Procedures Explained

Procedure Epidural anesthesia
What Is It? Regional anesthesia of lower two-thirds of body
Who Needs It? Women who do not have access to comfort measures and are not able to tolerate or don't want to tolerate the pain of labor
Who Doesn't Need It Women with continuous support and access to a wide variety of comfort measures and maternal positions; women with blood-clotting problems
Risks 1. Decrease in maternal blood pressure
2. Decrease in fetal heart rate
3. Lack of variability in fetal heart rate
4. Urinary retention requiring catheterization
5. Increase in chance for urinary infection
6. Itching if intrathecal narcotics used
7. Prolonged labor
8. Increase in need for instrumental delivery via forceps or vacuum aspiration
9. Reported increase (in some studies) of cesarean section (two to fourfold), especially in first-time mothers
10. Increase in need for episiotomy
11. Headache
12. Respiratory arrest or paralysis in rare cases
13. Increase in labor interventions
14. Infection
15. Ineffective pain relief
15. Increase in maternal temperature
16. Breastfeeding difficulties
Benefit Pain relief when other comfort measures are ineffective or when a cesarean section is needed

Note: Research suggests the use of these procedures in a routine way creates unnecessary risks for mother and baby. At the same time, there are clear indications for the use of most procedures when a medical complication arises. In the case of epidural anesthesia, when other comfort measures are either unavailable or ineffective.

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