How Does an Epidural Work?

Epidural is the most commonly used form of pain relief during labour in the US. A catheter is inserted into the epidural space in the membrane surrounding your spine. This tube is then used to deliver continuous medications for pain relief throughout labour. An epidural usually delivers a mix of an anaesthetic and a narcotic. An epidural decreases sensation in your lower body, but doesn’t cause numbness. An epidural enables you to stay conscious throughout labour.

How is an epidural administered?
You will be asked to sit at the edge of the bed, or lie in a curled position, for the epidural to be inserted. A numbing injection will be used to prepare the insertion site. Once the area is numb, a needle will be inserted into your lower back.

The catheter will then be fed through the needle and into your back. The needle will then be withdrawn, and the catheter will be taped into place to prevent it from coming out. Once it has been taped down, you will be able to lie back down on the bed.

You will be given a test dosage of the medicine to ensure that there are no problems, and once this has been confirmed you will be given a full dose. Your baby will need continuous monitoring if you opt for an epidural, and your blood pressure will need to be checked regularly.

Can I have an epidural?
Not all women are able to have epidurals. You will be advised against having one if you:

  • have very low blood pressure
  • have a bleeding disorder
  • have a blood infection
  • have a skin infection on your lower back
  • have had previous allergic reactions to local anaesthetic
  • are on certain blood thinning medication

When can I have an epidural?
You should be in active labour before you have an epidural. This means you must be at least 4cm dilated and having regular contractions. You can have an epidural fitted at any point during active labour, until your baby’s head is crowning. Then it is considered too late to start an epidural, but if necessary you will be offered other forms of pain relief.

Advantages of an epidural
The advantages of this form of pain relief are:

  • it is considered to be a very effective form of pain relief
  • the dosage and strength can be increased or decreased easily as required
  • you will be awake and alert during the birth

Disadvantages of an epidural
There are some disadvantages to this form of pain medication, including:

  • most epidurals restrict your movement and mean you are unable to stand or walk during labour, and this may restrict the birthing positions you can try
  • you will require an IV and regular blood pressure checks
  • your baby will require continuous fetal monitoring
  • women with epidurals tend to have to push for longer during labour
  • an increased risk of assisted delivery by forceps or vacuum extraction
  • in a very small number of women, epidurals may affect breathing, or cause nerve damage or infection

It is impossible to predict how you will experience labour. You may be crying out for an epidural after five minutes of active labour, or you may find relaxation breathing alone gets you through the birth. Keep your mind open to an epidural, but you may like to delay it until you feel it is truly necessary.

What pain relief are you planning to use during labour?

Written by Fiona, proud owner of a toddler, @fiona_peacock

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright Β© Health & Parenting Ltd 2017. All rights reserved.

Fiona PeacockHow Does an Epidural Work?

Comments 23

  1. Wanda

    Had epidural on my 1st & 2nd and will again on my 3rd, who is coming in less than 3 weeks. I’d rather be relaxed and save my energy for delivery πŸ™‚

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  4. Valerie

    I’m an anesthesiologist specialised in obstetrics.
    Would like to correct 2 false statements.
    It is no longer true that you need to wait till 4cm of dilation before getting an epidural. There are numerous studies that support getting an epidural when the woman desires one.
    Second, it no longer increases the risk of instrumental delivery. Over the last 20-30 years, we have worked hard to minimise side effects and this includes using lower concentrations of local anesthetic and better control of pain meds by patients via use of patient controlled devices. In addition, the statement where it says you may push for longer is more or less true with this modern regimen.
    There is no reason to forgo pain relief in 2017 if you need pain relief (and most women do). I’ve administered epidurals for years and I have absolutely no hesitation in getting an epidural myself for my upcoming baby. That being said, it is a personal choice, as long as it is an informed choice.

  5. Julia

    I have had 3 and planning on a fourth when this baby comes in 2 weeks! Best thing ever. I’ve never had to push long so I don’t agree with that statement. I’ve also never had any lasting issues by getting the epidural and my children never came out “drugged” as well. I’ve had multiple friends not use an epidural and to each their own but it’s a no brainer for me!

  6. Angel

    I had an Epidural and this is my first pregnancy. It wasn’t as bad as some said it will be. You are relax and comfortable so you can save all your energy to push when the time comes. I used it until the doctors came and I stop pressing the button to release more into me. I was full of strength and energy to push. And you do feel pain when it’s out your system.

    One thing they never said was it drys up your milk for sometime. But then again everyone and every pregnancy is different. But I would do it again if I have to.

  7. Mais

    I can’t understand what does “natural birth” mean! It’s silly to be in horrible pain while you can be fully relaxed by having an epidural and then you will save your energy for pushing.
    Epidural will not delay contractions. I had my baby after only few pushes.
    I’m sorry to be very honest and may be rude to those who don’t want to get an epidural but I have to say that the pain of contractions was unbearable to me and no damn breathing techniques helped. I could not think of breathing at all while I was struggling until I got that magical thing called EPIDURAL that was my life saver.

  8. Lauren

    I won’t be having one unless it is absolutely necessary. My mum had one when she was in labour with my brother and it caused permanent nerve damage to her left leg. I’ve had a spinal anaesthetic (basically the same thing but no tube left in your back). Which was great to be honest but I’m very wary about an epidural. Due in 18 days with second baby boy so hoping he comes soon!

  9. Rach

    Well, I had an epidural for an operation I needed during this pregnancy, I was 24 weeks pregnant and had to have a pilonidal abscess removed. They didn’t leave anything in my back (unlike the labour epidural), which was a God send.
    I went into surgery at around 9pm and came out at around 10pm completely drugged up to the eyeballs. I’ll not lie to you all, I will not be having another one! I couldn’t feel from my belly button downwards, this lasted until 5.30am when I had to request to be lifted to the toilet because I hadn’t had a wee in hours and I had an over active child bouncing on my bladder.

