It is generally expected that the woman be attached to a continuous monitoring machine (known as Cardiotocograph or
CTG) to record the baby's heart rate, after the insertion of the epidural. Some women do not like feeling 'tied down' with this machine and may want to be more mobile, especially if they have a walking or light epidural. Others find it reassuring and not a problem, particularly if they are staying in bed any way. It may be that the monitor is needed anyway because you are having an oxytocin drip to
augment or
induce the labour. You may wish to read more in
monitoring.
Image 8-13 shows a woman with an epidural in place, her intravenous drip and epidural infusion pump and her baby being monitored.
The crucial time to monitor the baby is in the first half an hour after the administration of epidural medications. It is at this time that the mother's blood pressure can fall to the point that it can affect the baby's heart rate, due to reduced blood flow to the placenta. After this time (if the heart rate pattern is normal) you may wish to negotiate for intermittent monitoring, with continuous monitoring only being confined to the half hour after epidural top-ups. You may wish to discuss these options with your caregiver during the pregnancy.
Checking your blood pressure
A common side effect of an epidural is a lowering of the woman's blood pressure. It is for this reason that the midwife will routinely check the woman's blood pressure every 5 minutes for the first 20 minutes to 30 minutes after the epidural medications have been administered and after any subsequent medication top-ups. The woman's blood pressure will continue to be checked every 30 minutes in between these times (or if a continuous epidural is being used).