An epidural is a common method for pain management during labor, offering significant relief by numbing the lower half of the body. As labor progresses with an epidural, questions often arise regarding bladder management. Understanding the use of a catheter helps prepare individuals for their labor experience.
Why Bladder Management is Necessary with an Epidural
The numbing effects of an epidural impact the body’s natural functions, including bladder control. When an epidural is in place, nerves that signal bladder fullness and control the urge to urinate are temporarily blocked. This results in a reduced or absent sensation of a full bladder, making it difficult or impossible to voluntarily empty the bladder.
Accumulation of urine in the bladder can lead to discomfort and may even impede the progress of labor. A distended bladder can physically obstruct the fetal head’s descent into the pelvis, potentially prolonging the second stage of labor. This physiological interference necessitates intervention to ensure the bladder remains empty, supporting both maternal comfort and labor progression. Nurses typically assess bladder status throughout labor, often every 2 to 4 hours.
How Catheters are Used During Labor
To manage bladder function with an epidural, medical staff typically use urinary catheters. There are two primary methods: intermittent catheterization and indwelling catheterization. Intermittent catheterization, also known as “in-and-out” catheterization, involves inserting a thin, flexible tube into the bladder to drain urine, and then immediately removing it. This method is often preferred for bladder management with an epidural.
Indwelling catheterization, commonly using a Foley catheter, involves a catheter that remains in place for an extended period, continuously draining urine into a collection bag. While this method offers continuous drainage, studies suggest that intermittent catheterization may be associated with a lower likelihood of cesarean birth compared to continuous catheterization. The insertion procedure for both types of catheters is performed using sterile techniques to minimize the risk of infection.
Understanding Catheterization During Labor
When a catheter is inserted during labor with an epidural, the numbing effect of the epidural typically prevents pain. While sharp pain is generally not felt, a sensation of pressure may be noticeable during insertion. The catheter is usually placed after the epidural has taken effect, ensuring maximum comfort for the birthing individual.
The timing of catheter removal depends on the type of catheter used and the progress of labor. An intermittent catheter is removed immediately after the bladder is emptied. An indwelling catheter is typically removed before the pushing stage of labor begins or shortly after delivery. Normal bladder function will gradually return as the epidural medication wears off. While some individuals may experience a slight stinging sensation or discomfort for a few hours after removal, this is usually temporary.