Epidural use of first method is in 1885, when a New York neurologist J. Leonard Corning injected cocaine into the spine of patients suffering from "weakness of the spine and the seminal incontinence." 1 More than a century later, epidural analgesia has become the most popular method, or painkillers, in the delivery room in the U.S.. In 2004, nearly two-thirds of women who reported that they had given birth epidural, including 59 percent of women who had given birth pervagina (2). In Canada, about half of women who give birth normally use an epidural (3) and in Britain, 21 percent of women given an epidural before giving birth (4).
An epidural is an injection of local anesthetic used (derived from cocaine) and injected into the epidural spaces that protect the spinal cord. In a conventional epidural will numb the client either sensory or motor nerves. Within five to ten years, epidurals have been developed with the concentration of drug (local anesthetic), and with a combination of local anesthetics and opiate (a drug similar to morphine and meperidine) pain killers to reduce the motor block, and to produce what is called epidural "walk".

 

 
Spinal analgesia has also been increasingly used in childbirth to reduce the motor block. Spinals injecting drugs penetrate the dura and into the space (intrathecal) spine, and produced only short-term analgesia. To extend the effects of labor pain relief, the dose can be added as needed
Epidurals and spinals offer the most effective form of pain relief that is available in childbirth, and women who have been using analgesia to reduce pain have a high level of satisfaction of this method, however, satisfaction did not experience this pain is not the same as the overall satisfaction Overall labor (5) other than that it also can endanger the safety of epidural mothers and babies.
Epidural and hormone delivery
Significantly interfere with the use of epidural labor several major hormones, which can have a negative impact on the process of birth (6). WHO says that epidural analgesia is one of the most striking examples of the medicalization of normal childbirth. that, changing the physiological event into a medical procedure (7).
For example, oxytocin, known as the hormone of love, which is also a natural uterotonic-a substance that causes the woman's uterus to contract during labor. Epidural make the production of natural oxytocin in the body decreases even lost (9). Epidurals also eliminate the peak excretion of oxytocin which should happen when the baby is born (11), whereas this hormone oxytocin that helps mothers and infants to fall in love at first meeting. Another important hormone in the uterotonic like, prostaglandin F2 alpha, were also reduced in women who use an epidural (12).
B eta-endorphin is a naturally occurring hormone that works to help women who labor to cope with the pain. Beta-endorphin is also associated with altered state of consciousness during delivery. These hormones also help guide the mother to struggle and work instinctively with her body and her baby, so sometimes laboring women often use movement and sound. Epidurals reduce the production of beta-endorphin in the body of a woman (13.14).
Adrenaline and noradrenaline (epinephrine and norepinephrine, known as catecholamines, or CA) was also released or in production under conditions of stress, and increases experienced during childbirth without medication (15) At the end of stage 2 labor, a natural hormone surge gives mothers energy to push the baby out, and make her excited and fully alert at the first meeting with her baby. This is known as the fetal ejection reflex (the fetal ejection reflex) (16)
However, delivery can be in the resistor with a very high level of CA, which can be released when she was hungry, cold, scared, or insecure during labor (17). This makes sense because if senses danger the mother says, then her hormones will slow or stop labor and give him time to "escape" to find a safe place to give birth. And this is normal in the process of human evolution.
Epidurals reduce the production of CA in the actual help birth mothers in childbirth. However, the decline in CA final production may contribute to the difficulty of a woman pushing to have the desire or passion to push the baby out. So finally it greatly increases the risk of instrumental deliveries (forceps and vacuum)
Effects on the birth process
Epidurals make labor go more slowly, because the evidence from research that the local anesthetics used in epidurals can inhibit muscle contraction by directly affecting the uterus (18).
