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What Is a Walking Epidural?

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As you begin planning for the birth of your baby, one of the top considerations many women have is what type of pain relief they would prefer, and how they will labor – lying down, sitting up, walking or squatting. The most common form of pain relief for moms in the United States is an epidural. But have you heard of a “walking epidural’’?

An epidural is a form of regional anesthesia, meaning it reduces or blocks feeling -- including pain --below your waist. When an anesthesiologist administers an epidural, a small tube is placed in your lower back to deliver the medication. You remain awake and alert, but you’ll probably experience loss of feeling in the lower half of your body.

A spinal block is similar to an epidural in that it’s a form of regional anesthesia that blocks pain. The anesthesiologist will give you a single shot into the liquid that surrounds the spinal cord. A spinal block provides fast pain relief and is commonly used in cesarean sections. However, it only lasts an hour or two.

A “walking epidural’’ is another name for a procedure called a “combined spinal-epidural.’’ It’s a combination of both an epidural and a spinal block. The spinal block gives you fast pain relief, and the epidural provides continuous pain relief after the spinal block wears off.

Why would I choose a “walking epidural’’?

With a walking epidural, lower does of medication can be used than a regular epidural for the same amount of relief from pain.

A regular epidural can make labor last longer, and it can increase the need for forceps and vacuum-assisted birth, also known as ventouse, in which a doctor use a vacuum device to help deliver the baby if labor has not progressed adequately. Having your baby with the help of forceps or vacuum is associated with the possibility of developing urinary incontinence, painful sexual intercourse and vaginal prolapse, when the top of the vagina weakens and collapses into the vaginal canal.

The lower doses of medication used during a walking epidural may mean that the woman can be more mobile during labor. Some experts believe that if a woman can be more upright during the later stages of labor, by standing, sitting or squatting instead of lying down, labor won’t be slowed down as much and she can avoid the negative side effects of an epidural.

How should I decide which form of pain relief to use?

You should discuss with your doctor which form of pain relief is right for you and your baby. You have other choices besides an epidural, spinal block or walking epidural. Medicines called analgesics, which lessen pain and relax you without loss of feeling or movement, are also available, and are usually given to the mom through an intravenous (IV) line. And some women choose to have childbirth without any pain relief medications. Pain relief during natural childbirth can include remaining active during labor by walking around the room, water immersion, massage and breathing techniques.

Ultimately, you and your doctor should decide what is in the best interest of yourself and your baby. Don’t be afraid to ask your doctor questions so that you’re sure you understand the benefits and side effects of whichever choice you make. The right choice for one person isn’t necessarily the right choice for another person.

Learn more about Rebecca Boudreaux, MD

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