For the majority of cases, we try to have the patient get an epidural when they are in active labor, which can be a dilation of about 4cm, or the person can be less dilated but can be effaced, maybe 90 to 100%.
It also depends upon whether it is the persons first child, a Primiparous (a woman who has had one child), or whether they have had children before. Sometimes, if it is the first child, we try to use other methods before the epidural, as it can affect the progress of labor, and it can affect the ability to push during the second stage of labor.
For my patients, I recommend trying ambulation (walking or moving from place to place) or the jacuzzi initially, then maybe Nubian (an opiate that offers pain relief but does not affect your ability to push) before the epidural.
If a person is on pitocin augmentation, then the epidural will not affect labor progress. Thus, each situation can be different.
— Dr. Scott Zuccala
Dr. Zuccala is a gynecologic surgeon at Mercy Hospital of Buffalo. He practices obstetrics and gynecology, including minimally invasive surgery, and vaginal and pelvic reconstruction for prolapse and urologic incontinence surgery. He was one of the first surgeons in the Buffalo area to perform minimally invasive gynecological surgery for non-cancerous conditions using the da Vinci® Robotic Surgical System.
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