    Little to my knowledge, the woman two beds down had the same surgery, she had the epidural, she had the abscess removed, difference being she had been in hospital for two weeks, bed bound because she had lost all feeling in her legs!

    If anything in this pregnancy has made my mind up, 100% I will not have another epidural, I’m now 37+2 and I am scared of the labour but this one thing, I will not budge!

    Sorry if this has scared anyone out of the epidural, but it’s always best to know other people’s experiences before making any decisions of your own.

    Good luck everyone! X

  10. Fiona D

    I had an epidural on my first daughter and I sailed through the birth, on my second daughter it didn’t work for me but I got through it and here I am 10 weeks away from meeting my little boy, I’m not making any plans so if I think I can give birth without it I will and if I can’t I’ll get it πŸ™‚ I guess its how you feel at the time.. Goodluck everyone πŸ™‚

  11. sim

    I didn’t want an epidural either and wanted a natural birth, but because of a lower back injury prolapse disks, nerve damage syatica, snapping hip syndrome it’s too dangerous for me and my baby to try natural at all. So let’s hope they don’t stuff up and I can enjoy holding my bub and feeding him. Due in 2 weeks.

  12. Fleur

    I wonder if women who say they want an epudural right from the start because they can’t deal with pain, realise that childbirth is also quite painful for the baby (because of the squeezes they get during contractions and the bones in their skull having to slide over eachother during the second stage), yet an epidural only offers relief for the mother. It increases the risk of complications and assisted delivery, which again can be quite painful for baby. I also don’t agree when people think the only way you can have a calm, relaxed, gentle birthing experience is when you’re on pain medication. That depends on your personality and attitude more than anything else.

  13. Melissa

    Epidurals are great if they work sadly for me I was one of the ones that not only it didn’t work on but also had my dura tap punctured & suffered nerve damage. I was hospitalised for a week after with pain worse than labour itself from the dura tap puncture. It’s rare for complications to happen but if it does it can have serious issues. I had mine purely because I was induced due to pre esclampia so the contractions were very painful esp as she was back to back also.
    On my 2nd child I had no pain relief at all just went for it far too scared to ever do a epidural again
    About to have 3rd now & defo don’t want epidural. I also know another girl who had exactly the same happen to her too but she was in hospital for 3 weeks. And now 2 years later still has back nerve damage from it. My back never recovered fully and it’s nearly 7 years later. So they can have serious side effects if go wrong

  14. Janina

    I was reading a lot about the pros and cons and decided that I will only have an epidural as a means of last resort. Espacially I do not want to be forced to lie down like a helpless bug for hours on end. It is my first child, but the idea of being helpless scares me more than the idea of the pain. Last year I had a miscariage and the butchers in the hospital did a curettage without ANY medication on me (and told me if moved, they might pierce my uterus and I might never have a baby). I cannot imagine that birth will be much more painful and during birth, I want to be able to “work with the pain” and be rewarded with my baby in the end. πŸ™‚

  15. Kam

    I learned in prenatal class that an epidural is slowing contractions, which will bring to longer labour, then to the need of taking pit medicamentaion for increasing contractions again, which can make you more tired, and in many cases get u into c-section bcs you cant go further anymore. So, it is kind of getting between the natural progress of delivery and your body might not work with that to keep having a natural birth…. Thats another ‘bad’ thing abt it.

  16. Laura

    I didn’t really want one during my first labour but as it went on so long, my baby was back to back and a decent size for my small frame, I needed something a bit stronger than gas and air! I was very glad I went for it as it gave me a rest, although I did need forceps in the end. I think that was more due to the fact I was just too tired to push.
    It seems in the UK they are not as quick to offer up the strong drugs (you tend to work up from codeine to morphine etc, although you can request) so the best bit of advice I got during my antenatal classes was is if a midwife suggests an epidural, you probably need one!
    I’m a few weeks away from having my second and I’m hoping I don’t need one again, but I won’t be too disappointed if I do.

  17. Yoland

    Epidural is the solution for a relaxed and joyfull delivery, I did it for The first delivery and I am going to do it again in the coming couple of days.

  18. Ellen

    I had one after being induced at 43 weeks +4 with my son. I couldn’t have got through labour without it. It’s different for everyone but I can tell you all that you don’t see the needle and the worst part of it was taking the huge plaster off as it pulled at my skin!

  19. Jenny

    I had a drug free water birth with my son and I’m doing it again for this baby πŸ™‚ It hurts but it’s so worth it!

  20. Kelley

    I have herniated disks and it was a risk to my lower spine to get pregnant to begin with, so anyone with a large needle won’t be going near my spine if I can help it! I know many people who’ve had epidurals, and I know many people who haven’t. You can survive without it, women have since the beginning of time. But everyone’s pain tolerance is different! Just make your decision before you go into labor and stick to your guns, dont let anyone force you to get something you dont want πŸ™‚ Good luck to all the pregnant mommies out there!

  21. Renee

    Epidural a scare me lol i didn’t have one for my last baby and was in labor for 28.5 hours I won’t be having one for this baby either so Im hoping for a fast delivery lol!

    The reason why they scare me, a close friend was paralyzed from the waist down due to an epidural. It wasn’t done in the states but the risk is still there, personally I’d rather endure some pain than endure the possible side effects πŸ™‚

    I’m not condoning getting an epidural, I’m just relating why I won’t have one πŸ™‚

    Best wishes and fast deliviries mommy’s!

  22. Cindy

    Bring on the epidural! I absolutely cannot handle pain so I’m all for it from the get go!

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