The Effect of Maternal Epidural Use on Labor and Delivery Outcomes
Problem Statement.
Epidural analgesic techniques are commonly renowned as the most effective methods for pain relief during labor and delivery. In most health facilities within the United States and the world over, epidural analgesics have shown a wide range of success in achieving pain reduction during and after labor. However, despite the benefits witnessed following increased use of these labor analgesics, an ongoing controversy continues to exist concerning the impacts of the intervention on the mother and the outcomes of delivery. The health facility discussed in this paper is not an exception.
Concerns surrounding maternal epidural use of analgesics are significant and more intense considering that achieving epidural analgesia requires a larger dose of drug which may have a far-reaching impact on the new born. While evidence shows that effective epidural analgesic interventions have little or no significance on the rates of caesarian outcomes, the use of such analgesics are associated with a variety of adverse outcomes both on the mother and the baby (Sharma, S.K., McIntire, D.D. et al., 2004). One major impact of epidural analgesics on the mother as observed within the facility and testified in other health facilities is a prolonged second stage of labor.
Under normal circumstances, without analgesics, the second stage of labor lasts about 1 to 2 hours. This period is significantly affected and prolonged to almost 3 hours under the use of analgesics. The consequence of this is that, apart from anxiety and depression on the mother, thee are various adverse impacts on delivery (Lederman, R.P., Lederman, E. et al., 20065). Most notably in this facility, there has been an increased chance of breech presentation which in most cases has led to an increased rate of instrumental vaginal delivery.
On the one hand, mothers given an epidural analgesia within the facility report less pain with more satisfaction on pain relief in the long run. On the other hand, mothers coming back for postnatal care following delivery under epidural analgesia have reported symptoms of hypotension, maternal fever and back pain on separate non-contingent occasions. While these symptoms may have no focal direction with regard to the epidural analgesic doses, they may be early indications of more serious conditions in the long run.
In the grand scheme of things, epidural analgesic methods have not been found to have significant effects on the newborns with little evidence available to support any notable consequences. However, it has been associated with effects on lactation success and urinary incontinence. Moreover, it has been established that newborns whose mothers received epidural analgesics generally have lower Apgar scores requiring intervention more frequently than do neonates whose mothers who had other forms of non-epidural analgesia (Johnson, S., & Rosenfield, J.A.2005). Essentially, these unintended effects are worth a closer scrutiny to improve epidural labor analgesia. Ultimately, knowledge on these effects would enable the health care provider to provide safe and effective labor analgesia.
References
Johnson, S., & Rosenfield, J.A. (2005). The effect of epidural anesthesia on the length of labor. J Fam Practice.
Lederman, R.P., Lederman, E. et al., 2006). Anxiety and epinephrine in multiparous labor: relationship to duration of labor and fetal heart rate pattern. A.M. J Obstet Gynecol.
Sharma, S.K., McIntire, D.D. et al., (2004). Labor analgesia and cesarean delivery: an individual patient meta-analysis of multiparous women. Anesthesiology.
