The Physician's Desk Reference (PDR) states the following about the Caine derivatives used in epidurals: "Local anesthetics rapidly cross the placenta (by passive diffusion) and when used for epidural blocks, anesthesia can cause varying degrees of maternal, fetal and neonatal toxicity. Adverse reactions in the mother and baby involve alteration of the central nervous system, periperal vascular tone and cardiac function." On average, 70 percent of women receiving an epidural during labor experience side effects. The PDR repeatedly states that "no adequate and well-controlled studies [exist] for use [of these drugs] in pregnant women" and that "it is not known whether [these drugs] can cause fetal harm when administered to a pregnant woman." The brain and heart of an unborn baby during labor are vessel-rich, therefore hypoxemia (inadequate oxygen) and the resulting lactic acid buildup in the fetal blood during labor and birth can increase the uptake of drugs given to the mother by the baby's heart and brain.
-Nancy Griffin, excerpted from "The Epidural Express" in Birthing magazine, Summer 1998
Reprinted from Midwifery Today E-News (Vol 1 Issue 20, May 14, 1999)
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