Heather Causey of South Carolina is a certified registered nurse anesthetist (CRNA) at Columbus Regional Hospital in Whiteville, North Carolina, where she supports surgical teams with regional, general, sedation, pediatric, and geriatric anesthesia. She began her nursing career as a registered nurse at Grand Strand Regional Medical Center in Myrtle Beach before earning her bachelor’s and master’s degrees in nurse anesthesia from the Medical University of South Carolina. Heather Causey previously worked at McLeod Loris Seacoast Hospital and remains an active member of the American Association of Nurse Anesthetists, as well as the Sigma Theta Tau International Honor Society. Among her many clinical responsibilities, she routinely administers epidurals for labor and delivery, helping patients manage pain safely during childbirth while remaining alert and engaged throughout the process.
Understanding Epidurals During Labor and Delivery
Pain management is an important part of preparing for childbirth. An epidural is a commonly used form of anesthesia that can provide significant pain relief while allowing the mother to remain awake and involved in the birth.
Understanding how an epidural is administered, the available options, its benefits, and potential risks can help expectant mothers make informed decisions with their healthcare providers.
For a typical labor epidural, the patient sits or lies on her side with her back curved while the lower back is cleaned and numbed with local anesthetic. A needle is used to guide a thin catheter into the epidural space, after which the needle is removed, and medication can be delivered through the catheter during labor.
Pain relief generally begins within about 10 to 20 minutes. IV access and fluid administration may also be used as clinically appropriate, but the amount and timing depend on the individual patient and care plan.
Healthcare providers can use different epidural techniques to manage pain during labor. A single-injection epidural involves giving one dose of anesthesia for pain relief.
An epidural catheter involves placing a flexible tube in the epidural space so that additional doses can be given when needed. A catheter is also used in a patient-controlled epidural, and the patient can request controlled doses of pain medication through a handheld device.
A combined spinal epidural uses both spinal and epidural anesthesia to relieve labor pain. It may allow some feeling and movement in the lower body and is sometimes called a walking epidural.
The effects of an epidural can last for several hours, depending on the type of epidural and the medication used. A single-injection epidural generally wears off within a few hours, with sensation gradually returning to the affected area.
Epidurals delivered through a catheter may continue to cause numbness for several hours after the final dose. During this time, the patient may experience mild tingling and should avoid walking until full sensation and strength return to the legs.
One major advantage of an epidural is substantial pain relief without loss of consciousness. This can allow a laboring patient to rest while remaining awake and able to communicate with the care team.
If cesarean delivery becomes necessary, an existing epidural catheter can often be used to administer a stronger anesthetic, although the anesthesia team must confirm that the resulting block is adequate for surgery.
Epidurals can cause side effects, although serious complications are uncommon. Blood pressure may fall temporarily, so the patient and fetal heart rate are monitored.
An accidental puncture of the membrane containing spinal fluid can sometimes cause a severe post-dural puncture headache, which may require treatment such as an epidural blood patch. Temporary numbness or weakness may continue after delivery, while complications such as infection, bleeding, or lasting nerve injury are rare.
An epidural can offer effective pain relief during labor and allow the patient to remain conscious and engaged in the delivery process. Professionals use different methods depending on the patient’s needs and circumstances.
While the procedure has potential side effects, careful monitoring helps healthcare professionals manage them. Discussing the available options, benefits, and risks with a qualified healthcare provider can help each patient determine whether an epidural is appropriate for her birth experience.
About Heather Causey
Heather Causey is a certified registered nurse anesthetist (CRNA) practicing in South Carolina, currently serving at Columbus Regional Hospital in Whiteville. She began her nursing career at Grand Strand Regional Medical Center in Myrtle Beach and later earned her anesthesia credentials at the Medical University of South Carolina. She has also worked at McLeod Loris Seacoast and remains active with the American Association of Nurse Anesthetists and the Sigma Theta Tau International Honor Society.
