Epidurals Video Transcript

My name is Juan Reina and I am an obstetrician and gynecologist and I practice at Hilltop Obstetrics and Gynecology in Middletown.

What is an epidural?

It’s a procedure done by the anesthesiologist at the labor and delivery area and they come in at a certain time of the laboring process when the patient has been pre-treated with some IV fluids to prevent drops in blood pressure and they place a small needle in the patient’s back in a special place where they can inject some medication, an anesthetic, that will help numb those nerve endings from the waist down thus creating that relief of pain when the patient needs it most which is the birthing process.

Epidural Facts

The disadvantages of the epidural are that the patient has no control over the actions she will have during the birthing process because she’s going to be numb. Some patients don’t like that. They want to have full control of their extremities and their legs and they want to feel the urge to push that comes along with having the baby’s head in your pelvis. But we have the nursing staff and the capability of coaching the patient with an epidural with the same gestures and efforts to deliver the baby. All these disadvantages are at a smaller scale; they don’t happen all the time, they do happen like anything you do in life, but they happen on a smaller scale and usually we have counter measures for any of these disadvantages. Sometimes epidural will slow down the laboring process, the contractions might mellow down, but we have again we counter measures for that. We use petocin to enhance the contractions at all times if we need to whether you have the epidural or not because ultimately we want to deliver the baby. Also, by placing the epidural we basically numb from the waist down and that can cause certain dilation or expansion of the blood vessels from the waist down which causes a drop in the blood pressure that will sometimes happen after an epidural. Again, we have counter measure for that. We usually give the patients enough fluids beforehand and if the blood pressure drops abruptly or suddenly then we have some medication to counteract that. As far as the husbands or the father of the baby is concerned the epidural brings a positive edge . . . and now we’re going into the advantages of it. Once he’s in there with his wife waiting for the big moment. That could be just a few hours or many hours . . . 12, 18, 24 hours of laboring until you finally deliver your baby. During that time the epidural gives the advantage of having a comfortable laboring process in which I tell my patients you could be playing cards with your husband, talking to your family who came to visit from out of town, watch movies (there’s free pay-per-view in the hospital) and have a relaxed atmosphere and sensation while you wait for your baby to come to the world. That also helps the family and father of the baby to feel comfortable. They are in a home environment while they wait for the baby to be born. It creates less anxiety and less stress. In some patients who have lower pain threshold it enables an emotionally positive experience. The other advantages of the epidural are that it also helps relax the muscles in the pelvis which when you’re in pain you try to contract everything in your body. By relaxing it creates that additional space so to speak for the baby to come down. Also while you are in the delivery process if there is a complication, the heart rate goes down in the middle of delivering the baby, we can act quickly to get the baby out.

Benefits of Epidural following Birth

The added benefit for having this control on the epidural is that once the delivery process is done we can turn off the epidural and the patient regains the function of her legs within an hour or two so by the time she goes from labor and delivery to the post partum unit . . . we have separate delivery rooms and postpartum rooms here at Atrium. They have regained almost all their mobility and can go about their business with their new baby and celebrating.

Dr. Reina’s Thoughts about Atrium

As a father of twin girls, I can tell you that being in a place where you get all the amenities where you feel at home while you’re waiting for the delivery of your child brings that homey comfort, that easiness, that smoothness in the process that anyone would like. I would love that for any other dad out there to enjoy those moments with his wife while she’s laboring and then enjoy that beautiful moment of their child being born.