutes, and is particularly likely following the use of opiate drugs administered via epidural and spinal.

Most of these changes in FHR will resolve spontaneously, with a change in position, or, more rarely, may require drug treatment. Note also that the use of opiate drugs for labor analgesia can also cause FHR abnormalities.

This makes the real effects of epidurals on FHR hard to assess because, in almost all randomized trials, epidurals are compared with meperidine or other opiate drugs. One researcher notes that the supine position lying on the back may contribute significantly to hypotension and FHR abnormalities when an epidural is in place. In one large study of first-time mothers, babies born to febrile mothers, 97 percent of whom had received epidurals, were more likely at birth to be in poor condition low Apgar score ; to have poor tone; to require resuscitation Maternal fever in labor can also directly cause problems for the newborn.

Because fever can be a sign of infection involving the uterus, babies born to febrile mothers are almost always evaluated for infection sepsis. Sepsis evaluation involves prolonged separation from the mother, admission to special care, invasive tests, and, most likely, administration of antibiotics until tests results are available.

Some epidural medicine does reach the baby. But it's much less than what a baby would get if the mother had pain medicines through an IV or general anesthesia. The risks of an epidural to the baby are minimal, but include possible distress. Usually, this means the mother's lowered blood pressure causes a slower heartbeat in the baby.

You may shiver a little after your baby is born which is common with or without an epidural. Your legs might be numb and tingly as the medicine wears off, which may take a little while. So you might not be able to walk around for at least a few hours after the birth. Even after that, ask someone to help you until your legs feel back to normal. If you had a C-section, the doctor may continue the epidural for a while after the delivery to control any pain.

Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study. Br J Obstet Gynaecol 6 : J Am Board Fam Pract 16 1 :7— Anesthesiology 6 — Clin Nurs Res 22 3 — J Hum Lact 32 3 : J Matern Fetal Neonatal Med 27 15 — J Perinatol 23 6 — Br J Obstet Gynaecol 90 3 — J Pediatr 5 — J Perinat Med 40 6 — Microbiology Pt 11 — Obstet Gynecol 3 — This can increase your chance of needing interventions, such as forceps, medication, or a C-section.

Research shows that perineal tears are more common in women who have epidurals. Other factors that increase your risk for perineal tear include:. You may experience some numbness in your lower half for a few hours after giving birth. Because of this, you may need to stay in bed until the numbness wears off. Having an epidural also increases your chances of needing a urinary catheter to empty your bladder.

This is only temporary. The urinary catheter can be removed once your numbness has resolved. Some evidence suggests that babies whose birth mothers have an epidural are more likely to develop respiratory distress immediately after birth. Though other studies have found no evidence of epidural usage increase risk for respiratory distress in babies. Talk to your doctor about any concerns you have about the safety of epidural for your baby before you begin labor.

Like with any medical procedures, there are pros and cons to consider. There are a number of factors that can determine what type of birth might be best for you.

Several factors can impact the level of pain you experience during delivery and childbirth. These factors may determine what, if any, medication is recommended:. It may be a good idea to come up with two birth plans. One plan can be your optimal plan. That can help you feel less caught off guard if plans need to change mid-labor. Work with your doctor or midwife to determine which options may be best for you.

Also called narcotics, these pain medications are given by injection or intravenously through an IV. It provides some pain relief while allowing you to remain awake and push.