Everything to Know About Epidurals During Labor

An epidural (sometimes called an epidural block or epidural analgesia) is a common type of regional anesthetic used during childbirth for pain relief. 

To administer an epidural, an anesthesiologist uses a needle and a thin catheter to insert numbing medication into the lower back. Epidurals can significantly reduce the pain of contractions during labor. 

Learn about epidurals during labor, including benefits, risks, side effects, and what to expect.

Benefits of an Epidural

Epidurals are a safe, effective pain management method for most people during childbirth. The procedure doesn’t affect the baby, and only low doses of medication are typically used. 

The most obvious benefit of epidural analgesia is pain relief, especially during the later stages of labor. Research suggests that many people experience little to no pain in their lower abdomen, back, and vaginal area after getting an epidural injection. Others feel some discomfort and pressure, but not severe pain. 

Studies suggest that epidurals usually are superior to other forms of pain relief during labor, such as opioid drugs. People who receive epidurals are more likely to rate their pain relief as “excellent” or “very good” in comparison to people who use other labor pain management methods.

Risks of an Epidural

While an epidural is a relatively low-risk method of pain management, no medical procedure is entirely risk-free. Some of the most common risks of epidurals during labor are: 

• Low blood pressure: Epidural medications can sometimes lower your blood pressure. This is unlikely to affect your baby unless it is not controlled. Intravenous (IV) medications can be used to increase your blood pressure if necessary. 
• Need for assisted delivery: There is some evidence that getting an epidural slightly increases the chance of needing an assisted delivery (delivering the baby using an additional device, such as suction cups or forceps). However, a 2018 review of studies didn’t found a link between epidurals and assisted delivery. 
• Difficulty walking or pushing: Overall, epidurals typically don’t prolong the process of labor. However, some people lose feeling in their lower extremities very quickly. This can sometimes make it more difficult to walk around or to push during contractions. Your anesthesiologist can lower your dose of medication if needed.
• Need for induction: Getting an epidural may slow your contractions down or speed them up. If necessary, a medication like Pitocin (oxytocin) can be used to induce labor—that is, speed up your contractions. People who get an epidural block are somewhat more likely to be induced. 

In extremely rare cases, an epidural can lead to serious medical complications. These rare complications may include:

• Long-term nerve or spinal cord damage
• Infection
• Seizures

Meanwhile, research suggests that having an epidural does not increase the risk of: 

• Needing a cesarean section (C-section), a surgical procedure that delivers the baby through an incision in the walls of the abdomen and uterus
• Long-term backache
• For infants, hospitalization in the neonatal intensive care unit (NICU) 
• Poor infant health outcomes
• Postpartum depression (PPD)
• Maternal health complications or death

Side Effects

Some of the most common side effects from a pregnancy epidural include: 

• Itching (which can typically be controlled with medication)
• Shivering
• Difficulty urinating
• Sore back for a few days after delivery

Rarely, an epidural block can cause more serious side effects, such as:

• Nausea
• Fever
• Vomiting 
• Drowsiness
• Dizziness
• Headache
• Rapid heart rate
• Difficulty breathing

If you experience any side effects from an epidural during labor, tell your healthcare provider right away.

How Is an Epidural Administered?

Unless your healthcare provider is worried about specific risks, you can ask for an epidural whenever you need one and an anesthesiologist is available. Typically, an anesthesiologist will administer your epidural once you are already in active labor. 

To administer an epidural, your healthcare provider will ask you to hunch over, either while sitting up or lying on your side. After cleaning the area, the anesthesiologist will place a needle near your spine in your lower back. Then, they’ll place a small catheter (flexible, hollow tube) into your back and remove the needle.

You’ll be given a low dose of numbing medication through the catheter. If you need additional pain relief, you can ask your healthcare provider to adjust your dose. The anesthesiologist will return to remove the catheter from your lower back after you’ve delivered your baby.

What to Expect

Many people who get an epidural during childbirth experience significant or total pain relief. Usually, people start to feel the effects of an epidural within about 15 minutes. Because the catheter will remain in your back until you deliver your baby, the pain relief from an epidural is continuous; it will last as long as you need it. 

Still, the experience may be uncomfortable or disorienting, especially in the beginning. At first, you may feel too numb to walk or move around much. However, you should eventually be able to actively push during the later stages of labor. You should also be able to stay awake and alert. Most people can still feel pressure from contractions and vaginal exams. 

If you have any concerns about your epidural, talk to your anesthesiologist. They can increase or decrease your dose or even switch your medication if needed.

Summary

An epidural is a common type of anesthesia given for pain relief during childbirth. An anesthesiologist typically administers an epidural by delivering numbing medicine through a needle and small catheter in the lower back.

Epidurals offer low-risk, effective pain relief for most people during labor and delivery. Many people experience complete or nearly complete pain relief from an epidural block.

Common side effects of an epidural include itching, shivering, difficulties with urination, and a sore back for a few days after delivery. More rarely, epidural side effects may include headache, nausea, vomiting, rapid heart rate, drowsiness, dizziness, or difficulty breathing.

Complications from an epidural may include low blood pressure, a higher risk of assisted delivery, and a higher risk of induction. Very rarely, an epidural can cause serious medical complications, such as seizures, infection, or long-term damage to the nerves or spinal cord.

A Word From Verywell

Epidurals typically are a safe, effective method of pain relief during childbirth. If you’re concerned about the potential risks or side effects of an epidural, talk to your healthcare provider about other methods of easing your pain during labor.