Q: Will my insurance plan pay for an epidural?
A: Epidurals are expensive procedures, because highly trained specialists who are on-call 24 hours a day must administer them. Epidural charges are based on the duration of time the epidural is used for labor. Most insurance plans will pay at least a portion of the professional fee for an epidural. We suggest you contact The Women’s Hospital financial counselor at 812/842-4240 for a detailed explanation of epidural fees.
Q: Who should NOT have an epidural?
A: Epidural analgesia is not appropriate for patients with bleeding disorders, some neurological disorders or evidence of severe infection, or individuals who have had some types of major back or spine surgery. If you fall into one of these categories, the anesthesiologist will discuss with you the particular difficulties involved in your situation.
Q: When can I have an epidural?
A: We prefer to begin epidural analgesia only after mother has clearly demonstrated progress in labor. For most patients, this is usually cervical dilation of 3 to 4 cm. Your obstetrician or family doctor will consult the anesthesiologist when it is most appropriate to administer the epidural.
Q: Is it ever too late to get an epidural?
A: It takes approximately 15 minutes to administer an epidural, and another 15-20 minutes to achieve pain relief from the injected medications. Occasionally cervical dilation in labor progresses so quickly (particularly after multiple children) that there will not be enough time before delivery to achieve epidural pain control. In some of these situations, a more rapid-acting analgesia can provide the best conditions for delivery.
Q: Will having an epidural prolong my labor?
A: As it makes you more comfortable, epidural analgesia will change many of the conditions of your labor including your blood pressure, heart rate and breathing rate. It may also change the rate of your uterine contractions, resulting in a longer labor. Alternatively, the relaxing effect of the epidural may induce changes in the baby’s position in the pelvis, resulting in a more rapid labor and delivery. On the average, there is no prolongation of the labor and delivery process with appropriately administered epidural analgesia.
Q: Can I become permanently paralyzed by an epidural?
A: The epidural is an injection made into an area of nerves, therefore, it is theoretically possible to damage the nerves with the epidural needle. Nerve damage and subsequent paralysis is an exceedingly rare, but possible, complication of both epidural and spinal injections. Put in perspective, the risk of such a complication is far less than the risk of death in a car accident on the way to the hospital.
Q: Will the baby be exposed to the epidural medication?
A: The baby is exposed to any medication given to the mother. However, the amount of epidural drug that crosses to the baby is almost immeasurable, and has no effect on the health of the baby.
Q: What is the difference between an epidural and a spinal?
A: An epidural is an injection of local anesthetic into the epidural space, where the nerves come out of the spinal canal to the various parts of the body. A spinal is an injection of local anesthetic into the spinal fluid, which is in direct contact with the spinal cord. Both techniques produce “numbness” by temporarily reducing the function of the sensory nerves.