How true, Theresa. The internet has made geniouses out of us all, hasn't it?
GOOGLE is our friend!!
While I've made some very stupid comments on topics I knew very little about and posted information I acted like I knew, but which actually had just come from a "Googled" site, this
IS one area I know a little bit about.
I was a CRNA for almost 10 years, did my research proposal on the effects of one particular narcotic on the fetus during epidural analgesia, placed quite a few labor epidurals and "sat on" (waited on) hundreds (if not a thousand) more and was involved in many, many deliveries where epidural (and spinal) analgesia were administered. Epidural (and spinal) pain control in labor is the largest form of analgesia used today. It is
VERY safe and has negligible, and most times
ZERO, effect on the fetus.
The reason? These drugs are placed in the spinal column (epidural) or the spinal canal (spinal) and only
very minute amounts of these drugs reach the blood stream over the time they are in the body. Sure, some of these drugs can enter into the fetal circulation, but we're talking fractional amounts. The research I did showed
no statistical significance in regards to fetal/newborn compromise (lethargy, drowsiness, respiratory depression) after these two forms of analgesia for labor.
Also, the thought that if an epidural is placed too late then the baby is at greater risk is wrong. It actually takes a longer time for the drugs to enter the mother's blood stream with an epidural, so
the longer a woman has an epidural the greater the amount of narcotic that enters her blood stream, which is the
ONLY WAY (through the blood via the placenta) the drug can get to the baby. So, an epidural placed late in labor is actually "safer" (if that's even an appropriate term) for the baby.
Regarding placement times, the epidural is typically placed when a "first timer" is >4 cm dilated,
IF she's progressing. If not, the decision may be made to wait a bit longer. I've seen them placed at 7cm if the lady was moving
REALLY slow, since epidurals can,
occassionally, slow labor. If the woman has had multiple deliveries, the epidural may be placed upon arrival or when she reached 3-4 cm dilation (which some multiparas achieve even
before they get to the hospital!!)
Anyway, that's my take. No, I am not an MD and haven't done anesthesia for 6 years now (OB anesthesia for about 8 years), but I do remember that much about it. Also, you will see practices and opinions on this topic vary from practitioner to practitioner.
Obstetrics was the most enjoyable
AND horrific part of my job as a CRNA! The joy of seeing a new life entering the world and the reactions of mom and dad are priceless!! To be a part of that was incredible!!
*edit* I just realized that I only covered the narcotic portion of the epidural/spinal. They are used in conjunction with local anesthetics that numb (deaden) the nerves, too. These types drugs have even less of a chance of getting into the baby's system. Only by direct injection into a vein of the mother (which does happen
VERY, VERY rarely) can either of these drugs have a serious effect on the fetus.
Bro. Eastman! I pray your child is healthy and blessed and used mightily in the Kingdom of God!!
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