Ambulatory Or Walking Epidural - BabyCenter Australia

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1. Pregnancy /
2. Labour and birth

Ambulatory or walking epiduralWritten by Jenny LeachIN THIS ARTICLE

• What is an ambulatory or walking epidural?
• How does it work?
• When can I have an ambulatory epidural?
• What are the advantages of an ambulatory epidural?
• What are its disadvantages?
• Any useful tips?

What is an ambulatory or walking epidural?

This is similar to a standard low-dose epidural, which gives excellent pain relief, but also allows you to retain some sensation in your legs. It is a regional anaesthetic, which means the drug is injected around the nerves that carry signals from the part of your body that feels pain when you're in labour. The difference with a walking epidural is that you will need extra monitoring and support so that you can move around safely. Advertisement | page continues below Remember, though, that the main aim of this kind of epidural is to relieve pain and that keeping you mobile is only a secondary concern. Some women find that they're not really mobile at all. Walking epidurals use the same lower dose combination of drugs as the low-dose epidurals that most hospitals in Australia offer as standard. The usual combination of drugs used is the local anaesthetic, bupivacaine, and the opioid painkiller, fentanyl. These epidurals are only offered in a few hospitals, usually the larger teaching hospitals. They require additional, specially trained staff, which most maternity units are not able to provide. The few hospitals that do offer walking epidurals have procedures in place to ensure that it is safe for you (and your baby) to move about with an epidural in place, and that they have enough staff to support you while you're doing so.

How does it work?

In the same way as a standard low-dose epidural. A walking epidural uses a combination of drugs that maximise pain relief while limiting the loss of sensation in your legs. To be able to walk safely you will need extra care. For example, before you can get out of bed and walk with your epidural in, doctors have to ensure that your legs feel strong enough for you to walk. Your blood pressure and your baby’s heartbeat must also be stable. If the medical staff agree that you are safe to walk, you must always be accompanied and monitored while you are moving around.

When can I have an ambulatory epidural?

If you want an epidural at any stage of labour you should be allowed to have one (NCCWCH 2007:115), but most women have them during the first stage of labour, when they are finding their contractions hard to cope with.

What are the advantages of an ambulatory epidural?

An ambulatory epidural has the same advantages as a standard low-dose epidural. In addition, you should be able to move about and even to walk around to some extent, but you will need help to do so (NCCWCH 2007:120).

What are its disadvantages?

A walking epidural has the same disadvantages as a standard low-dose epidural, except that you won't necessarily have to stay on the bed. However, you may find that you only have a very limited amount of movement (Simmons et al 2007). Some women can manage to move from the bed to a chair, and a few can walk with help. You may also find the extra monitoring intrusive.

Any useful tips?

Check whether your hospital offers walking epidurals. Very few Australian maternity units offer them, because of the extra resources that are needed for them. For other useful tips, see our main epidural article. Advertisement | page continues below Was this article helpful?YesNo

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Sources

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organisations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.

NCCWCH. 2007. National Collaborating Centre for Women's and Children's Health. Intrapartum care: Care of healthy women and their babies during childbirth. Clinical Guideline. London: RCOG Press. www.nice.org.ukOpens a new window [Accessed June 2009] Simmons SW, Cyna AM, Dennis AT et al. 2007. Combined spinal-epidural versus epidural analgesia in labour. Cochrane Database of Systematic Reviews Issue 3. www.mrw.interscience.wiley.comOpens a new window [Accessed June 2009]Jenny LeachJenny Leach is an editor and writer specialising in evidence-based health content. Opens a new window Opens a new window Opens a new window

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