Epidural for labor pain
An epidural is a common practice used during labor and childbirth to help women find relief from the pain and discomfort from contractions. The goal is to numb your body from the upper abdomen to your toes, helping you relax your lower muscles.
In this article, we'll delve deeper into a few epidural pros and cons you should know. We'll also discuss the potential side effects and risks associated with the procedure so you can make an informed decision about whether an epidural vs. natural birth is the right choice for you and your baby.
How the Procedure Works
Epidurals can be administered at nearly any point during active labor—as long as birth is not imminent within the next 30 minutes. A common misconception is that it's “too late” for an epidural once labor begins, but this isn’t necessarily true. Timing depends on how quickly labor is progressing and whether it's safe for both parent and baby.
To begin the procedure, you’ll sit on the edge of the hospital bed, curl your body over your belly, and push your lower back outward. A certified anesthesiologist will first numb the injection site with lidocaine. Then, a needle and a small flexible tube (called a catheter) will be inserted into the epidural space in the lower part of your back. The needle is removed, but the catheter remains in place to allow continuous or on-demand delivery of medication throughout labor.
After the epidural is placed, you’ll usually lie flat or on your side to help distribute the medication evenly. It typically takes 20–30 minutes for full pain relief to take effect, although some women report feeling noticeable relief within 10 minutes.
Other Considerations
Once the epidural is in place, your nurse will monitor your blood pressure closely, especially within the first hour, as a rapid drop in blood pressure is a known side effect. If this happens, medication and IV fluids can help stabilize it.
Another misconception is that you have to lie flat the entire time. While you’ll be confined to bed, you can still change positions with help, which can aid in labor progression. Because epidurals often reduce sensation in the lower body, a urinary catheter is also typically inserted to keep your bladder empty and prevent discomfort or complications.
Epidural vs. Natural Birth: Which Is Better?
There is no universal answer. The choice between having an epidural or pursuing a natural birth—whether unmedicated or using alternative pain relief methods—depends on your personal comfort level, birth plan, and medical needs.
Natural births offer the freedom to move, squat, or use water for pain relief, and some people find that staying active can speed labor. However, they also require managing pain without the assistance of strong medication. Epidurals, on the other hand, can be a powerful tool for managing pain, especially in long or difficult labors.
It’s important to know that epidural anesthesia is available only in hospital settings, but your labor can be managed by either an OB-GYN or a certified nurse midwife.
Pros of Epidurals
It's reported that an average of 60-70% of laboring women get epidurals a year. Some of the advantages of this procedure include:
Labor pain relief: An epidural is the most relieving form of medication that you can receive during labor. However, it's not uncommon to still feel pressure with contractions or for it to be less effective for some women.
Relaxation and sleep: If you've been laboring for a long time, an epidural may provide enough relief to help you sleep and gather energy for the next stage of labor, which is pushing.
Tense muscles: If you're having difficulty releasing your muscles during labor, this can cause slow progression and exhaustion. An epidural helps to relax all those muscles.
Placenta delivery and repairs: The epidural is not turned off until after the delivery of the placenta and if a repair is needed. Therefore, you may not feel any pain or discomfort during the afterbirth.
Cons of Epidurals
It's important to keep in mind that like any medical procedure, there are risks of side effects and complications when it comes to epidural anesthesia.
Let's review a few.
Limited movement: With an epidural, you will be unable to get out of bed and move your body. Some people can still move their legs.
Slowed labor progression: It is common for labor to slow down with lack of movement from the epidural. If this happens pitocin will be administered to get labor contractions in a good, strong pattern.
Headaches: One out of 100 women will experience a spinal headache lasting 2-3 days. The headache is resolved only when lying down flat. The headache is typically caused by the needle going in too deep.
Low Blood Pressure: As previously mentioned, receiving an epidural during labor may lead to a drop in your blood pressure, which can have an impact on your baby's heart rate. To decrease the likelihood of this happening, you'll be given additional fluids through an intravenous (IV) tube and may need to lie on your side.
Blood Clots: Some medical conditions may prevent individuals from receiving an epidural. For instance, if you have blood clotting issues, your doctor may advise against it. Additionally, there is a risk of bleeding if the injection accidentally damages a blood vessel, which can cause a hematoma or blood clot to form.
Temporary Nerve Damage: It is possible for nerve damage to occur as a rare complication of a needle or epidural tube. This can cause a loss of feeling or movement in the lower body. The most common symptom is a small area of numbness, but there is no loss of strength or movement. Generally, this condition improves within a few days or weeks, but in some cases it may take several months to fully recover.
Women may also experience fever and leg heaviness or tingling during labor.
Need to Book a Consultation?
Our team at the Twin Cities Birth Center + Women’s Health Clinic is always ready to assist you with your concerns and provide you with the necessary services to help you deliver your baby confidently. We are also here to offer you the ongoing support that you need.
If you have any questions or would like to schedule a consultation with us, please don't hesitate to get in touch.