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At the Westminster Maternity Suite we offer effective pain management solutions for you during your labour and birth.
Our obstetric anaesthetists are trained doctors who specialise in pain relief. They are responsible for your well-being and safety, they are on hand to ensure that your birth is as comfortable as possible.
As a private maternity patient you will have the opportunity to choose your own anaesthetist. Our anaesthetists are available to discuss options for pain relief including epidurals.
There are many different pain relief methods, broadly split into two groups: with medication and without medication. Without medication includes using a TENS machine, water births and complementary therapies (such as acupuncture and hypnotherapy). Pain relief with medication can include gas and air (Entonox), opioid injections, patient controlled analgesia (PCA), intravenous analgesia and epidurals.
Anaesthesia is not included in the hospital fee and will be billed separately by the anaesthetist. Find out more about our maternity prices and packages here.
What is an anaesthetic?
Anaesthesia stops you feeling pain during an operation.
- A local anaesthetic uses an injection to numb a part of your body. You stay awake but don’t feel pain.
- A regional anaesthetic uses an injection of anaesthetic to numb a larger part of your body (such as an arm or a leg). You stay awake but don’t feel pain.
- A general anaesthetic gives a state of controlled unconsciousness during which you feel nothing. This is essential for many operations and you will be asleep for the entire procedure.
Epidural
A common choice of anaesthetic during labour is an epidural. An epidural can drastically reduce the amount of pain you feel while keeping you present and alert. It is the most effective method of pain relief for labour and will have very little effects on your baby.
An epidural is a procedure involving the injection of a local anaesthetic into the space around the spinal nerves in your lower back. The anaesthetic blocks pain caused by labour contractions. Epidurals are always performed by our experienced anaesthetists.
Although an epidural can cause you to have a reduced sensation in the lower part of your body, you can still walk and push during the birth. This is why we offer ‘walking epidurals’ that allow you to stay mobile and walk around during labour.
Types of epidural
There are two types of epidurals types used during labour – epidural with a catheter and combined spinal-epidural.
Epidural with a catheter
The anaesthetist will administer medicine through a catheter (thin tube) into your lower back. The catheter allows for multiple doses of the epidural medication. This way, if your labour lasts longer than one dose of pain relief, it can easily be topped up.
This type of epidural is sometimes called a ‘walking’ epidural due to the fact you can still move once it’s administered. We use low dose solutions that will take the pain away but still allow you to stay mobile during labour. You are in control of how much pain relief is administered via a button attached to a pump that can be pressed every time you have pain. This is called a patient controlled epidural analgesia (PCEA). The epidural can also be topped up and used if an intervention is required in theatre.
Combined spinal-epidural (CSE)
Combining two injections, a spinal block and an epidural to provide faster pain relief. The epidural catheter is left in your lower back similar to the above and managed in the same way.
How does an epidural work?
Anaesthetists can use two different types of medicine in an epidural, analgesia and anaesthesia.
Analgesia is pain relief and anaesthesia is the loss of feeling or sensation in a particular area of your body. Typically, anaesthesia is used during a caesarean section (C-section). So you’re awake but won’t feel any of the surgical procedure.
Most epidurals during labour are a combination of the two, so that you’re numb in the lower half of your body and feel no pain.
Epidurals prevent pain signals caused by contractions from travelling through your spine to your brain.
The anaesthetist injects epidural fluid into the space around your spinal cord. Your spinal cord connects all the nerves in your body to your brain – so, by blocking the pain in your spinal nerves with an epidural, the pain signals sent to your brain are also blocked.
When might you receive an epidural?
If you’re considering an epidural to assist you during labour, then it will be administered during the first stage. You can have it at later stages. But sometimes, it can be too late if you’re already pushing or fully dilated.
You can receive an epidural even if you go into unplanned labour or if you did not previously want to have one. You can decide at any point if you feel the need for pain relief in the form of an epidural.
Most women can safely have an epidural, but you’ll need to discuss your circumstances and health with your midwife or nurse before going into labour.
Risks and side effects of an epidural
Epidurals are a safe and effective method of pain relief to help you during the intense process of labour. Our dedicated maternity team will be by your side to ensure you’re comfortable and supported throughout.
If you’re considering an epidural during your vaginal birth, tell us and we’ll make sure all the arrangements are in place for you when the time comes.
Some side effects of an epidural can include:
- feeling cold or itchy
- a painful headache within 48 hours
- a low risk of infection
- temporary and permanent nerve damage (this is extremely rare)
Our anaesthetist team work closely with your consultant to manage your anaesthetic and pain control throughout your stay on the maternity ward, you can rest assured your safety comes first.
Frequently asked questions (FAQs)
Here are some of the most frequently asked questions about epidurals so you can feel fully informed when creating your birthing plan.
It can take up to 30 minutes before you start to feel pain relief from the epidural. A CSE is an option if stronger pain relief is required faster as it can work almost immediately.
An epidural tends to last for a few hours before it starts to wear off, so it will last you the duration of your labour and can be topped up if you still need it.
The medicine from the epidural can potentially reach your baby but in a much smaller dosage. The risk of harm to your baby from an epidural is very low. Distress is possible if your blood pressure lowers, but this risk is rare.
You may feel a slight pinch when the anaesthetist inserts the needle or catheter or slight pressure during the injection. But having an epidural is not painful as local anaesthesia is used to numb the site first.
The epidural solution we use is low dose concentration of numbing drugs and so is called a ‘mobile epidural’ and we encourage mobilising. However, your epidural can make the lower half of your body feel numb, you may have a Foley catheter (another thin, plastic tube) inserted into your urethra and into your bladder to drain your urine.
If you’re fully (10cm) dilated, then most of the time, it’s considered too late for you to have an epidural as your baby will be born very soon, however a CSE is an option to help with the stronger pain quickly.
The effects of your epidural will not significantly impact your ability to push. Although your lower half will be numb from the epidural, you’ll still feel pressure and the movement of your baby in your birth canal and when they are born.
Anaesthetists
Explore our team of highly experienced private anaesthetists below.
Dr Nhathien Nguyen-Lu is a consultant anaesthetist and the fellowship lead for obstetric anaesthesia at St Thomas’ Hospital.
Her interest is in high-risk obstetrics including postpartum haemorrhage and she is the lead anaesthetist for patients with invasive placentation.
Dr Neel Desai is a consultant anaesthetist at St Thomas’ Hospital and honorary senior clinical lecturer at King’s College London. He is a caring, compassionate and committed anaesthetist who listens to parents and understands the importance of providing evidence-based and individualised care in a holistic manner.
In collaboration with the obstetricians, midwives and neonatologists whom he works closely with, Neel supports the attainment of effective, high quality and safe outcomes for mother and baby. He remains calm and focused in emergency situations, paying attention to the details which matter to maintaining a positive birth experience for parents.
Neel has excelled in the academic field, publishing widely in national and international journals in subject areas related to obstetrics and anaesthesia.
Locations
Our maternity services are offered at the following locations:
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