Labour pains - those two most dreaded words in every pregnant woman's mind. Much has been made out of the pain of labour - thanks to old wives tales and labour room gossip. Most women fear labour to the extent that it almost robs them of the joy of giving birth. But today, modern pain management techniques like epidural blocks can make an otherwise painful experience more comfortable. Though many women get through labour without pain medication, there are others who request an epidural block as pain-relief during labour.

What is an Epidural?
An epidural (also known as an Epidural Block) is a type of regional anesthesia that provides continuous pain relief during labour and delivery. It blocks the pain of labour, though the woman can feel the contractions. With an epidural, the expectant mother can stay comfortable and be fully awake while giving birth.

How is an Epidural given?
The epidural injection is given in the lower back. Before giving you the injection, the doctor or nurse will numb your lower back with a local anesthetic. While you are sitting or lying on your side with your back curved outward, the doctor or nurse will insert the needle for the epidural. He or she will then pass a small flexible tube called a catheter through the needle into the area just outside the membrane covering the spinal cord (called the epidural space). The amount of medication can be regulated according to your needs.

Usually, it only takes a couple of minutes to insert an epidural. You should start to feel the effects in about 10 to 20 minutes. As your labor progresses and you start to deliver, the anesthesiologist can administer medication as needed through the catheter in your back without having to inject you again.

The Advantages
The main advantage of using an epidural block is that it eliminates the fear of pain. It also

• Helps the expectant mother to stay alert
• Blocks pain in the lower body
• Does not slow down labour
• Can be used for several hours

The Risks
An epidural block has some disadvantages. One problem is that it may provide uneven pain relief, affecting one side of the body more than the other.

While complications or side effects from epidurals are rare, the following risks are possible:

• Blood pressure could drop during an epidural. This may slow your baby's heartbeat. To prevent this, you will receive extra fluids through an intravenous (IV) tube
• You may also need to lie on your side to improve blood flow
• If you receive extra fluids, the risk of shivering increases. Even without an epidural, shivering can occur during labor and delivery. Covering up with a blanket often helps
• The epidural injection could cause soreness after delivery. This usually lasts for a few days. An epidural should not cause long-term back pain
• You may get a bad headache - though this is quite rare. If not treated, this "spinal headache" may last for days
• Sometimes, if an epidural is given late in labor or a lot of anesthetic is used, you may find it hard to push your baby through the birth canal. However, the dosage of medication can be adjusted if this happens

An epidural block is not the only medication that helps you deal with the pain and stress of labour and delivery. You could discuss with your doctor about the other methods of pain-relief such as a Combine Spinal-epidural (or CSE), a "walking" epidural, nerve block or other tranquilizers.

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