An epidural is a type of regional anesthetic. The anesthetic (numbing medicine) is injected into the space around your spinal cord (epidural space) in the lower back. An epidural can be used during labour to partially or fully numb your lower body.
When an epidural is given, a needle is positioned between the bones of your spine in order to allow an anesthesiologist to insert a very thin catheter into the epidural space.1 Once the needle is inserted, a catheter is threaded through the needle into the epidural space. The catheter stays in place while the needle is removed. The anesthetic is delivered through the catheter during childbirth to numb the lower body partly or fully.1 The amount of anesthetic you receive will affect how numb you are.1 For labour and vaginal birth, a low dose of anesthetic is used to decrease pain but allow enough feeling and muscle strength so that you can push during contractions. Most labouring mothers cannot walk while receiving anesthetic via an epidural.2 For a C section, a higher dose of anesthetic can be given to block all feeling in the lower body but still allow you to remain awake and alert.3
How and When Is an Epidural Administered?
The process for administering an epidural consists of a few basic steps:
- First, you’ll receive an IV drip so that you can receive adequate fluids throughout the duration of your epidural.2
- You’ll be asked for sit on the edge of a bed and lean forward or lie on your side with your knees pulled up to your chest.4 However, given the size of your belly, you may need to sit up and lean forward. This will stretch out your spine and create space between your vertebrae, allowing the catheter to be placed correctly.3
- An anesthesiologist will first inject you with a local anesthetic to numb the skin where the epidural will be inserted.4
- When the site is properly numbed, a sterile guide needle is used to insert a very small plastic tube called a catheter into your back. This will be in between your vertebrae, near the nerves that carry pain messages to your brain.4
- The guide needle is removed, while the catheter remains in place. The excess tubing is taped securely in place.3
- Medicine is then injected into the catheter to numb your lower body.3 You can manually administer pain medication or use an automatic pump.4
You may request an epidural at any time during labour.2 However, it is important to remember that it may take up to 15 minutes to experience pain relief from an epidural and if you are unable to remain still due to intense labour pain, an epidural may not be possible.7
Does the Epidural Hurt?
When the anesthesiologist numbs the area where the needle is to be inserted, you may feel a stinging, pinching or burning sensation.2,4 However, this numbing means that you should feel very little pain with the actual injection of the catheter.2 If you feel any sharp or intense pain during or after the procedure, tell your healthcare provider immediately.6
How Long Does an Epidural Last?
Once your epidural has been administered, it should start to work within 10 to 15 minutes.2,3 The medication should take full effect within 20 minutes.5 The catheter is left in your back to deliver continuous medication until you no longer need it, so there’s no worry about it wearing off or failing to provide pain relief.2
When your provider stops the medication, it may take some time before the numbness wears off, possibly a few hours.6 You may have to rest in a sitting or lying position until you regain full feeling in your legs.6
Are There Risks or Side Effects of an Epidural?
Epidurals are typically safe, and complications are rare.2 However, as with all medications, there are potential risks and side effects that may present themselves in some women. Here are some of the risks:7
- Lowered blood pressure. This is the most common side effect of an epidural.2,3 In order to reduce the risk of this happening, you will be given extra fluids through an IV.2 In other cases, you’ll receive additional medication to help maintain your blood pressure.
- Headache. Rarely, the needle used to insert the catheter can pierce the dura, or protective covering of your spinal cord.2 This can result in a headache that may last for a few days.2 Talk to your caregivers if you experience a headache that won’t subside. Less than one percent of all mothers who receive an epidural experience this.6
- Sore back. You may experience some soreness where the needle was inserted.2 This should fade in a day or two and will not lead to permanent back pain. The belief that an epidural may lead to permanent back pain may stem from the fact that many mothers experience back pain during and after labour and delivery, whether or not they’ve had an epidural.6
- Another catheter. Since the epidural will numb your lower body and render you unable to walk or feel certain sensations, you may lose control of your bladder and bowels.6 You will probably need a catheter inserted into your bladder to help manage this.6
It’s also important to remember that getting an epidural will not hurt your baby.2 There is evidence that a very small amount of medication can reach your little one, but this is unlikely to cause harm.2
While the prospect of getting an epidural might be a little scary, know that the procedure is generally considered to be safe, and that your doctor and anesthesiologist will be there to help you through it.
- https://www.healthlinkbc.ca/pregnancy-parenting/labour-and-birth/during-labour/childbirth-epidurals
- https://www.nhs.uk/conditions/epidural/
- https://www.mountsinai.on.ca/patients/having-a-baby-at-mount-sinai/labour-and-birth/pain-management
- https://my.clevelandclinic.org/health/treatments/21896-epidural
- https://anesthesiology.hopkinsmedicine.org/wp-content/uploads/2019/04/Epidural-Handout-11-20-2018.pdf