There are many unknowns when it comes to birth and despite the best laid plans, we cannot predict how your baby will decide to come earth side. Rather than completely rule out an epidural it might be good to learn about them in the event that you may want one, or you decide it’s the right choice for you. This way you can be informed when it comes to making that choice.
If you would like to eliminate some pain from contractions and delivery, but still be alert and awake, then an epidural may be for you. Let’s look at what an epidural is, if there are any side effects, and when is the best time to get an epidural during labor.
- What is an Epidural?
- How is an Epidural Given?
- Are There Any Side Effects?
- When is the Best Time to Get an Epidural?
- Is it Ever Too Late to get an Epidural?
Table of Contents
What is an Epidural?
An epidural is a numbing medication that combines anesthetics (pain relief due to decreased sensitivity to pain) with analgesics (pain reliever). Epidurals can be adjusted to your particular needs. You often can determine if you want higher or lower doses of the medicine. This is nice so that you can determine how much you would like to feel from your bellybutton on down, such as if you would like to feel a little pain or pressure, or none at all.
Generally, with epidurals you are numb and yet can also feel pressure when someone touches or moves your legs. It can be a little strange at first. During an epidural, you will still be alert and awake. You should be able to feel the pressure to push during the second stage of labor.
For me, it was a great relief to not feel pain, but it was also strange to not be able to control my legs very well, kind of like the feeling of them being asleep and feeling very heavy. I could control the amount of medicine I was given with a little button, and I purposefully pushed mine a few times to get the medicine flowing because I didn’t want to feel anything. My husband and nurse had to help hold my legs while I was pushing. For some women, that may be too much medicine, but for me after the labor I had already gone through on my own, it was such a relief.
How is an Epidural Given?
An epidural is given by an anesthesiologist, when a birthing mother wants one and as soon as an anesthesiologist is available. It can be given during active labor or when you are further along in the delivery process. Mentioning to your nursing staff that you would like an epidural will get you on the anesthesiologist’s rounds. Sometimes an anesthesiologist is not always immediately available. By discussing with and using the skilled and knowledgeable staff around you to help, they can try to get the anesthesiologist to you before your need is too great.
When the anesthesiologist comes to give an epidural, usually they will administer it as you lie on your side or sit leaning on a nurse or your partner.
The anesthesiologist will first sanitize your lower back, and then use a small needle to numb the area, just like at the dentist if you’ve had a cavity, before using the epidural needle. For me, I don’t remember feeling the sting that came from the smaller needle or the pressure from the epidural needle due to the contractions and back labor I was experiencing. In my case, it was a relief to have the epidural as my back labor made it impossible for me to ride through contractions naturally, so I wasn’t progressing due to pain. And know that you won’t be alone if you do choose an epidural. According to Yale medicine and Johns Hopkins, 60-70% of women going into labor use epidurals.
The epidural needle is combined with a catheter, or small tube. Once the tube is placed, the needle will be removed, the tube will be taped down, and the pain medication can be administered. Usually the anesthesiologist will do a small test dose to see that the catheter or tube is properly placed and you can feel the pain lessen.
Pain relief should come 15-20 min after the tube is inserted, with your uterus starting after 10 min or so. You should have decreased pain and feeling from your bellybutton on down.
You can also see a video of how it is done below *PS There are needles shown so be prepared.
Are There Any Side Effects?
Some common side effects from an epidural include:
- Lowered blood pressure (typically why they give you an IV before the epidural so there is less of a dip in your blood pressure), see our article about IV fluids during labor here.
- Mild itching,
- Difficulty passing urine (due to you not feeling your nerves or muscles of the bladder).
A few women can also feel:
- Nausea and vomiting (read our article about this)
- Mild back pain after delivery.
Some women can also get a spinal headache if the needle pierces the covering in the spinal cord, which is more rare. Inform your medical provider if you have a headache that is worse when you sit up, but goes away when you lie down. They will be able to help you.
When is the Best Time to Get an Epidural During Labor?
