Today, i will refrain from complaining about the myriads of problems bedeviling the healthcare provision in Nigeria. I will not complain about the fact that Joint Health Sector Union (JOHESU) has given the federal government 15days ultimatum to meet their demands or the fact that the National Association of Resident Doctors (NARD) also gave the government 21 days to meet their own demands. I will not complain about the attitudes of healthcare personnel to their patients or the unavailability of essential consumables to aid the healthcare worker do his work effectively.

Today is dedicated to the women, our mothers and wives, the good women of Nigeria who have played a role in our existence as humans. May The Almighty continually bless you all.


The essence of marriage to the average African is to bear offspring that will take after them when they are gone and look after them in their old age. In order to achieve this a man and a woman shall come together, with the man donating a spermatozoa and the woman donating an ovum (egg) which fuses to form a zygote which develops into the fetus which at term (9 months) is delivered. Normally delivery should be through spontaneous vaginal delivery but due to one reason or another may end up caeserean section.


All methods of delivery is associated with pains though to a varying degree. Spontaneous vaginal delivery still remains the commonest method of delivery which has been described to be as painful as a fracture. this pain has been noted to make some women detest the idea of going into labour spontaneously.


So why labor in pains in this 21th century? The good news today is that there are various methods of controlling pain in labour but the commonest is the EPIDURAL ANALGESIA IN LABOUR which will form the core of our discuss today.


In the US about 50% of the pregnant women make use of Epidurals, in Nigeria, it is sparingly used because the populace is not aware that it is available in most hospitals in Nigeria, also the skill and requisite manpower to monitor pregnant women with epidurals in labour is not adequate.

What we have noticed is that those who request for this are wives of doctors or healthcare workers. This ought not to be so.

Why subject our wives to immense pain and discomfort when there are alternatives with minimal discomfort.?

As you visit the obstetrician and prepare for labor, ask him/her about pains in labour and how it can be controlled. Ask about the choices you have or concerns about any form of analgesia they may want to use for you.


What is Epidural Analgesia?


This is a form of regional anaesthesia where pain impulses are blocked in a particular part of the body. It blocks nerve impulses from the lower segment of the spine and is associated with reduced sensation in the affected body part. A local Anaesthetic agent is often used for this alone or in combination with opioid analgesics to improve the block.


Who will benefit from an Epidural?


1. Every pregnant woman who requests it

2. A woman with Pregnancy Induced Hypertension or Pre-eclampsia

3. Conditions of prematurity or intra-uterine growth retardation

4. Conditions of Intra-uterine fetal death

5. Induction or augumentation of labour

6. Instrumental or caeserean delivery

7. Twin gestation

8. Presence of significant medical disease such as hypertension, diabetes or heart disease.


Epidurals are contraindicated in women with bleeding disorders, skin infections around the lower spinal segments or any systemic infection. A pregnant woman also reserves the right to refuse an epidural. Note that Epidurals are given when a woman enters the active phase of labour.


http://americanpregnancy.org/labor-and-birth/epidural/ explains the procedure in a clear and simple way below

How is an epidural given?

Intravenous (IV) fluids will be started before active labor begins and before the procedure of placing the epidural. You can expect to receive 1-2 liters of IV fluids throughout labor and delivery. An anesthesiologist (specialist in administering anesthesia), an obstetrician, or nurse-anesthetist will administer your epidural.

You will be asked to arch your back and remain still while lying on your left side or sitting up. This position is vital for preventing problems and increasing the epidural effectiveness.

An antiseptic solution will be used to wipe the waistline area of your mid-back to minimize the chance of infection. A small area on your back will be injected with a local anesthetic to numb it. A needle is then inserted into the numbed area surrounding the spinal cord in the lower back.

After that, a small tube or catheter is threaded through the needle into the epidural space. The needle is then carefully removed, leaving the catheter in place to provide medication either through periodic injections or by continuous infusion.The catheter is taped to the back to prevent it from slipping out.


When this is done, the Local anaesthetic agent will be injected through the catheter at intervals or through a continous infusion through a syringe pump or a patient controlled mechanism as when needed.


What are the benefits of an Epidural?

1. It improves the experience of labour

2. It reduces the discomfort associated with labour

3. it allows you the opportunity to participate actively in the process of childbirth

4. It can help you deal with exhaustion, irirtability and fatigue associated with labor.


What are the risks associated with Epidurals?

1. There maybe a sudden drop in blood pressure following this procedure, which will necessitate your blood pressure being measured regularly at intervals.

2. Some women experience severe headaches due to leakage of spinal fluid.

3. Numbness in the lower half of the body following delivery

4. Some side effects noted include nausea,urinary retention,shivering, backache, or soreness at the site where the needle is inserted.



In view of the above possible risks, it therefore implies that this procedure requires expertise to be successful and to avoid situations were the epidural is ineffective or a unilateral block to only one side of the body is achieved. So among the questions you must ask your obstetrician is the level of expertise of the person giving the epidural and adequacy of monitoring to both yourself and your baby.


Like i said earlier, epidural anaesthesia is available in Nigeria but most women dont request for this mainly because the awareness of its availability is not there. Every hospital with a trained anaesthetist should be able to offer this and note that you may need to pay a little bit more than the normal delivery fee.


I therefore encourage you to try this option as there are alternatives to experiencing pain in labour.


HAPPY MOTHERS DAY!!!


....kindly follow me @drscopey

My dear, it is 4 d rich only. Epidurals are avaliable especially in big private hospitals which d poor cannot afford