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Epidural vs. spinal tap
I am 33 weeks pregnant. And I am considering the method of pregnancy. I want natural birth but I am wondering what is the difference between an Epidural and Spinal Tap. Is one more safer than the other. What are the pros and cons?
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I don't know if you have access to a good childbirth class--they will often have an entire session on obstetric anesthesia, and many times an anesthesiologist will give the talk and answer your exact questions.  If you can, take the class!

Some basic information is as follows:

A spinal is easier to perform and works much faster for pain relief.  In this type of anesthesia, a single injection of anesthetic/pain reliever is given into the spinal fluid.  The down side to the procedure is that it often wears off within 2-4 hours, so it has to be timed very carefully so that it lasts longer than labor! Headaches afterwards are a little more common with this procedure.

An epidural is a more technically difficult procedure, and takes a little longer to work.  In this procedure, a tiny cather (tube) is placed in an area just outside of the spinal column (the spinal fluid is not actually entered) and anesthetic/pain relievers are continuously pumped through the catheter for as long as it is needed.  The dosage can be adjusted up or down for the various stages of labor.  Because the spinal fluid is not actually entered, the chance of a headache afterwards is lower with this procedure.

Many institutions do what is called a CSE or a combined spinal epidural.  This gives you the benefits of both types of anesthetic.  I had this for my vaginal delivery ( I had the spinal for my c-section) and I LOVED it!!! I felt it allowed me to be "present" for the delivery ( labor can be so painful, that the natural endorphin levels are high enough to make you really "out-of-it" even without IV pain relievers).

That (IV pain relievers) is the third option.  In this option, the baby gets a little higher dosage of medicines than with the spinal or epidural, so, again, it needs to be carefully timed.

There has been tons of research done on all the methods, and they are all very safe--complication risks are very minimal [ but there is ALWAYS some risk with any procedure ].

Hope this information is useful! Congratulations on your new baby to be!

Dr B
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