how many cm should you get epidural?
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Most women want an epidural when their contractions are getting strong, often when their cervix has dilated to about 5cm (2in) or 6cm (2.4in). Your midwife may advise against an epidural once you've reached the pushing stage, but it will depend on how your labour is progressing.
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Dilation: Your cervix opens. Dilation is checked during a pelvic exam and measured in centimeters (cm), from 0 cm (no dilation) to 10 cm (fully dilated). Typically, if you're 4 cm dilated, you're in the active stage of labor; if you're fully dilated, you're ready to start pushing.
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An epidural can be given to you as soon as you ask for one (and an anesthesiologist is available), even if you're minimally dilated.
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The active stage of labor can range from a woman dilating anywhere from 0.5 cm per hour up to 0.7 cm per hour. How fast your cervix dilates will also depend on if it's your first baby or not.
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Because they're spaced only about two or three minutes apart, it may seem as though you barely get to relax before the next contraction begins. During transition, unless you're numbed by an epidural or other pain relief, you may feel: Strong pressure in the lower back and/or perineum.
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Spinal blocks work faster than epidurals, and a smaller amount of anesthetic medication is needed. General anesthetics can be done faster, so they are used if the operation is an emergency, or if the woman can't have a regional anesthetic.
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After the epidural wears off, you may have some hip or back pain from childbirth. You may have a small bruise and the skin may be sore where the epidural was put in your back. This will probably get better in 1 or 2 days. In rare cases, an epidural can cause a headache when you sit or stand.
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Your cervix opens from 7 to 10 centimeters. For most women, this is the hardest or most painful part of labor. This is when your cervix opens to its fullest. Contractions last about 60 to 90 seconds and come every 2 to 3 minutes.
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Hold the "0" end of your tape measure against the top of your pubic bone and carefully stretch it across your pubis, up and over the curve of your stomach, and to your fundus. Record this measurement (in cm). Generally, fundal heights should be within 1-4 cm of the baby's gestational age in weeks.
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But in fact, dilation is NOT a Magic 8 Ball. Some women begin dilating at 36 weeks and go to 41 weeks before they finally go into labor at 7 centimeters. Some women are checked with a routine cervical exam and found to be just "a finger tip dilated," then go into full blown, active labor 24 hours later.
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How many epidurals does Medicare allow in a year? Medicare has specific requirements for Epidural Steroid Injections (ESI). However, the injections must be medically necessary to relieve pain. Six or more weeks of conservative therapy need to fail, and the patient must complete physical therapy.
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Some women begin dilating at 36 weeks and go to 41 weeks before they finally go into labor at 7 centimeters. Some women are checked with a routine cervical exam and found to be just "a finger tip dilated," then go into full blown, active labor 24 hours later.
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Once your cervix is dilated to 3 centimeters, the Foley catheter falls out on its own. In some cases, this is enough to start active labor. If not, your doctor might resort to a different method of induction.
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At this point, your cervix will be dilated 3-10 centimeters. (Dilating 1 cm/hr is textbook, but like in early labor, it's different for every woman.) If you're opting for an epidural, the time is…now!
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How long does it take to do? Placing the epidural takes about 10 minutes, with good pain relief starting in another 10-15 minutes. In patients who are obese or have scoliosis, more time might be required to place the epidural.
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Studies have estimated that 40% to 84% of patients receiving a cervical epidural steroid injection experienced at least partial relief. It is important to note that a cervical epidural steroid injection may not provide relief for some people.
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Typically, a spinal block lasts 2-6 hours depending the type and amount of local anesthetic given by the anesthesiologist. If you received an epidural catheter, it can be left in place for several days after surgery to allow a continuous infusion of pain relieving medications.