Epidural Anaesthesia NARRATOR: Epidural anesthesia. Epidural anesthesia works by blocking or freezing the nerves involved in labor pain. Freezing or anesthetic medication mixed with a small amount of narcotic is given through an epidural catheter, a small tube placed into the lower back outside the spinal cord. Generally, your abdomen and lower body will feel numb or frozen, and your ability to move will be limited. You will be able to move your legs, roll from side to side, and sit up in your birthing bed, but you will not be up walking. It is normal to still feel pressure with an epidural. If you choose to have an epidural, the anesthesiologists will discuss the specific risks and benefits, and answer any questions you may have before starting the epidural. One of the risks is a drop in your blood pressure, which may make you feel dizzy or nauseous. An intravenous will be started, and you will be given fluid through the IV to help prevent any drop in blood pressure. You will have blood work done and it will be reviewed by the anesthesiologist prior to starting the epidural. In some cases, an epidural may not be an option for you based on your blood work results. Depending upon which medication is used, you may feel itchy. The possible effects for baby often are related to the epidural side effects that may be experienced by mom. If there are any concerns, the neonatal intensive care unit team will be called to attend your birth and provide care for the baby. Once you have given your consent, the anesthesiologist will begin by cleaning your back and freezing the area with a local anesthetic. You will feel a sting or burning sensation for about 10 to 20 seconds as they freeze the skin. As the epidural needle is inserted, you will feel pressure, but not pain. You will be asked to remain very still during this procedure. Your nurse and support person will be present to support you through your contractions. Once the needle is in the proper position, the epidural catheter will be threaded through the needle into the epidural space. The needle is then removed, only the thin catheter tube remains and it is taped onto your back. The doctor will give you an initial test dose the medication to be sure the catheter is in the correct place. You will continue to receive medication through this catheter, which will help block the pain sensations throughout your labor, birth, and immediately after, if you require any stitches. Your nurse will frequently assess the effectiveness of your epidural block by asking about your pain and comfort levels, asking you to move your legs, and using ice to check the level of your block. You will likely not have an urge to pee, so the nurse will use a catheter to empty your bladder when necessary. As labor progresses and your baby moves down the birth canal, you may feel discomfort or pressure. This is a normal sensation, even with an effective epidural. During pushing, this feeling of pressure is helpful for you to know when and where to push. It will take a few hours after you have given birth for the epidural to wear off completely. Generally, you will be on the mother baby care unit before the effects of the epidural have fully worn off. The nurses will continue to assess your sensation and leg strength, and will assist you the first time you get up to go to the bathroom. [MUSIC PLAYING]