But waiting until you’re actually in labor to determine if an epidural is right for you probably isn’t the best way to go. Learning about the different kind of epidurals, what to expect if you receive one and the pros, cons and risks involved in this popular choice of labor pain relief will help you weigh your options ahead of time and empower you to make decisions when your labor begins.
Here’s everything you need to know about getting an epidural.
What is an Epidural?
An epidural is a type of anesthesia used to provide pain relief during labor and delivery. The anesthesia is injected near the bottom of the spine and works by blocking nerve impulses in the lower back, resulting in decreased feeling in the bottom half of the body.
The goal of an epidural is to provide relief from pain, not total numbness, while keeping you comfortable and completely alert during your birth experience. You may still feel your contractions happening (though you may not feel the pain of them much or at all), and you should still be able to push when the time comes.
Types of Epidurals
The term epidural is used fairly broadly. Technically speaking, there are three types of epidurals:
Epidural An epidural is administered via a catheter in your epidural space in the spinal area. The catheter is left in place so more medication can be given at a later time if needed.
Spinal injection Administered directly into the spinal fluid, this single injection can be used either alone or in combination with an epidural. Because it’s a single dose, it wears off more quickly.
Combined spinal-epidural (CSE) A hybrid of the two, a CSE—often referred to as a “walking epidural”—is a combination spinal and epidural. Because it involves a lower dose of medication, it leaves you with a bit more feeling in your lower half and provides more freedom to move around and change positions, and pain relief can be a bit more customized.
According to the American Pregnancy Association,2 hospitals and anesthesiologists often differ on the types of epidurals they offer as well as the combinations of medications and dosages used. If you’re interested in getting an epidural, talk to your healthcare provider to find out what your hospital’s specific protocols around epidurals are to make sure they’re right for you.
Does an Epidural Hurt?
Like so many things related to giving birth—the answer to this one is going to depend on who you ask!
Some women report some level of discomfort associated with getting an epidural, while others do not. One of the most common epidural fears is related to the size of the needle, but as with lots of things birth-related, this fear is a bit of a myth.
Although the needle used for an epidural is a few inches long, it’s only left in place for a very short time, just until the catheter can be put in place. And before that happens, your doctor will numb the area with a local anesthetic. Most women report feeling a pinch or a sting for about 5-10 seconds, and then pressure—not pain—when the epidural is actually administered.
How Long Does an Epidural Last?
An epidural usually takes about 10-15 minutes to take effect and, because the medication can be continuously administered via the catheter as needed, it can last throughout labor.
So the not-so-great news: sometimes, labor can last a long time. The really great news: so can the pain relief from an epidural. Let’s hear it for modern medicine!
Epidural Pros and Cons
There are pros and cons to any medical intervention, so if you’re considering getting an epidural during labor, it’s good to learn as much as you can about what they might be to feel more informed and empowered around your decision.
Pros: The benefits of an epidural include:
Pain relief It’s no secret that giving birth isn’t exactly a walk in the park. If you’re looking for a safe, effective option for pain relief during labor, an epidural is an ideal choice.
Allowing you to be present for your birth An epidural will help to relieve your pain during birth—whether it’s vaginal or via c-section —while also allowing you to be awake and alert.
A much-needed break For some women, especially if it’s your first baby, labor can last a while and leave you feeling pretty exhausted. An epidural provides a much-needed opportunity for you to rest, re-focus and restore your energy before it’s time to push.
Cons: A few things you may want to consider when making to the decision to get an epidural during labor include:
Limited movement. Although walking epidurals do allow for more movement and more sensation during labor, the “walking” part is a bit of a myth. The majority of women are not able to walk around after receiving an epidural. You’ll also need to be hooked up to an IV and a fetal monitor once you receive an epidural, further limiting your mobility.
A (slightly) longer labor. According to a recent study3 , there was approximately a two-hour difference in the length of the second stage of labor (the pushing part) between women who received an epidural when compared to those who did not. There isn’t, however, any correlation between women who get an epidural and an increased rate of c-sections.
Post-birth numbness. The effects of an epidural can take a few hours to fully wear off, so if you’re looking to get up and walk immediately after giving birth, an epidural may not be the right decision for you.
Urinary catheter Since the medication used in an epidural will numb the lower part of your body, you may need a urinary catheter put into place if your labor lasts more than a few hours. The catheter will be removed once the epidural wears off, but some women still report a bit of stinging and discomfort a few hours after the catheter comes out.
Epidural Risks and Long-Term Side Effects
Making any medical decision can be stressful, especially when you’re pregnant. It’s good to be aware of the risks and long-term side effects of getting an epidural—but the good news is the overall risk is extremely low.
“As long as the standard of care practice is followed, it is very unlikely to have any long-term side effects from an epidural,” says Dr. Mary Casciano Geneve, anesthesiologist at Monmouth Medical Center in Long Branch, NJ.
Risks and side effects can include maternal hypotension (a sudden drop in blood pressure), shivering, nausea, soreness or bruising around the injection site, and, very rarely, permanent nerve damage in the area where the catheter was injected. According to Dr. Casciano Geneve, there’s also a very small risk—about 1 in 200—of developing a severe headache called a post-dural puncture headache. “This can be severe and debilitating, but there are treatment options available,” she says.
And what about epidural effects on baby? According to Dr. Casciano Geneve, one of the biggest benefits of the epidural is that it provides relief for the mother without affecting the baby. “Unlike some intravenous medications, such as narcotics, which can cause neonatal respiratory depression (respiratory distress), the epidural should not affect baby,” she says.
Real Moms Share What Epidurals Feel Like
“I had an epidural for the birth of my second daughter. I was able to sleep until I was ready to push, and 10 minutes later, she was born!” —Anka Roberto, mom of two, from NC.
It’s also important to remember that the experience and skill level of your anesthesiologist can play a role in how smoothly your epidural may go.
“Getting an epidural for the birth of my first son was pretty painful. For my second birth, I changed hospitals, and it was a completely different experience. When I asked the nurse to bring someone in for an epidural, I was mentally preparing for it to hurt again—but before I knew it, it was in, and I hadn’t even felt a thing.” —Brittany Gabel, mom of two, from NJ.
“I think that I was more nervous about getting the epidural than any other part of the birth; however, I was pleasantly surprised about how easy the whole thing was. Placing the epidural only took a few minutes and wasn’t painful in the least. I only felt a small bit of pressure in my spine when the needle was inserted—it didn’t hurt, and only felt odd in that it was unfamiliar. Once the line was in, I could comfortably lay back and try to sleep as my labor progressed.”—Amanda Stratton, mom of one, from Washington, D.C.