How Does an Epidural Work?

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 The needle will then be withdrawn, and the catheter will be taped into place to prevent it from coming out.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 © Health & Parenting Ltd 2017. All rights reserved.