The decision to use an epidural for pain relief while giving birth is a personal one. For some women, it's a no-brainer - if there's a way to make giving birth easier they'll take it! But that's not the case for everyone, and women may have different reasons for wanting or not wanting such strong pain relief, for example, an epidural will give you strong labour pain relief, unlike something more natural like gas and air, but could mean that you won’t feel anything at all. For some women this could take away from the natural experience of giving birth.
Around 30 per cent of women in the UK choose to have an epidural during labour, it's known as the big mama of pain relief, but it has pros – and cons, so it's really important to consider all these before making a decision. Here's everything you need to know, including the pros and cons of epidural...
What is an epidural?
According to the NHS: "An epidural is an injection in your back to stop you feeling pain in part of your body." Essentially, it's an anaesthesia that's commonly used during labour and childbirth, including caesareans, but also during and after some types of surgery - for example, steroid medicine can also be given with an epidural injection, to treat pain in your back or leg that's caused by sciatica, or a slipped (prolapsed) disc.
During an epidural, the strong painkillers are injected into your back via a fine tube. It’s a regional anaesthetic, which means the drug is injected around the nerves that carry signals from the part of your body that feels pain during labour. It will numb your tummy completely, but although it provides you with strong pain relief, mums-to-be will be relieved to know that the drugs will have no effect on your baby.
How is an epidural is given?
A specialist doctor called an anaesthetist will administer the pain relief through an epidural needle or catheter into your back. You'll usually be awake for this procedure.
The NHS dexplains that a drip will first be place in your arm so you can be given fluids wile you're having the epidural. Then you'll be asked to sit and lean forwards or lie on your side with your knees up to your chest so that they can inject you.
First you're given an injection of local anaesthetic to numb the skin, then a needle is used to insert an epidural catheter, which is a fine plastic tube, into your spine near the nerves that carry pain messages to your brain. Finally, the needle is removed, leaving the catheter in your spine. It might feel uncomfortable.
How does an epidural work?
Epidural injections or pain relief medicines are then given through the catheter, which will take about 20 to 30 minutes to take full effect, and can be topped up manually or using an automatic pump for several hours during childbirth.
You my feel your chest, tummy and legs are numb while the epidural medicines are being used. Your legs may also feel weaker than usual. If you have the mobile epidural, which uses a lower dose of pain relief medicines, you'll be able you to walk around during labour.
When would you use an epidural?
A low-dose epidural will probably mean that you will have some sensation in your legs and feet, but generally, it acts as a way of completely numbing you from the waist down. If you want to move about leading up to the birth, you will need a mobile epidural, but this will require extra staff to monitor you.
If you are planning a C-section, or end up needing one, you will probably be given an epidural. The other options are a spinal block or general anaesthetic in some cases.
What are the pros of having an epidural?
When it comes to epidural and birth, this is a popular option amongst mums-to-be for many reasons. Here are some of the pros to having an epidural...
• Provides you with very strong pain relief
• It will numb your tummy and most women feel little or no pain during labor and delivery
• It has minimal side effects on both mum and baby
• It works quickly and can begin to relieve pain within 10 to 20 minutes
• An epidural can help you to feel more alert so you can take an active part in the birthing experience
• Allows you to rest, which is beneficial if you have a long labor.
• The strong pain relief will help you to feel calmer and relax, providing a more positive birth experience
• If you are given an epidural early on in labour, it can be topped up to maintain the pain relief later on
• You won't have to experience the discomfort pf forceps or a vacuum if they're needed during birth
• Allows you to stay awake during a C-section and provides pain relief during your recovery
• Some evidence was found that epidural use may decrease risk for postpartum depression (PPD)
• You can get an epidural anytime during labor if the need arises, even if it's not part of your birth plan
What are the cons of having an epidural?
Some of the cons of epidural and labour include epidural side effects during and the effects after epidural, as well others listed here...
• Your midwife will have to tell you when to push as you'll be numb and won't feel the natural urge
• Pushing may be more difficult, increasig the potential need for interventions such as forceps, medication, or a C-section.
• It can cause severe headaches caused by a leakage of spinal fluid
• Permanent nerve damage is possible if the spinal cord is damaged by the needle or catheter, or by bleeding or infection in the epidural area - although this is rare
• You could experience side effects, including shivering, fever, or itchiness
• After removal you may feel nauseous or dizzy
• When the needle is removed you may have back pain after epidural and soreness where it was inserted
• Increases the risk of your baby being delivered by forceps or ventouse
• Can cause a sudden drop in blood pressure and you may need oxygen, fluids, and medication
• You’ll need to be put on a drip and have your baby’s heart rate continually monitored during labour
• Perineal tears are more common in women who have epidurals
• You may need to stay in bed for a few hours until the numbness of your lower half wears off
• The numbness increases your chances of temporarily needing a urinary catheter
FAQ: Epidurals
How long does an epidural last?
An epidural will last as long as a woman is in labour, as the medication is delivered continuously until it's time to deliver.
What is the difference between a spinal block and an epidural?
The main difference between a spinal block and an epidural is the placement of the injection and the resulting onset of pain relief. Spinal blocks provide total pain relief, while epidurals provide partial pain relief. The reason for this difference is that the former is an anesthetic, while the latter is an analgesic—no sensation versus no pain.
What is the epidural needle size?
Epidural needles can vary in size, but are typically between 16 and 25 gauge, and 8 to 15 cm in length
When is the best time to get epidural during labor?
The best time to get an epidural during labor depends on a number of factors, including how dilated you are, how close you are to delivery, and whether you can remain still and calm for the procedure. A woman can get an epidural at almost any time in labour if she can remain relatively still - however, an epidural is generally not given if the baby is close to being delivered.
Does an epidural hurt?
An epidural typically doesn't hurt because the area is numbed with an injection before the procedure. However, you may feel mild discomfort when the epidural needle is positioned and the catheter is inserted.
Does an epidural cause back problems?
It's very rare for an epidural to cause long-term or chronic back problems. It's normal to experience temporary back pain or tenderness at the site of your epidural. This usually goes away within a few days.
Does epidural slow down labor?
There is some evidence that an epidural can slow down labor by 20 minutes or a half hour, but it's not a significant amount of time.
Can you have an epidural with a water birth?
No, you cannot have an epidural while birthing in water. You must leave the water if you need an epidural or other injection for pain relief.
Can you feel baby coming out with an epidural?
Yes, it's possible to feel your baby coming out with an epidural, though it depends on several factors, including how the epidural affects you and where it's placed.
How long after an epidural can you walk?
You can usually walk within 30 minutes after an epidural injection, but you should be careful and take it slow. You may need support and be unsteady.You should wait until you regain feeling in all of your limbs before moving around, which can take a few hours. If you want to return to normal daily activities, you should wait at least 24 hours
How many cm dilated before you can't get an epidural?
If you're more than 8 centimeters dilated, it might be too late for your care team to place the epidural.
Proud aunt to her teen niece, Zara Mohammed is a Digital Writer for Mother&Baby. She has 10 years freelance writing experience creating lifestyle content for various platforms, including pregnancy, women’s health, parenting, child development and child mental health, plus lots of fun seasonal family articles and celebrity news.