Headaches after Child Birth from Epidural or Spinal
Headaches after childbirth are common. Sometimes, the headaches can happen because of the anesthetic (epidural or spinal) you received. The technical term for this headache is a “post-dural puncture headache,” or PDPH. That is the kind of headache we will discuss here.
WHAT DOES A HEADACHE AFTER EPIDURAL OR SPINAL FEEL LIKE?
- Usually dull and throbbing, and the pain can be from mild to severe.
- Usually in the front and/or back of the head or neck.
- Usually, the headache disappears or gets better when you lie down flat, and it gets worse when you sit or stand up. This is a very important and common feature of headaches related to spinal or epidural anesthesia.
- This type of headache can also cause dizziness, nausea, being bothered by light, blurry/double vision, ringing in the ears, short-term hearing loss, and painful or stiff neck.
- It is very important to let your doctors know if you are feeling this kind of headache even if it starts after you have gone home.
WHEN DOES IT HAPPEN?
- If it is because of the anesthetic, it usually starts the day after you had your epidural or spinal, or at most within 5 days.
- It is very important to tell your healthcare team if you have a headache because there are ways to treat them.
WHY DOES IT HAPPEN?
There are 2 diff erent ways that this can happen:
- Our brain and spinal cord are surrounded by a fl uid-fi lled sac called the dura (this fl uid is called cerebrospinal fl uid). When a spinal anesthetic is done, the tip of the small spinal needle intentionally pokes the dura (sac). When an epidural is being done, the epidural needle, which is larger, may accidentally poke the dura (sac).
- The fluid can leak through the hole and can lower the pressure around your brain. The low pressure around your brain is what causes the headache.
WHAT CAN I DO AT HOME?
WHAT SHOULD I DO IF I STILL HAVE A HEADACHE OR IT GETS WORSE?
Make sure to tell your healthcare team.
If the at-home steps do not relieve the pain, your doctor may recommend a procedure called an epidural blood patch.
WHAT IS AN EPIDURAL BLOOD PATCH?
This procedure is very similar to the one you had for your epidural or spinal anesthetic. In 8 out of 10 women, the headache is relieved or significantly improved by the blood patch.
- Once the epidural space is found in your back, the doctor will draw blood from a vein (usually your arm or hand) and inject the blood slowly into your back.
- Usually the headache goes away very quickly, but it may take a few hours.
- You will be asked to lie flat for about an hour or so.
- You should be allowed to go home after that if you are ready for discharge from the hospital or if you came to the hospital from home for the procedure.
- A second epidural blood patch might be needed if the first one does not work or if the headache returns.
ARE THERE ANY RISKS?
ARE THERE ANY RISKS IF I DON’T GET AN EPIDURAL BLOOD PATCH WHEN IT HAS BEEN RECOMMENDED?
The decision to have an epidural blood patch is made by you and your doctor. They will be able to explain further if needed!