AHA ACLS, BLS, PALS, NRP, PEARS, ACLS EP, PHTLS and Heartsaver First Aid, CPR/AED Saving American Hearts, Inc 6165 Lehman Drive Suite 202 Colorado Springs, Colorado 80918 Catherine Brinkley (719) 551-1222 email: admin@savingamericanhearts.com
Epidural Birth Injuries
Epidural Birth Injuries
An epidural is a popular pain-management method used by millions of women each year while going through the labor and delivery. In fact, an epidural is the most common type of pain relief used during labor and delivery; more than half of all pregnant women in the United States are given an epidural. Yet, despite its popularity and common use, there are a variety of risks associated with epidurals which can lead to epidural birth injuries as well as long-term maternal injuries.
What is an Epidural?
An epidural, also known as epidural anesthesia, is a regional anesthesia administered intravenously to block pain in the lower part of the body. A long needle is typically inserted into your back, around the spinal cord area, usually after the cervix has dilated to at least 4 centimeters. A thin catheter is threaded through the needle, which ensures that the medication hits the epidural area and the catheter stays in place. Once the catheter is in place, medication will fluidly disperse either intermittently or continuously.
Types of Medications Used in Epidurals
Medications used is epidurals are known as local anesthetics, meaning medicines used to reduce pain sensation in the targeted areas without you being fully unaware or unfeeling of other local senses. The most common types of medications used in epidurals include:
Bupivacaine
Lidocaine, or
Chloroprocaine
In the majority of instances, these medications are used in combinations with narcotics or opoids to ensure maximum pain relief and to help reduce the dosage amount of the local anesthetics.
Risks Associated with Epidurals
If you’re considering an epidural, it’s important to understand that risks that come along with it. In some cases, proper medical procedures still will not eliminate potnetial issues, and in other instances, negligent and careless medical mistakes cause injuries that could have otherwise been prevented.
Maternal risks associated with epidurals include:
Seizures and dizziness
Infections
Spinal membrane injuries
Arachnoiditis
Breathing problems
Nerve damage
Long-term back pain
Increased risk of vacuum extraction or forceps use during delivery
Lower blood pressure
Infant risks include:
Difficulties with breastfeeding
Lack of oxygen, leading to more serious health problems, such as cognitive disorders and cerebral palsy
Brain injuries
Infant stroke
Coma
Low Apgar scores
Poor muscle tone
Medical Mistakes and Epidural Injuries
Administering an epidural must always be done by a professional anesthesiologist or nurse-anesthetist with proper education, experience, and training. Since the area involved is so close to the spinal cord, even a small mistake can lead to devastating consequences. Typical reasons for epidural injuries due to medical mistakes include:
Administering too much medication
Administering medication the mother is allergic to
Injecting the needle into the wrong area
Failure to monitor maternal and fetal distress
Administering the epidural before proper cervix dilation
Administering an epidural to a mother who uses blood thinners or has a low platelet counts
Additional Information to Remember
You should always give permission before an epidural is administered. All too often, many healthcare providers make the mistake of assuming an epidural is necessary prior to getting express approval from the mother. Even when you do give permission or request an epidural, it’s the healthcare provider’s obligation to inform you of all the risks associated with the procedure. Be certain to request information on the type of medicine to be used, the risks, the complications, and any other pertinent information before consenting to an epidural.
Although an epidural provides significant pain relief during labor, it’s important to understand that risks as well as the benefits. It’s always a good idea to research beforehand and weigh out the pros and cons.
Sources:
http://bja.oxfordjournals.org/content/87/3/512.full
http://www.apsf.org/newsletters/html/2011/spring/08_epidural.htm
http://www.rcoa.ac.uk/system/files/PI-Risk11_1.pdf
A new study has shown that epidurals cause the second stage of labor to be longer that what has previously been recognized. Traditionally, when a woman has been in the second stage of labor (the pushing stage) for roughly over three hours, the doctor may intervene with a c-section, instruments or medication that can be potentially dangerous for both the mother and the unborn child. For example, a doctor may induce delivery using Pitocin, forceps or a vacuum extractor and can leave the child with birth injuries in order to speed up the delivery process.
In this study from the Journal of Obstetrics and Gynecology, researchers observed over 42,000 women who gave birth vaginally over a span of 32 years and recorded the length of each woman’s second stage of labor. They discovered the following:
First time mothers with an epidural had an average second stage labor time of 5 hours and 36 minutes.
First time mothers delivering naturally had an average second stage labor time of 3 hours and 18 minutes.
Mothers who’ve previously given birth and had an epidural had an average second stage labor time of 4 hours and 15 minutes.
Mothers who’ve previously given birth by delivering naturally had an average second stage labor time of 1 hour and 21 minutes.
Dr. Barbara Leighton, a profession of anesthesiology at Washington University in St. Louis said to the New York Times
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Catherine Brinkley (719) 551-1222
Saving American Hearts, Inc 6165 Lehman Drive Suite 202 Colorado Springs, Colorado 80918
admin@savingamericanhearts.com