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Physicians have been administering anesthesia to pregnant women since the 1800s to help them manage pain, but the risks associated with it still exist. An anesthesiologist must make sure the mother and baby are in good health and must act within the expected standard of care. If not, mistakes can happen, potentially leading to a baby developing complications that lead to cerebral palsy.
About Anesthesia During Labor and Childbirth
There are two common types of anesthesia used during childbirth. Epidurals are used during standard vaginal deliveries, while spinal blocks are used during C-sections. Although both forms of anesthesia have substantial benefits, there are also risks.
What is an Epidural?
According to the American Academy of Anesthesiologists, an epidural consists of a tiny tube and needle being inserted into a mother’s back and into the spinal column. When the needle is removed, a catheter remains in the back, administering medication to help with labor pain.
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The area on the back is numbed first by an anesthesiologist before the needle is inserted, but the patient feels a temporary sting. Once the medicine is administered, it creates numbness around the area below the abdomen and the upper legs.
The mother remains awake and alert after an epidural, but the numbness blocks out pain associated with childbirth.
The amount of pain decreases with the strength of the epidural. For instance, with an “alight” epidural (less anesthesia), a mother may still feel pain, although it is less. With higher levels of anesthesia, a mother may not feel any pain.
The benefits of an alight epidural are that mothers can more actively participate in the delivery, such as feeling the pressure to push during contractions.
The epidural effect will generally start to wear off after a few hours.
Complications with Epidurals
Low Blood Pressure
According to a study published by the National Center for Biotechnology Information, low maternal pressure can be a complication for some women who have epidurals.
“In about 14 out of 100 women, the epidural causes blood pressure to drop, which can lead to dizziness or nausea,” the study states.
Maternal hypotension poses potential risks to the baby. It can potentially cause the baby to pass infant meconium (which can lead to brain damage and cerebral palsy) and intrauterine growth restriction (IUGR). It has been linked to both low Apgar scores and fetal acidosis.
Use of Forceps or Vacuum Extractor
Delivering a baby after receiving an epidural also increases the chances of prolonged labor, leading to a physician using birth-assisting instruments, such as forceps or a vacuum extractor to pull the baby out.
Although obstetrical forceps can be effective during a difficult birth, the process requires someone highly qualified and skilled when using these instruments.
One small mistake can lead to permanent injuries and disorders, such as a spinal cord injury, hydrocephalus, or permanent brain damage, leading to cerebral palsy and a host of other medical issues.
Abnormal Uterine Contractions
Since an epidural blocks pain, it can also block the urge to push. This, in turn, masks strong uterine contractions, which makes the process of determining uterine rupture more difficult.
Uterine rupture can lead to dire consequences for the infant, including the potential development of hypoxic-ischemic encephalopathy (HIE) and, in some cases, even death.
Women with bleeding disorders are at heightened risk of developing blood clotting and other serious blood-related issues if they get an epidural.
An epidural hematoma is a brain injury that results in bleeding inside the skull, the outer covering of the brain, and in some instances, the spinal column. An epidural hematoma happens when blood vessels are ruptured.
Although an epidural hematoma is rare, it can happen due to traumatic needle insertion and spontaneous bleeding during the insertion of an epidural needle.
What is a Spinal Block?
A spinal block, also called spinal anesthesia or a subarachnoid block, in which a a qualified medical expert injects a small needle into the cerebrospinal fluid around the spinal cord.
The needle transfers medicine to the mother, and the effects of the medication take place almost immediately. A spinal block allows the mother to stay awake during a C-section procedure while the medication blocks pain.
A spinal block differs from an epidural in that it is a one-time shot of anesthesia, while an epidural can provide continuous anesthesia.
Like an epidural, spinal blocks come with risks, especially if a medical professional makes a mistake.
Maternal Low Blood Pressure
Maternal low blood pressure is also associated with C-section anesthesia, which, as aforementioned, can pose serious risks to the infant.
Keep in mind that maternal low blood pressure is considered a severe medical issue. Doctors and healthcare staff must act immediately to ensure the health of both the mother and baby.
Wrong Dosage or Incorrect Dosage
Rarely a health professional will administer an anesthetic that the mother is allergic to. Other times, they might use the incorrect dosage of anesthetic.
Both scenarios can lead to placenta previa or placental disruption, which is extremely dangerous for the infant.
Keep in mind that medical professionals must do their best to ensure the health and safety of mothers and babies at all times and abide by the medical standards of care.
Reasons that medical mistakes lead to birth injuries and cerebral palsy include:
- Failure to properly administer the epidural
- Failure to closely monitor both mother and baby
- Failure to have a skilled team on-hand
- Failure of the medical team to communicate with each other and detect signs of trouble in time.
- Failure to monitor the infant’s heart rate
If you feel your baby’s injuries were caused by medical negligence, you could have a valid case for medical malpractice. Contact an experienced lawyer to determine your options.
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- Silva, M., & Halpern, S. (2010, December 8). Epidural analgesia for labor: Current techniques. U.S. National Library of Medicine. PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417963/#__sec2title
- Epidurals: Meaning and side effects of anesthesia during labor - Made for this moment. (n.d.). Anesthesia, Pain Management & Surgery. American Society of Anesthesiologists.
Retrieved from: https://www.asahq.org/madeforthismoment/pain-management/techniques/epidural/
- Pregnancy and birth: Epidurals and painkillers for labor pain relief - InformedHealth.org - NCBI bookshelf. (2018, March 22). National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK279567/
- Neuraxial analgesia effects on labor progression: Facts, fallacies, uncertainties, and the future. (2014, August 4). U.S. National Institutes of Health. PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308552/
- Epidural and spinal anesthesia. (2019, August 21). University of Michigan | Michigan Medicine.
Retrieved from: https://www.uofmhealth.org/health-library/rt1583
- Waters, M.D., J. (n.d.). Complications of Obstetrical Anesthesia. UPMC.
Retrieved from: https://www.upmc.com/-/media/upmc/services/neurosurgery/documents/complications-of-obstetrical-anesthesia.pdf?la=en