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Epidurals for childbirth


Epidurals: Meaning and Side Effects of Anesthesia During Labor

An epidural is the most common type of anesthetic used for pain relief during labor. Here’s what you should know before having an epidural, including information that dispels some common myths.

How and when is an epidural for labor pain administered?

If you choose to have an epidural, an anesthesiologist will insert a needle and a tiny tube, called a catheter, in the lower part of your back. The needle is removed and the catheter left in place for delivery of the medication through the tube as needed. You can begin an epidural at any time during your labor — in the beginning, in the middle, or even toward the end — in consultation with your physician.

Does it hurt when the epidural is administered?

The anesthesiologist will numb the area where the epidural is administered, which may cause a momentary stinging or burning sensation. But because of this numbing, there is very little pain associated with an epidural injection. Instead, most patients will feel some pressure as the needle is inserted.

What does an epidural do?

An epidural provides anesthesia that creates a band of numbness from your bellybutton to your upper legs. It allows you to be awake and alert throughout labor, as well as to feel pressure. The ability to feel second-stage labor pressure enables you to push when it’s time to give birth to your baby. It can take about 15 minutes for the pain medication to work.

How long does the pain relief last?

You can continue to receive pain relief through an epidural for as long as you need it. The amount of medication you receive through the epidural can be increased or decreased as necessary.

Can an epidural slow labor or lead to a cesarean delivery (C-section)?

There is no credible evidence that it does either. When a woman needs a C-section, other factors usually are at play, including the size or position of the baby or slow progression of labor due to other issues. With an epidural, you might be able to feel contractions — they just won’t hurt — and you’ll be able to push effectively. There is some evidence that epidurals can speed the first stage of labor by allowing the mother to relax.

Can epidurals harm the baby?

The amount of medication that reaches the baby from the epidural is very small, and there is no evidence that it causes any harm.

Are there risks and side effects?

Epidurals are very safe; serious complications are extremely rare. However, as with all medications and medical procedures, there are potential side effects:

  • Decrease in blood pressure – The medication may lower your blood pressure, which may slow your baby’s heart rate. To make this less likely, you will be given extra fluids through a tube in your arm (IV), and you may need to lie on your side. Sometimes, your anesthesiologist will give you a medication to maintain your blood pressure.
  • Sore back – Your lower back may be sore where the needle was inserted to deliver the medication. This soreness should last no more than a few days. There is no evidence that an epidural can cause permanent back pain.
  • Headache – On rare occasions, the needle pierces the covering of the spinal cord, which can cause a headache that may last for a few days if left untreated. If this situation arises, discuss the treatment options with your anesthesiologist.

What is combined spinal-epidural anesthesia?

A spinal block is sometimes used in combination with an epidural during labor to provide immediate pain relief. A spinal block, like an epidural, involves an injection in the lower back. While you sit or lie on your side in bed, a small amount of medication is injected into the spinal fluid to numb the lower half of the body. It brings good relief from pain and starts working quickly, but it lasts only an hour or two and is usually given only once during labor. The epidural provides continued pain relief after the spinal block wears off.

Anesthesiologists are committed to patient safety and high-quality care, and have the necessary knowledge to understand and treat the entire human body.

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Key facts

  • An epidural is procedure used to relieve pain during labour and birth.
  • It uses an injection of local anaesthetic in the space around the spinal nerves in your lower back to block pain from contractions.
  • Epidurals are usually done during the first stage of labour.
  • After an epidural, you’ll need to stay in bed because your legs will be weak, and so that your health and your baby’s health can be monitored.
  • An epidural does not increase your risk of needing a caesarean section, but it may prolong the second stage of labour and increase your chance of needing an assisted delivery.

What is an epidural?

An epidural is a procedure that injects a local anaesthetic into the space around the spinal nerves in your lower back.

This anaesthetic usually blocks pain from labour contractions during birth very effectively. With an epidural you can usually still push your baby out when you need to.

An epidural is usually done by an anaesthetist.

What does an epidural involve?

Before an epidural, you will usually have a drip for fluids put into your arm.

You will need to sit up and bend forward over a pillow, or lie on your side curled up into a ball. This makes it easier to insert the needle into the right place. It is important that you stay very still during the procedure to avoid complications.

Your lower back will be washed with antiseptic. A small amount of local anaesthetic will be injected into the skin of your lower back. Your anaesthetist (specialist doctor) will insert the epidural needle between contractions, so it is important that you tell them when you have a contraction. The needle will be inserted between the bones of your spine into the space around your spinal nerves.

A small soft plastic tube will be inserted, and the needle removed. The plastic tube delivers the anaesthetic that will numb your pain.

It usually takes between 5 and 30 minutes for the epidural to relieve your pain.

When can I have an epidural?

Usually, if you have an epidural to help you give birth, you will have it during the first stage of labour. You can also have an epidural at any stage of labour.

Who can have an epidural?

Most people can safely have an epidural, but there are some medical reasons that mean it is not possible. It’s a good idea to think about your options for pain relief before the birth. Discuss these with your doctor or midwife, who can help you decide between options that are suitable for you.

Epidurals are available at most hospitals, but not in birth centres or during home births.

What are the advantages of an epidural?

Epidurals have many advantages:

  • They are usually very effective.
  • They are generally very safe.
  • After an epidural, you may still be able to move around in bed and push when you need to.
  • If you have a long labour, an epidural allows you to sleep and recover your strength.
  • If you're having a caesarean, you can stay awake and your partner can be there.

What are the disadvantages of an epidural?

If you have an epidural, you will usually develop some temporary weakness in your legs. This means that you will need to stay in bed to avoid falls.

Since epidurals can cause low blood pressure, you will need to have your blood pressure monitored. You might also need to have fluids given to you through a tube in your arm.

You will also usually need a catheter (tube) in your bladder to help you pass urine, as an epidural can make you lose feeling in your bladder.

Your baby will need to be closely monitored during your labour.

Having an epidural does not make it more likely that you will need a caesarean section. However, it may slow down the second stage of labour, and increase your chance of needing an assisted delivery.

What are the risks of having an epidural?

An epidural is effective and generally safe. But there are some risks:

  • Some people feel cold or itchy.
  • A small number of people get little or no pain relief.
  • Some people develop a bad headache 24 to 48 hours after an epidural.
  • There is a small chance of developing an infection.
  • Very rarely, an epidural can cause permanent nerve damage.

Epidurals do not directly affect your baby.

What should I ask my doctor or midwife about having an epidural?

You can check:

  • If you can have an epidural at your chosen hospital or birth centre.
  • What their epidural procedures are.
  • If there are any extra costs or fees involved.
  • The type of pain relief that might suit your personal circumstances best.

Sources:
Royal Women's Hospital Melbourne (Epidural information), Queensland government (Epidurals), Queensland Health (Epidural analgesia in labour - clinical guidelines), RANZCOG (Pain Relief in Labour and Childbirth), WA Health (Epidurals for childbirth)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2022


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Related pages

  • TENS (Transcutaneous electrical nerve stimulation)
  • Gas (Entonox)
  • Non-medical pain relief during labour
  • Pain relief during labour
  • Making a birth plan
  • Giving birth - stages of labour

Need more information?

Epidurals for childbirth

An epidural can be used to relieve pain during child birth and is very safe. Your anaesthetist will discuss pain relief options with you as part of your antenatal care.