Epidurals

Also called: Epidural Block

What Are Epidurals?

Epidurals are a way to make labor and delivery less painful and more calm and controlled.

Epidurals are a form of regional pain control. They provide pain relief to a whole area of the body, including below the belly button (including the vaginal walls) to the legs. With an epidural, a woman in labor is comfortable and still fully awake.

An epidural (ep-ih-DUR-el) is the most common way that women get pain medicines during childbirth.

How Are Epidurals Done?

An epidural involves the insertion of a thin, tube-like catheter through the lower back into the area just outside the membrane covering the spinal cord (called the epidural space). You'll sit or lie on your side with your back rounded while the doctor inserts the epidural catheter.

It takes just a few minutes to insert the epidural catheter. The skin is numbed first, so you'll feel just a stick or pinch and some pressure. A needle is only used to thread the thin catheter into place. Then, it's removed. You may be aware of the catheter in your back, but this isn't painful or uncomfortable.

The epidural catheter will stay in place throughout your labor and delivery.

What Does an Epidural Feel Like?

The medicine given through the epidural catheter can be pain relievers (such as opioids), a numbing medicine (anesthesia), or a combination of both. You should start to feel the effects of the medicine in 10–20 minutes. You may still feel the pressure of contractions, but you shouldn't feel the pain. Being aware of your contractions will help when you start to push.

As the doctor adjusts the dosage, your legs may feel a little weak, warm, tingly, numb, or heavy. Unlike with some other labor and delivery medicines, you'll be fully alert and aware of what's going on.

What Are the Benefits of Epidurals?

Epidurals provide good pain relief for as long as a woman needs it during labor. The dose of medicine can be adjusted as the labor progresses, and even stopped if needed. Usually the dose is small enough that women stay alert, are aware of contractions, and have enough strength to push with each contraction. And because most of the medicine stays in the epidural space, very little enters the mother’s (and baby’s) bloodstream. This is why epidurals are usually very safe for both mother and baby.

A woman who needs to have an unplanned C-section in the middle of labor can get stronger numbing medicine through the epidural catheter. This will make her lose all feeling from the waist down, but she can still be awake during surgery. (If no epidural catheter is in place and a woman needs an emergency C-section, she might get general anesthesia to "sleep" through the procedure and not feel any pain.)

What Are the Risks of Epidurals?

Epidurals do have some drawbacks. They might:

• make it harder for a woman to push the baby out (the anesthesiologist can adjust the medicine if this happens)
• make the mother's blood pressure drop, which can affect blood flow to the baby
• cause a headache, itchiness, fever, nausea, or vomiting
• cause temporary trouble with peeing, requiring a urinary catheter

Will an Epidural Affect My Baby?

Some epidural medicine does reach the baby. But it's much less than what a baby would get if the mother had pain medicines through an IV or general anesthesia.

The risks of an epidural to the baby are minimal, but include possible distress. Usually, this means the mother's lowered blood pressure causes a slower heartbeat in the baby. This is easily treated by giving the mother fluids through the IV and changing her position to improve her circulation.

How Will I Feel After Delivery?

You may shiver a little after your baby is born (which is common with or without an epidural). Your legs might be numb and tingly as the medicine wears off, which may take a little while. So you might not be able to walk around for at least a few hours after the birth. Even after that, ask someone to help you until your legs feel back to normal. If you had a C-section, the doctor may continue the epidural for a while after the delivery to control any pain.

Your back might be sore for a few days where the epidural was inserted. Very rarely, women who get epidurals may have very bad headaches after the birth.