For example, epidurals also make the pelvic muscles were numb / numb, when pelvic muscles are important in guiding and changing the baby's head to move toward the best position to be born. Epidural make the risk four times higher likelihood for posterior position of the baby's head on stage akhhir in an incidence study, 13 percent higher compared with women who birth without an epidural that only 3 per cent (21). This posterior position of course would reduce the chance of spontaneous vaginal delivery in one study, only 26 percent of the mothers who gave birth the first time (and 57 percent of mothers who experienced) with a posterior baby baby can be a spontaneous vaginal delivery, direct others to do forcep , vacuum or even SC (22).
The risk for infants, with the help of instrumental delivery can increase the risk of short-term such as bruises, facial injuries, and cephalohematoma (blood clot under the scalp) (24) The risk of intracranial hemorrhage (bleeding in brain) was increased in a study of more than four times for babies who was born with forceps compared with spontaneous birth, (25) although the two studies show no developmental differences were detected for the child's birth forceps (26.27
Epidurals also increase the need for Pitocin to increase contractions, women who labor with epidural nearly three times more likely to be given Pitocin (29). The combination of epidural and Pitocin, can cause abnormalities in fetal heart rate (fetal Heart Rate) that trigger fetal distress, thus significantly increasing the risk of surgery (forceps, vacuum, or caesarean section). DiAustralia In one survey, about half of first-time mothers be given maternity and ended with labor epidural SC (30)
Epidural side effects
Drugs used in labor with an epidural that is strong enough to make numb, and often disabling, and can affect the mother's blood pressure, so it is not surprising that there will be significant side effects for both mother and baby.
Side effects for the mother
1. The most common side effects of epidural is a decrease in blood pressure. This effect is almost universal, and usually preceded by administering IV fluids before giving an epidural. Hypotension can cause complications ranging from feeling faint of heart attack, 37 and may also affect blood supply to the baby. Hypotension can be treated with more IV fluid administration and, if severe, with an injection of epinephrine (adrenaline).
2. Inability to urinate (and the need for urinary catheter)
3. itchy skin (pruritus) (39.40)
4. chills (41)
5. nausea and vomiting (43)
6. Epidurals can also cause an increase in maternal body temperature.
7. Ddapat cause unexpected breathing difficulties for the mother (47)
8. Increases the risk of post partum persarahan (48-53)
9. causes severe headaches that can last up to six weeks (57.58)
Side effects for infants
1. Birth trauma (71)
2. The risk of addiction later in adolescence (71)
3. Changes in fetal heart rate that can cause distress
4. Oxygen supply is reduced due to reduced maternal blood pressure
5. Apgar less
6. One researcher has noted a tenfold increased risk of newborn encephalopathy (signs of brain damage) in infants born to mothers with a fever caused by an epidural (76).
7. The risk for having a seizure in the newborn period is higher, compared with infants of normal birth (75)
8. several studies of the condition of infants at birth, and nearly all babies born after epidurals compared with infants born after exposure to opiate drugs, which are known to cause drowsiness and difficulty breathing.
9. Several studies comparing babies exposed to epidurals with babies whose mothers did not receive drugs that have found significant neurobehavioral effects, (86.88)
Epidurals can also affect the experience and success of breastfeeding through several mechanisms. First, babies exposed to epidurals may have neurobehavioral abnormalities caused by exposure to drugs that will likely be maximal within a few hours of birth-a critical time for initiation of breastfeeding. Recent research has found a (rather obvious) that the higher the score neurobehavior in newborns, the higher their value for feeding behavior (108)
In another study, infants exposed to epidural and spinals more likely to lose weight in hospital,
second, the epidural can affect behavior and condition of new mothers, making it more difficult to breastfeed. This is possible if he had experienced a long labor, delivery by an instrumental, or separation from their infants, all of which are more likely to occur in persalinanepidural. hormonal disturbances also play a role given the hormone oxytocin is a major in nursing
Conclusion
An epidural may have benefits but also have a significant risk for birth mothers and their babies. This risk is well documented in medical literature, but can not be disclosed to the mother in labor. Well if you want a normal delivery and smooth start trying to do since now the effort is natural and healthy and safe.