Epidural Headache: What You’re Not Told (and should be)

Although we’ve talked about epidural headache before (more on that in a moment), it’s worth repeating some information. A recent article at Today’s Parent has highlighted the fact that some parents are not being given the whole story about the risks of epidurals.

Not every mother can get an epidural. For example a bleeding disorder, certain neurological diseases, infections, and even at times lower back tattoos (although usually this can be worked around) may lead your doctor to recommend you not get an epidural.

That being said, there are also specific risk factors for epidural headache, more properly known as a post-dural puncture headache (PDPH).

Some doctors may not bother mentioning the possibility of headaches because they’re considered to be a “rare” outcome. However, there are a couple of problems with this:

1. “Rare” in this case means around 1 woman in a hundred. So you’re chances are good, but still that’s not uncommon. Plus, if you’re at a higher risk your chances are, of course, not as good (more on this below).
2. Severe headaches during the first two weeks after birth can affect your ability to bond with your baby. This is a special time that you don’t want to “miss” because of headaches. Don’t let anyone tell you that it’s “just a headache” and so it really doesn’t matter. It does.

The article previously mentioned makes this point well. It’s titled What I wish I knew about post-dural puncture headaches before I got an epidural. To quote:

Sadly, all of that time spent in pain can impact a mother’s ability to bond with her little one in those crucial first days, because sitting up to breastfeed or even just hold the baby can be too difficult. “It is hard to deal with everything that comes along with being a new parent at the same time as being in pain,” says Toronto-based OB-GYN Beth Cruickshank. “It is an emotional time, both high and low, and complications can absolutely impact some patients’ emotional health.

Treatment is not always easy – it’s not just a matter of popping a pill. Usually, mothers just need to wait until the headache goes away. Most often it’s gone in 10 days, but in rare cases epidural headache can last longer.

Are you at risk?
Here are some key things to condsider:

• You’re between 31 and 50 (older sources suggest a higher risk for young adults – but let’s just say the worst risk is between 31 and 40)
• You have a low body-mass index
• Your anesthesiologist is inexperienced
• You’ve had spinal issues, spinal surgery in particular, before

Remember, any one of these can increase your chances of getting an epidural headache.

Be sure to talk to your doctor and your anesthesiologist about the risks (headache is not the only possible side effect, although generally epidurals are considered quite safe). There are other options available to you. Keep an open mind and you may find a better solution.

We haven’t talked in detail about causes and treatments – so your next step is to learn more about epidural headache here.

Remember, although epidural headache is not common, if your risk is higher than normal it is important to consider the risks before agreeing to have an epidural.