Epidural For Labor Pain & Everything About It

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Epidural for labor pain

Table of Contents

Fairly one of the safest methods of pain relief management, epidural barely reaches a woman’s blood and rarely affects the baby- a primary reason why most pregnant women advocate the usage of epidural. Not only does epidural minimize the infamous labor cramps but also help mothers stay active for the delivery. Despite the fact that doctors generally mark epidural safe for labor and delivery, there’s still a lot of debate around taking epidural for labor pain relief and management. Let us find out everything there is to know about using an epidural for pain relief during labor in this blog today!

What is an epidural ?

An epidural is a safe local anesthetic medication that is injected directly into the spine which numbs the receiver waist down. Epidural is recommended to laboring women to reduce the labor pain and to help them remain active, awake, and alert for the childbirth process.

Where is an epidural administered?

Epidural medication is injected into the epidural space, i.e.,  between the ligament that sheathes the vertebrae and the membrane that covers the spinal cord.

How is an epidural administered?

The administration of epidural varies from one hospital to another and depends on a hospital’s own policies. As per the independent policy of your delivering hospital-

  • A urinary catheter or thin tube is first inserted into your bladder to help you get rid of the urine while the epidural is in effect, as you may not want to use the loo.
  • In another scenario, your bladder may be first drained with a catheter.
  • You will also be administered IV fluids prior to the administration of epidural in order to prevent a drop in blood pressure.
  • Before you get the main epidural shot, you will first be given a shot of local anesthesia in your low- to mid-back area.
  • Once the anesthesia shows its magic and numbs the area, you’ll be asked to lie on your side or lean over a raised bedside table.
  • When a comfortable and administrable position is ensured, a larger needle will be inserted into the epidural space of the spine as the main epidural shot.
  • The needle is then removed, leaving a fine, flexible catheter in place through which the drug is delivered.
  • The medicine delivering tube will be taped on your back to allow side-to-side movement.

Can an epidural shot be felt ?

While some women do not feel anything when given an epidural shot, some report to have felt a slight pressure, a tingling sensation, or a brief shooting pain. But ultimately, all women agree that the briefly felt sensation is incomparable to the mighty labor pain.

At what stage of labor can you get an epidural ?

Epidural can be administered to you whenever you ask your doctor for it. There is no minimum dilation requirement for using an epidural shot. However, it is usually recommended to take an epidural as soon as possible because the shot requires the receiver to sit perfectly still. As you may have guessed, the sitting still requirement gets harder to achieve as the labor advances.

Does epidural increase the chances of a C-section ?

No, epidural does not increase the chances of cesarean delivery or reduce the possibility of a normal delivery. There have been no studies to confirm the statement and so, this is a baseless myth. However, it should be noted that if you do happen to end up having your baby via C-section, the dosage of the epidural will be increased to ensure you don’t feel anything in your lower half of the body at all.

How long does the epidural take to work ?

The effect of an epidural and the relief in pain thereof can be experienced in less than 15 minutes.

Here’s what happens after an epidural is administered-

  • Within 3-5 minutes of the dost, your uterus nerves begin to numb.
  • The full-effect is then seen in another 10-15 minutes.
  • Typically, 15 minutes past administration of an epidural, women cannot feel anything ribcage-down, making the contracts bearable.

What does pushing with an epidural feel like ?

An epidural makes it hard for a woman to feel any pain in the lower body at all, or in other words, it can numb the lower half of the body. However, most women are typically known to be able to push desirably even with an epidural in. In some other cases, however, if the pushing does not progress owing to the lack of sensation, the epidural could be adjusted to help you feel the contraction and sensations.

Pitocin may also be administered in case the labor tends to slow down.

What is a walking epidural or combined spinal-epidural anesthesia ?

Some women may prefer to be administered a smaller amount of pain management medication in comparison to the traditional epidural shot. Such an epidural shot, a combined spinal-epidural (CSE), is commonly known as a “walking epidural.”

A walking epidural uses a small amount of medication to offer pain relief while allowing some sensations to remain in the lower part of the body. It should be noted that-

  • Unlike an epidural, a walking epidural is administered as a shot of analgesic directly into the spinal fluid.
  • While a traditional epidural shot makes a laboring mother numb to contractions, a walking epidural allows the sensation and use of muscles in the legs (since it is a spinal fluid)

If at a later point, you happen to feel the need for a heavier dose,  medication may then be placed into the epidural space. Besides, though the name suggests ‘walking’ a walking epidural will make you feel weak in the legs and will restrict your movement. In other words, you cannot get up and walk after the administration of walking epidural, you can just expect to not be numb to lower body sensations.

Does Getting an Epidural Affect The Baby

There is no one-word answer to this question. Here’s why: Since a typical epidural will be a  combination of anesthetics and opioid analgesics, it may increase the heart rate of the baby (owing to the nature of opioid analgesics). Post childbirth, your baby may also have temporary trouble in breathing, drowsiness, and reduced muscle tone. In the initial days, it may also be difficult to latch on and breastfeed the baby.

However, these effects usually fade away and are not long-term, and are momentary concerns. It is also for these reasons that doctors advise constant fetal monitoring with an epidural. Hence, though there are some effects on the baby, the effects are only temporary.

Epidural during labor: Is epidural safe for laboring women ?

Epidural may cause a drop in blood pressure after kicking in and hence, your doctor will ideally hook you up with an IV prior to epidural administration. Lying on the side is also recommended to allow the body to counteract the BP dips.

In some rare cases, epidural may also cause headache, fever, or a sore feeling. The infamous opioids may also cause some itchiness, nausea, or vomiting. In some unfortunate (and very rare) cases, epidural may injure the receiver’s spinal cord and nerves and result in breathing problems. Permanent nerve damage may also take place in rarest, unfortunate scenarios.

But again, though there are these rare risks, an epidural is generally considered fairly safe. If you are in doubt, talk to your healthcare provider and receive some professional consultation on epidural in advance.

Final Thoughts- Are there any long terms risks and side effects of epidural ?

Though rare, some side effects of epidural may be experienced by women including:

  • A prolonged pain sensation in cases of women experiencing back labor
  • Limited birthing options: An epidural negates the possibility of water birth and does not support delivery at a birthing center. You will have to mandatorily give birth in a hospital if you choose to have an epidural administered.
  • Longer labor: As per research, “Epidurals may extend the length of the second stage of labor by an hour or more.”
  • Difficulty in peeing post-delivery: Epidural numbs the sensitivity of the bladder and makes urinating in the first 24 post-delivery hours very difficult in terms of urination.

Bottom line: Still doubtful about taking epidural? There is nothing to worry about as this decision is completely yours to make. Take some time, speak transparently with your doctor, and make the decision you deem fit for yourself and your baby.

Epidural For Labor Pain FAQs:

1) Can epidurals be taken for multiple pregnancies ?

Yes, an epidural can be taken in multiple pregnancies. Some doctors may even suggest or mandate the administration of the epidural in twin or multiple pregnancies- especially if a vaginal delivery isn't possible and a C-section is required. As a woman pregnant with multiple babies, if you are not OK with the usage of epidural, it is recommended to have this talk with your practitioner in advance as some hospitals may not allow non-administration.

2) Can an epidural be taken with lower back tattoos ?

Unless your back tattoo is fresh or unhealed, an epidural is typically safe for administration by an anesthesiologist.

3) Does scoliosis interfere with epidurals ?

No, scoliosis (abnormal lateral curvature of the spine) does not interfere with epidurals. A professional and seasoned anesthesiologist should not find it difficult to place the epidural in the right position despite scoliosis.
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