Tuesday, January 25, 2011

Epidural

What is it?

It's an injection into the small of your back, using a curved, hollow needle. A needle with a curved tip goes between the vertebrae of your back, and into the space outside the coverings that surround your spinal cord called the epidural space. A fine tubing (or catheter) is passed through the needle and then the needle is removed. The fine catheter is taped up your back and over your shoulder. The anaesthetist injects a local anaesthetic (similar to what you would have at the dentist) into the catheter to numb the lower part of your abdomen. Generally, your legs and feet go numb as well. You can't feel your contractions any longer.

Sometimes, the catheter is attached to a small pump, which allows the anaesthetist to control how much local anaesthetic you have, or the pump may be primed to release a small dose of the anaesthetic every so many minutes.




How does it work?

It works in just the same way as a local anaesthetic works when the dentist numbs your mouth before extracting a tooth. The anaesthetic deadens the nerves which are carrying pain signals from your womb and cervix.

When should I have it?

Theoretically, you could have an epidural at any point in labour, even in the second stage when you are pushing your baby out, although a spinal anaesthetic would probably be offered in that situation.

Most people, however, choose to have an epidural when the cervix is about five to six centimetres dilated and the contractions are getting stronger. If you are as much as eight or nine centimetres dilated, you may be told that it's too late for an epidural and advised to manage without because your baby would be born soon.

What are the advantages of epidurals?

• More than 90 per cent of women get complete pain relief.

• Your mind remains totally clear.

• Can help to control high blood pressure.

• Can put you back in control of your labour, and restore your confidence.

• Epidurals are more sophisticated than they used to be and you might find that your legs and feet are not completely numb.

What are the disadvantages?

• May find that you are numb down only one side of your body or that a small part of your tummy has not been anaesthetised.

• May make you feel very shivery.

• You have to stay in bed.

• You need to have a drip in your arm. This is because epidurals make some women's blood pressure drop which may seriously affect the flow of oxygen to the baby. The drip is a safety precaution so that, in an emergency, the volume of your blood can be quickly boosted to bring your blood pressure back to normal again.

• You will probably have a catheter into your bladder. An epidural means you can't tell when you need to empty your bladder, so this has to be done automatically for you.

• You might feel very out of control. You have three tubes going into your body and you have to be told when to push if the anaesthetic hasn't worn off by the second stage of labour. Your obstetrician and nurse midwife effectively manage your labour for you.

• Epidurals can increase the length of labour, especially the pushing stage.

• Your baby's heartbeat will be monitored continuously, using a transducer strapped to your abdomen, or a smaller transducer clipped onto his scalp.

• There's a greater chance of needing to have a forceps or ventouse (also known as vacuum) delivery because epidurals often prevent the baby moving into the best position to be born. Also, it often stops you from feeling the urge to push in the second stage of labour.

• If the epidural needle goes beyond the epidural space, there will be a leakage of cerebro-spinal fluid after the tubing is taken out. This fluid buffers your brain and even a very small leak will give you a terrific headache. This is usually treated by taking a small amount of blood from your arm, perhaps the day after your baby is born, and injecting it into your back to seal the hole made by the epidural needle.

• Some women have problems passing urine after having an epidural.

Any useful tips?

• Keep very still while the anaesthetist is setting up the epidural. You will be on your side or sitting on the edge of the bed, leaning forward and curled up in a ball. Concentrate on your breathing. Breathe in deeply through your nose and sigh out slowly through your mouth. Hold your husband's hand and keep eye contact with him.

• Discuss with your obstetrician and nurse midwife the possibility of letting the epidural wear off for the second stage of labour when you are going to deliver your baby. Being able to feel the contractions will help you push more effectively.

• If you cannot feel any sensation of pressure during the second stage of labour, and/or if the epidural weakens your muscles, you may not be able to push effectively during the second stage. Slowing or stopping the infusion of epidural medication will help you regain some sensation and/or muscle strength. Additional doses can always be re-administered should the need arise.


This articles has been taken from babycenter.com


Note: Ibu takde plan nak amik epidural ntok kelahiran adik kamu nanti. Macam mana ibu boleh bertahan dari segala macam rasa sakit and serba tak selesa tu waktu menanti kelahiran kamu dulu, InsyaAllah..ibu boleh lalui untuk kali yang kedua Semoga ibu diberikan ketabahan dan kesabaran dalam meniti detik waktu itu untuk kesekian kalinya.. Doakan yang terbaik untuk ibu dan adik kamu ye sayang.. ;)


P/S: I Love us!!


2 comments:

MiJa said...

mija amik dulu masa zharif.
sbb dh puasa 1 hari (ramadhan).
serius x larat dh.huhu.

acik juju said...

semuga lancar dan smooth sumenye ye awak..