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Epidural in the spinal chord

Epidurals Have No Side Effects in Kerala

I had an opportunity this week on Facebook to be completely flabbergasted by this misinformation. It came from reading the following post written by consultant anesthesiologist Dr. Neelam MBBS, DA, DNB at The Cradle Hospital in Calicut, Kerala.

Painless Childbirth

Labour pain is rated as severe by most women who do not receive pain relief. With advent of modern medicine and availability of techniques with skilled practitioners, it is now considered ‘inhuman’ not to relieve the pain of labour.

Just like surgery is never done without anaesthesia, so also techniques are available to ensure painless delivery. Receiving pain relief in labour is not a pre-requisite for delivery! It is dependent on your tolerance level and the choice you want to make.

  • Epidural is a small injection placed in your lower back, through which a fine tube (epidural catheter), the size of a thread, is passed into your back. Drugs can be injected through this tube to facilitate painless normal delivery.
  • These drugs are local anaesthetics which cause numbing of the nerves and pain sensation without affecting the ability to move.
  • These drugs are also very safe for the baby. With an epidural in place, you may feel the contractions, but they will not be painful.
  • Epidural is the best method of pain relief in labour, among all the options available.
  • Epidural can allow you to rest, relax, get focused and give you the strength to move forward as an active participant in birthing.
  • By reducing the discomfort of childbirth, most women have a more positive birth experience.
  • If you deliver by caesarean section, the same epidural can be used to provide anaesthesia during the operation and effective pain relief during recovery.
  • When other types of coping mechanisms are no longer helping, an epidural can help you deal with exhaustion, irritability and fatigue. And, it ensures that you have painless labour and delivery. www.thecradlecalicut.com

Don’t get me wrong I am not anti-epidural.
I am anti-misinformation.
Especially when it comes from health professionals with the importance of ‘selling’ their services over motherbaby well-being.
I have spoken to at lengths to hundreds of women about the side effects they suffered with an epidural.

The most common epidural side effects I hear are:

  • Terrible nausea and vomiting. A woman said to me recently “I would have been able to cope with the contractions if I would have been allowed out of the bed. I agreed to the epidural and never would have if I’d had any idea I would spend the next 3 hours uncontrollably vomiting into a tray while unable to move my legs.’
  • Titanic shakes. “I was shaking so bad I couldn’t hold my baby for over an hour.”
  • Uncontrollably itchy! “I felt like I had a thousand bugs running under my skin. I scratched myself raw.”
  • Numbness at injection site.
  • Headaches. For weeks after the birth

In fact this is often one of the reasons second time mums come to my Hypnobirthing classes, they suffered the effects of the epidural for the first birth and want to find other coping mechanisms for the next.

Of course each and every one of these side effects will affect the baby; we know by now, the emotional state of the mother is more or less the emotional state of the baby. The side effects above sound like high agitation producing a high level of stress hormones.

Also the drug dosage is a problem for the baby because it is based on the mothers body mass, not the baby’s and these these drugs cross the placenta. For this reason many hospitals have protocols that not not allow women to have epidurals if labor is too far advanced and baby’s birth is imminent.
The bolus of drugs will just be hitting baby’s system putting him at higher risk of difficulties inflating his lungs during that high level of sedation. Epidurals are highly increase likelihood of operative delivery of course. In Singapore I see epidurals match every well with vacuums and forceps. It just so much easier for the care provider to say, ‘hmm things not progressing well, you cant feel to push, let me give you a bit of help down here.’
Epidurals are also known to interfere with breastfeeding, the baby might be too drowsy and mother also might be too busy with her shivering to get breastfeeding established early on.

There have been many studies done and research on epidural side effects. This study is interesting done in 1992 and showing delayed motor skills in babies lasting over the first month of their lives for epidurals.
“The epidural group showed poorer performance on the orientation and motor clusters during the first month of life”.

There are rare instances of more severe side-effects

  • Acute drug allergy
  • Respiratory distress
  • Permanent nerve damage

I support all women in whatever decisions they make around birth.
And I see when decisions are made from a place of informed consent women are so much better equipped to own the outcome regardless what it is. As care providers we are obligated to inform, then she can weigh the risks and benefits and make a decision that makes sense for her.
At least that is what I thought.

There is no way Dr Neelam made it through med school without having the information you now do from a simple google search. Her statement is a lie, an insult, a sales pitch. Why do we tolerate it?

If you’d like more information there are tons of articles written on the subject of epidural side effects. You might like to read the following links:







Wiki Images: https://en.wikipedia.org/wiki/Epidural_steroid_injection

Here is the original Facebook post in case you would like to leave your comments: