Epidurals

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 anesthesia. They provide continuous pain relief to the entire body below the belly button (including the vaginal walls) during labor and delivery. With an epidural, a woman is comfortable and still fully awake.

An epidural (sometimes called an epidural block) is what most women think of when they consider pain medicine during labor.

How Are Epidurals Done?

An epidural involves medicine given by an anesthesiologist . A thin, tube-like catheter is inserted 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 only takes a couple of minutes to insert an epidural. 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.

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 once 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.

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

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
• cause a headache, itchiness, nausea, or vomiting
• cause temporary difficulty with peeing, requiring a urinary catheter

Some studies suggest that epidurals may increase the chances of C-sections or vaginal deliveries that require forceps or vacuum extractions, but others show no connection.

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.

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.