Obstetric Anesthesiology

MaineHealth obstetric anesthesiologists deliver expert anesthesia services during the labor and delivery process.

What is obstetric anesthesiology?

Obstetric anesthesiology refers to anesthesia services provided at the time of labor and delivery. There are several different anesthetic pain relief options available during childbirth:

  • Local anesthesia for childbirth is most commonly given as a shot that numbs the area around the vagina before an episiotomy is done or after delivery when stitches are necessary. Local anesthesia does not harm the baby and does not relieve pain from contractions.

  • Regional anesthesia (also called epidural, spinal, or systemic anesthesia) greatly reduces or eliminates pain throughout the birthing process. It can also be used if a cesarean section becomes necessary. There are three types of regional anesthesia: Spinal, epidural and combined spinal/epidural. With each type, medicines are placed near the nerves in your lower back to “block” pain in a wide region of your body while you stay awake. It can also be used if a cesarean birth becomes necessary.

    • Epidural – a thin plastic tube or catheter is placed in the back and medicine can be given through the tube when needed. The tube is left in place during labor. If a cesarean section is needed, a stronger dose of medicine can be given through the tube.
    • Spinal – most commonly used in a planned cesarean section. Local anesthetic is placed using a very fine needle using a single injection. The spinal makes you numb quickly but the epidural catheter can also be used to give more anesthetic if needed (usually when anesthetic is needed for a longer period of time than can be provided by the spinal alone).
    • Combined Spinal-Epidural or CSE – a combination of the above two. The spinal makes you numb quickly but can also be used to give more anesthetic if needed.
  • General Anesthesia is used for emergencies during the birthing process. General anesthesia induces sleep and must be given by an anesthesiologist. Although safe, general anesthesia prevents you from seeing your child immediately after birth.

Watch a quick video to learn more about Anesthesia Care for Labor and Delivery.

Why MaineHealth?

Highly-qualified anesthesiology providers are available at all MaineHealth system hospitals. And, Maine Medical Center is the referral center for high risk pregnancies and deliveries for southern Maine and southern New Hampshire. That means that the anesthesia providers at Maine Medical Center have extensive experience in managing complex deliveries. You can rest assured that you and your baby are in good hands whether you are having a normal or high-risk delivery. 

Frequently Asked Questions

 

Does an epidural affect labor?

Epidurals do not affect the progress of labor. However, labor that is progressing more slowly than than average has been associated with higher levels of pain and this higher level of pain may make a woman more likely to request an epidural.

 

What are the “rare but serious effects” of an epidural?

Serious undesired effects of an epidural are very rare and your doctor will do everything possible to make sure that they do not occur. If anesthesia medication enters your bloodstream, for example, instead of the epidural space, it could cause a serious reaction. To avoid this, your doctor will test the catheter location prior to administering the anesthesia medication to be sure that they will go into the correct location in your body. Or, if the level of the epidural block were to become too high, it could cause breathing problems. To avoid this, your doctor will check the level frequently to be sure that it is at the desired level. Sometimes even a well-functioning epidural can cause a decrease in blood pressure. Your doctor will monitor blood pressure throughout the birth process and if needed, treat blood pressure that is determined to be below the optimal level.

Does having an epidural affect breastfeeding?

An epidural does not make it any less likely that a woman will be able to breastfeed.

Does an epidural affect the baby?

The medications in epidural infusions are contained within the epidural space rather than being present in the mother’s bloodstream and therefore are not passed to the baby.

Is it ever too late to ask for an epidural?

An epidural can be administered at almost any time once a woman is in active labor. However, if delivery is felt to be imminent (minutes away) it is less likely that there would be adequate time for an epidural to take effect and at this point it may be recommended that a woman forgo epidural placement.

Can an epidural be turned off for pushing?

Yes, but this is unlikely to result in a significant improvement in pushing effort and is not likely to lead to faster delivery. Also, some women find it more difficult to push due to the discomfort that is likely to occur if the epidural is turned off.

Do epidurals cause headaches after?

There is a very small chance of a headache related to epidural (called a ‘spinal headache). Your doctor will have effective treatment options should this occur. If a spinal headache occurs, it will happen within 24-48 hours after time of epidural placement. There is no association between epidural placement and long-term headache.

Do epidurals cause back pain later on?

There can be some tenderness at the site of epidural placement for a day or two after placement. There is no association between epidural and long-term back pain. While some women do have back pain after having a baby, this occurs at the same rate in women who did not have epidurals as it does in those who did have epidurals. This is likely due to the stress on the lower back caused by pregnancy itself.

Epidural Anesthesia

When people are expecting a baby, they often ask about epidural anesthesia. They want to know how it's given and what to expect. Watch this short video to learn more.

Source: https://my.clevelandclinic.org/health/articles/4450-pregnancy-epidurals--pain-relief-options-during-delivery