Saturday, May 7, 2011

Epidural Effects on Labor - Defined

This chart goes into detail about some, but not all of the effects an epidural has on labor. After researching, in my opinion, if you can avoid an epidural during labor, please do. I haven't listed it here, but cesareans carry their own risks, and you are much more likely to have a cesarean if you have an epidural. For more info on the risks or cesareans, click here.

Please click on the below flowchart to enlarge:


Risks in detail

For the mother
88% increased risk of being dissatisfied with birth
4 fold increased risk of malposition of baby
5.6 fold increased risk of dystocia
3 fold increased risk of needing synthetic oxytocin (see above for risks associated with induction)
2 fold increased risk of needing the maximal dose of synthetic oxytocin
31.6 fold increased risk of motor blockade
18 - 74 fold increased risk maternal hypotension
5 fold increased risk of shivering
29 fold increase risk of itching
46% increased nausea
3.3 - 5.6 fold increased risk of maternal fever (see below for risks associated with maternal fever)
42% - 6 fold increased risk of needing a forceps / vacuum delivery (see below for risks associated with forceps / vacuum delivery)
2.4 - 3.7 fold increased risk of cesarean for failure to progress (see above for risks associated with cesarean delivery)
43% increased risk of ceasarean for fetal distress
2-5 fold increased risk of postpartum hemorrhage
3.2 fold increased risk of anal sphincter tears
85% increased risk of 3rd and 4th degree perineal lacerations
2 fold increased risk of not breastfeeding at 6 months postpartum

For the infant
3.3 fold increased risk of variable or late decelerations
80% increased risk of bradycardia
3.5 fold increased risk of neonatal infection
75% increased risk of jaundice
19% Increased risk of admission to NICU

Infants whose mothers had a fever while giving birth face increased risks, these include…
3 fold increased risk of having 1 minute Apgars scores less than 7
10 fold increased risk of being hypotonic after delivery
4 fold increased risk of requiring bag and mask resuscitation
6 fold increased risk of needing oxygen in nursery

When both forceps and vacuum are used the risks substantially increase, these include...
11 fold increased risk perineal tear
4 fold increased risk neonatal seizures
8 fold increased risk neonatal intercranial bleeding
13 fold increased risk neonatal facial nerve damage

Risks of induction include...
3 fold increased risk fetal asphyxia
2 fold increased risk of cesarean
2 fold increased risk of hemorrhage
The following adverse reactions have been reported in the mother:
Anaphylactic reaction Premature ventricular contractions, Postpartum hemorrhage Pelvic hematoma, Cardiac arrhythmia Subarachnoid hemorrhage, Fatal afibrinogenemia Hypertensive episodes, Nausea Rupture of the uterus, Vomiting, Excessive dosage or hypersensitivity to the drug may result in uterine hypertonicity, spasm, tetanic contraction, or rupture of the uterus. The possibility of increased blood loss and afibrinogenemia should be kept in mind when administering the drug. Severe water intoxication with convulsions and coma has occurred, associated with a slow oxytocin infusion over a 24-hour period. Maternal death due to oxytocin-induced water intoxication has been reported.
The following adverse reactions have been reported in the fetus or neonate:
Bradycardia Low Apgar scores at five minutes, Premature ventricular contractions and other arrhythmias Neonatal jaundice, Permanent CNS or brain damage Neonatal retinal hemorrhage, Fetal death. Neonatal seizures have been reported with the use of Pitocin.

Source: http://naturalmamanz.blogspot.co.nz/2011/07/my-ob-said-what-commentary.html

2 comments:

  1. As a mom to two, both delivered in pitocin induced labors, one delivered with an epidural and one delivered without, I can definitely suggest delivering WITHOUT an epidural. Given, the unmedicated birth was my second, so I was feeling more confident, but I would have to say that if I could do it over again, I would choose to say "no thank you" to the epidural the first time - instead of electing to have one. I was totally disconnected from the urge to push under the epidural - and without, I knew exactly what to do to help my baby deliver. It's a huge difference.

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  2. Thanks Amy! Great to get a perspective from a mum who's been through labor both with and without an epidural. It's women like you who can give us a clear picture on the differences.

    Though I didn't have an epidural, with my first birth I took pethidine, and was able to compare it to my later births in which I chose not to take it. I can't warn women about the side effects of pethidine enough! I was literally falling asleep every 2 minutes between contractions, then suddenly waking up with the start of contractions, I could barely think or concentrate.

    Without medication, I found I was able to focus and concentrate on pushing, relaxing, visualizing the the birth canal widening, using birth affirmations etc, which I was not able to do with pethidine.

    I know I did take A LOT of pethidine during my first birth, but in my opinion during birth the clearer your mind can be the better.

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