Many of today’s parents choose to manage their pain during labor with an epidural. But what exactly is it, and what should you expect if it’s your first time?
What is an Epidural?
An epidural is a form of pain relief commonly used during labor. It involves an injection in the lower back that delivers medication into the epidural space, an area around the spine. This medication blocks pain signals from traveling to the brain, providing numbness or decreased sensation in the lower half of your body.
Importantly, an epidural does not significantly affect your baby. The medication stays localized and doesn’t readily enter the bloodstream. In fact, by reducing the mother’s pain and stress, epidurals can improve oxygen flow and blood supply to the baby.
How Are Epidurals Used and How Long Will An Epidural Take to Kick In?
To place the epidural, you’ll be asked to sit up or lie on your side and curl your back to open the space between the vertebrae. After cleaning your skin, the anesthesiologist will inject a small amount of numbing medicine. You may feel a brief sting lasting five to 10 seconds.
The epidural catheter is then carefully inserted and connected to a pump, which delivers medication to the epidural space throughout labor. You’ll also be given a button that allows you to administer extra doses as needed.
You should expect significant pain relief. However, you may still feel pressure and some discomfort, especially during contractions.
The procedure takes about 10 minutes, with another five to 15 minutes for the medication to take full effect. If you’re very close to delivery, there might not be enough time for it to work before the baby arrives.
The impact of an epidural is temporary with three factors determining its strength:
- Type of anesthetic used
- Concentration of the drug
- The dosage
When Should I Ask for an Epidural?
You can request an epidural at any point during labor, as long as it’s safe to proceed. Most people choose to get one when their contractions become too painful to manage with breathing or movement. Your anesthesiologist will go over your medical history and obtain your consent before the procedure.
What Are the Risks Associated with Using an Epidural?
Epidurals are considered safe and are widely used. Serious complications are very rare, but some possible side effects include:
- Itching
- Temporary numbness or weakness in the legs
- Patchy or uneven pain relief (if the epidural is patchy or inadequate, anesthesiologists will assess the epidural catheter, change the medicine or dose and may replace the epidural catheter)
- Lowered blood pressure
- Difficulty urinating
- Soreness at the injection site
- Headache (rare)
- Infection (extremely rare)
Always tell your care team if something feels off. Most side effects are easily managed once identified.
What Other Pain Management Options Are Out There for Labor Pains?
While epidurals are the most effective method for managing labor pain, other options include:
- IV pain medication
- Nitrous oxide (“laughing gas”) inhaled through a mask
- Nerve blocks (numbing injections near the cervix)
These alternatives can help ease labor pain but may come with different side effects or levels of effectiveness. Talk to your OB/GYN or health care provider to determine what’s right for you.
Have Questions About Epidurals or Your Birthing Experience?
Consult the UofL Health – UofL Hospital – Center for Women & Infants, a Baby-Friendly birthing facility that offers services to meet your needs for low-risk and high-risk pregnancies. Here, your baby will receive patient- and family-centered care while receiving the most advanced and innovative maternity care available. Contact the Center for Women & Infants by calling 502-562-3325.
Authors
Jersey Mettille, D.O., is a board-certified anesthesiologist with UofL Physicians – Anesthesiology, providing expert care at UofL Health – UofL Hospital. With a focus on anesthesia, Dr. Mettille is committed to delivering safe, personalized care to patients throughout their surgical and procedural experiences. She earned her Doctor of Osteopathic Medicine degree from Philadelphia College of Osteopathic Medicine in Suwanee, Georgia, in 2018. Dr. Mettille completed her residency in anesthesiology at University of Louisville in 2022. As a member of the Department of Anesthesiology and Perioperative Medicine at the UofL School of Medicine, she supports the advancement of evidence-based practices in perioperative care.
Daisy Sangroula, M.D., is an obstetric anesthesiologist at UofL Health – UofL Hospital. Dr. Sangroula joined our team in 2012 at UofL Hospital, where she completed a residency in anesthesiology. Dr. Sangroula also serves as an associate professor at University of Louisville School of Medicine in the Department of Anesthesiology and Perioperative Medicine.
