Labor pain relief
Pain relief during natural birth
In natural birth, the labor pain catheter (epidural catheter) is the most efficient method to eliminate contraction pain during a birth.
After administration of epidural anesthesia you can still move your legs and, in most cases, you can also go to the toilet. You can still actively participate in the birth. The epidural has no influence on whether a birth becomes a natural birth or a cesarean section.
First, a local anesthetic is administered with a small syringe on the back, which is barely noticeable. After a short exposure time, a small tube is inserted through a longer cannula through which the local anesthetic is injected. This can be administered again and again – as long as you need it.
You will feel a tingling sensation in your belly, a dull numbness. If the epidural is successful, you will feel no labor pain or almost no pain. You just feel your belly getting hard again and again in the rhythm with the contractions.
Woman can often relax, sleep briefly and gather new strength.
What are the risks of an epidural?
The most common side effect is headache, which occurs when you stand up and gets better when you lie down. Out of every 1,000 births we have each year, this happens about 3-4 times.
Bleeding or infections occur extremely rarely.
Back pain is more common and generally occurs during pregnancy and childbirth, i.e. it often cannot be directly attributed to the epidural.
Epidurals have been performed for decades and have shown no specific risks to the child.
When is an epidural administered?
The earliest possible time for an epidural is when it is clear that the birth process has started. In principle, the epidural can be administered at any time during birth. Once the push contractions have started, it is no longer possible. Then the birth process is already in the final phase.
Alternative methods to epidurals
Alternatively, nitrous oxide can also be used, but pain reduction is only possible to a very limited extent; pain cannot be eliminated anywhere near as with the epidural.
Nitrous oxide can be used as a bridge to epidurals or for mothers who are already at an advanced stage of the birth process.
Another alternative is the opiate nalbuphine, which can only partially reduce the pain. Not all doctors use it because it also enters the baby's bloodstream and can make the child tired and a bit depressed.
In fact, there is no real alternative to the epidural, which can be administered quickly and almost painlessly in the vast majority of cases. In some cases, it takes a little longer or has to be done twice.
Some women ask for sedatives - I advise against sedatives, as they are also absorbed by the baby.
Anesthesia during cesarean section
During a cesarean section, spinal anesthesia – also called spinal block - is performed. Compared to general anesthesia, spinal anesthesia is a better and safer procedure - for the child and the mother. This is why spinal anesthesia is performed during every planned cesarean section.
A very thin needle is inserted deeper into the spinal fluid where the nerves are floating, and a combination of local anesthetics and analgesics is administered. The mother will hardly feel this. If she gets a warm feeling in her legs and buttocks, the anesthesia is working exactly where it is supposed to. The anesthesia takes full effect after 10 - 15 minutes, during which time a bladder catheter is inserted and the abdomen is washed and prepared. The procedure only begins when the patient no longer feels any pain in her belly.
Circulatory weakness and malaise occur more frequently - this is to be expected and can be treated immediately.
The risks are similar to the epidural – a headache may occur, which improves when lying down. Other side effects are extremely rare.
Our service 24/7
Of course, we have set up a 24-hour anesthesia service here at the Döbling Private Hospital. In addition to the anesthesiologists employed in the hospital, there is a network of freelance anesthesiologists who are accessible and available at short notice. This makes it almost always possible for us to offer you a timely epidural