This is entirely up to you Mama. If you feel like the pain is unmanageable then it may be time for an epidural so you can concentrate on pushing. Talk with and be honest to those who are supporting your birth. You can have lower doses or increased doses of the medicine as necessary, depending on how much pressure you’d like to feel.
If you would like more feeling in your legs and uterus, talk with the staff around you and they can help adjust the levels to your needs. Contrary to a lot of sayings out there, if you think that you need help managing pain, any time is the best time for an epidural. According to the American Society of Anesthesiologists, “You can begin an epidural at any time during your labor — in the beginning, in the middle, or even toward the end …”
Is it Ever Too Late to Get an Epidural?
It could be considered “too late” for an epidural, if your baby’s head is already crowning or that close to delivery. As it takes about 10 minutes to place the epidural tube and another 15 min or so for you to feel the medication working. So if you are about to deliver, then it may be a little late for the medicine to take the pain away. Another possibility is if you suddenly decide that you want an epidural, but the anesthesiologist is unavailable for an extended period of time. This is why we recommend you inform the staff supporting your birth ahead of time of your desires for an epidural or make it part of your birth plan.
Other Frequently Asked Questions
- Do Epidurals Hurt? When the anesthesiologist uses a local anesthetic to numb your back, that can sting for 5-10 seconds. You should just feel some pressure from the epidural needle being inserted due to that numbing medicine, but you should not feel pain.
- Can I move around after I receive an epidural? Unfortunately, after the catheter or tube is placed, you will need to stay in your bed. You will also be hooked up to a few machines that will monitor your vital signs and baby’s to ensure that all is well, so it is best to not wander with those. You are also at an increased risk for falling as you have less sensation in your legs.
- Who Cannot Get an Epidural? Those with clotting disorders; certain brain or spine disorders; certain back surgeries; current skin infection in the area where the needle will be placed; very low blood pressure; too close to delivery; those who cannot hold still or cooperate with the injection.
- Will an Epidural Slow Down Labor or Lead to C-Section? There has been no conclusive evidence to show that epidurals slow down the progression of labor or increase the frequency of cesarean delivery. See here also what the American Society of Anesthesiologists say.
If you are in need of a C-section, the epidural catheter can actually be used for surgery. According to Johns Hopkins, the catheter will be dosed with a stronger medicine that will take away the pain associated with surgery and allow you to be awake for the birth of your baby. You will still feel pressure, touch and pulling but no sharp pain associated with surgery.
- Will an Epidural Hurt My Baby? A small amount of the medication from an epidural can potentially cross into the mother’s blood stream, however epidurals have been found to be fairly safe for Mom and baby. It is much less than what would happen if there was an IV of pain medicine or general anesthesia. A potential side effect, and another reason for monitoring baby, is that with lowered blood pressure in Mom, it can lead to a slightly lower heart rate in baby, however it is not detrimental and does not generally slow labor down.
- Do Some Women Actually Need an Epidural Twice? If for some reason women do not feel the epidural working and still have pain after a time, or have the pain of contractions on one side, then yes, the anesthesiologist can come back in and replace the catheter.
Wondering about other options for pain relief during birth? Check out our article on nitrous oxide and the pros and cons of using that option.
Whether you are trying to have an unmedicated birth and want to be informed, or if you really don’t want to have to feel more than you have to during labor and delivery, I hope this article has answered the questions you may be facing on epidurals. Epidurals are a safe and effective pain management option during labor and delivery, but only you can determine if it is the right option for you and baby.
Niki Cowan has a background in Medicine and Public Health. She is a Certified Health Education Specialist as well as a Medical Assistant. She’s passionate about Women’s Health and empowering women in their journeys. She is married to her wonderful husband Kevin, and they have an active son. While trying to have another little one hasn’t worked out yet, she is pursuing her passions and hoping to gain further education and experience in the area she loves, while playing with her son. She’s an avid reader, Original Great British Baking Show watcher, and very amateur kickboxer.