There was recent conversations regarding informed consent. Often times if a mom chooses to get an epidural it will be after she has been in a situation where she is hurting and it is hard to make a decision much less read the form- so here is a form from http://www.gentlebirth.org/archives/epdrlrsk.html for you to read now so you understand the risks involved.
Epidural Consent Form
Here’s the consent form I mentioned a while back. The only thing I’d like to see added is increased c-section rate, which seems to finally be proven.
CONSENT TO EPIDURAL FOR LABOR PAIN CONTROL AND/OR CESAREAN SECTION
1. I authorize the performance upon _________ of the following
procedure ______________ performed under the direction of
2. I consent to the administration of local anesthetics, narcotics,
and/or other medications into the epidural space.
3. I understand that the following, among others, are possible
complications or risks of the procedure and that while they are
uncommon, they have been reported in the medical literature:
-Failure to relieve pain.
-Hypotension (low blood pressure).
-Postdural puncture (spinal) headache which may require
-Persistent area of numbness and/or weakness of the lower
-Temporary nausea and vomiting.
-Breakage of needles, catheters, etc. possibly requiring
-Hematoma (blood clot) possibly requiring surgery.
-Rapid absorption of local anesthetics causing dizziness
-Temporary total spinal anesthesia (requiring life
-Respiratory and/or cardiac arrest (requiring life
-Fetal distress resulting from one of the above complications.
4. I consent to the performance of procedures in addition to or
different from those now contemplated, whether or not arising from
presently unforeseen conditions, which the above named doctor or his
associates or assistants including residents, may consider necessary or
advisable in the course of the procedure.
5. The nature and purpose of the procedure, possible alternative
methods of treatments, the risks involved and the possibility of
complications have been fully explained to me. I understand that no
guarantee or assurance has been given by anyone as to the results that
may be obtained.
Notes from Midwifery Today tape on epidurals
After 7 hours on an epidural, the woman’s temp is up 2.1 deg. F, which is considered a maternal fever, which requires a neonate septic workup.
Of 96 first-time moms, 0 w/o epidural had a c-sect., 25 w/ had a c-sect. Of those getting epidurals < 3 cm, 33% had c-sects, 3-4 cm, 26%, > 5 cm, 0% MORAL – try to wait until 5 cm before epidural.
Problems with epidurals: 5% got no pain relief; 5% got inadequate pain relief, often had windows of sensation, which are just as annoying as all over pain.
Epidurals require catheters, which can require antibiotics, which may interfere with nursing.
Another study of 11,000 women having epidurals showed that 18% of women had chronic backache within 6 months of birth, lasting > 3 months. Of those with chronic backache, only 10% didn’t have an epidural.
Lactation consultants say that nipples don’t get erect for 24 hours after end of epidural. Newborns can’t get a good latch. (Ref: Dr. Edie? Laurence, “Measuring Effects of Breastfeeding Success and Epidurals”, U. Rochester.)
Rare complications of epidurals: cardiac arrest, respiratory paralysis, convulsions (most often from high spinals or intravascular injection). Other complications, 9 had spinal headache for 6 weeks, 5 for a full year.
Ways to minimize risks: Choose attendant w/low -sect. rate. One study showed that 46% of primips have epidurals. 1% of “clinic” patients have c-sects. 20% or private patients. If you get an epidural, make sure the facility has emergency c-sect. available and full resuscitation team. For a first baby, posterior or VBAC, delay epidural until after active labor is well established.
Robbie Davis-Floyd says “Women’s satisfaction with the birth experience is directly related to her sense of having mastered it.”
You lose endorphins and euphoria.