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Week by Week

Reported Side Effects of Epidural Anesthesia
Compiled by Vicki Elson, CCE



All obstetric interventions carry benefits and risks. While some of the following effects are rare and others are common, it is important for every mother to be aware of these risks, to explore the many natural forms of pain management, and to decide carefully whether the benefits of epidural anesthesia outweigh the risks. Many mothers find it helpful to reconceptualize "pain" as "intensity," to prepare well, to choose their midwife/doctor with care, to arrange for loving support, and to cultivate an awareness of their own courage and beauty.

Mother: Additional interventions


  • Restricted mobility, IV, and EFM (all epidural patients)
  • Increased likelihood of bladder catheterization, oxytocin administration, internal monitoring
  • Increased likelihood of operative (i.e. forceps, episiotomy, cesarean) delivery
  • Automatic blood pressure cuff throughout labor

Mother: Short term


  • Dural puncture
  • Hypotension (29%)
  • Nausea, vomiting, shivering (frequent)
  • Prolonged labor
  • Uneven, incomplete or nonexsistent pain relief
  • Feelings of emotional detachment
  • Respiratory insufficiency or paralysis
  • Convulsions
  • Toxic drug reactions
  • Slight to severe headache
  • Septic meningitis
  • Allergic shock
  • Cardiac arrest
  • Maternal death

Mother: Long term


  • Neurological complications
  • Backache (weeks to years)
  • Postpartum feelings of regret, loss of autonomy
  • Fecal and urinary incontinence or bladder dysfunction (inability to urinate)
  • Paresthesia ("pins and needles")
  • Loss of perineal sensation and sexual function

Baby


  • Direct drug toxicity
  • Fetal distress, abnormal FHR (can lead to emergency cesarean)
  • Drownsiness at birth, poor sucking reflex
  • Maternal fever (impeded thermoregulation from numb skin) leads to fetal hyperthermia and neonatal
    NICU workup (spinal tap, etc.)
  • Poor muscle strength and tone in the first hours
  • Neonatal jaundice
  • Decreased maternal-infant bonding, behavioral problems
  • Hyperactivity up to seven years (suspected)

Economic


  • Increased costs (all epidural patients)

Sources


  1. Cohen, Nancy Wainer. Open Season, 1991.
  2. Enkin, M., M. Keirse, and I. Chalmers. An Guide to Effective Care in Pregnancy and Childbirth, 1992.
  3. Goer, Henci. Obstetric Myths versus Research Realities: A Guide to the Medical Literature, 1995.
  4. Macauley, JH, et al. Epidural analgesia in labor and fetal hyperthermia in
    Obstetrics and Gynecology, October 1992 80(4):665-669.
  5. Rothman, Barbara Katz (ed.). The Encyclopedia of Chidbearing, 1993.


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