By Elizabeth Helen Spencer
There are many types of pain relief for women in labor. From non-medical approaches like counter-pressure to anesthesiologist-administered treatments such as an epidural, you have a lot to choose from when deciding how you want to deal with the pain of childbirth. However, if you end up having a scheduled or emergency C-section, you'll most likely get a spinal block before the surgery. Romper spoke with Dr. Julio Duarte, Chief of Anesthesiology at Saddleback Medical Center in Laguna Hills, California, to find out what you need to know about getting a spinal block during labor so you can feel prepared.
Also known as a "saddle block," according to WebMD, spinal anesthesia works faster to relieve pain than epidural. It also results in "complete loss of feeling and muscle control below the waist," so it can only be used for an assisted delivery, like a C-section. Since more women are familiar with epidurals than spinal blocks, Romper asks Duarte to elaborate on the differences between the two.
"In a spinal block, anesthetics are injected directly inside the Dural Sac (a covering that surrounds and contains the spinal cord and cerebral spinal fluid). Those blocks are typically done as a single shot. Once the block settles, it will last for a few hours depending on the type and quantity of the medication used," says Duarte.
"In an epidural block, anesthetics are injected inside the epidural space which lays between the Dural Sac and the Vertebra. Epidurals are typically delivered via a catheter which remains in place and is infused with medication until the procedure or labor is complete," he adds.
Overall, spinal blocks are faster acting, but epidurals can last longer if needed since they are administered by infusion.
Epidural and spinal block are not the only choices for anesthesia during childbirth though. Duarte explains that "some anesthesiologists will also perform a combined spinal epidural (CSE) during labor to get the immediate pain relief from a spinal block followed by the slower onset of a continuous infusion of an epidural catheter." Recent studies on this hybrid approach have been positive, noting that CSE is best for pain control during early labor, and that it has no meaningful impact on delivery outcomes.
So what should you expect if you get a spinal block for childbirth? According to Duarte:
"The patient will immediately feel their legs warm and tingly. The sensation moves to their belly within a few minutes. After the block settles, the patient will not feel any pain below the level of the block. The patient will also be unable to move her legs for a few hours."
If you're concerned about the effects of spinal block on your baby, Duarte offers this reassuring response: "most of the medication stays within the Dural Sac and is only detected in the mother's blood in very low concentrations. Therefore the effects to the baby are minimized. This is partly why spinals are the anesthetic of choice for cesarean sections."
One more thing to keep in mind? Certain medical conditions. According to Duarte, the following would exclude a woman from having a spinal block: Severe Spinal Stenosis, recent use of anticoagulants, infection at the site, and Multiple Sclerosis.
If your birth plan includes a spinal block, you can rest easy knowing why and how it's an important part of delivering your baby. Even if you intend on a natural birth with no pain medication, being informed and prepared is best for you and your baby.