Health A to Z

Epidural

Worried about the pain of childbirth? An epidural can help you cope with painful contractions.

Epidural, epidural benefits, epidural side effects

Worried about the pain of childbirth? An epidural, anesthesia injected into your lower back to block the pain signals through nerves near the spinal cord, can help you cope with painful contractions. An anesthesiologist provides the medication during active labour. (Epidurals are also used for conditions other than pregnancy, such as delivering injections to treat conditions such as sciatica, an inflammation of the sciatic nerve in the lower spinal cord.)

While you’re lying on your side or sitting the anesthesiologist inserts a special needle between the bones of the spine, a few inches above the tailbone, which will take a few minutes. A catheter, a thin tube will be passed through the needle and local anesthetic will be injected through the tube and secured to your back with tape. Within about 30 minutes, the epidural will start working, which may begin with a warm tingly feeling in the legs, and pain relief. You may notice that your legs feel heavier. The first dose may last up to two hours and medication is delivered continuously (and sometimes the dose is increased) to prevent the pain from returning. When the time comes to push during labour, the anesthesiologist may lower the amount of medication or stop it altogether so that the numbness of the epidural doesn’t make it harder to push.

Health benefits You won’t feel the pain of the contractions if you have an epidural but you’ll still feel the pressure so you’ll be able to sense your contractions are happening. You’ll also be alert; the epidural doesn’t make you drowsy unlike some other pain medications.

Side effects While epidurals are generally very safe for mothers and their babies, there is a small risk of complications. For example, having an epidural can slow down labour if it’s given before active labour. The most common side effect of an epidural is low blood pressure so your pressure will be carefully monitored. Shivering is also common but it’s not serious. It’s also possible to have a headache after an epidural and to lose bladder control if you can’t feel that your bladder is full or have back pain after the birth, but that may be due to the labour itself. A very small percentage of women also feel no pain relief from the epidural. In one out of every 2,500 births, the epidural may cause nerve damage or numbness in one leg that lasts for weeks. There is also the risk of a severe drug reaction to an epidural and of paralysis or death, which occurs in about one in 100,000 cases.

Need to know Most women who want to have an epidural during childbirth can have one. However, women with bleeding problems, an infection or tattoo on the lower back, among others, are not able to have an epidural.

Outside resources
Women’s Health Matters