Many of today’s parents choose to control their pain during labor with an epidural, but what exactly is it and what should first time parents expect?

What is an Epidural?

An epidural is an injection in your lower back to provide pain relief or a lack of feeling during labor. The injection sends an anesthetic into the epidural space around your spine to prohibit pain signals from travelling from your spine to your brain and provides a lack of sensation in the lower half of your body.

It is important to note that choosing to have an epidural injection will not affect your baby. The medicine given through the epidural does not readily reach the bloodstream in a significant amount, so it is very unlikely to affect your baby. Epidural pain relief helps lower stress hormone levels and improves oxygen transfer and blood flow to the baby.

How are Epidurals Used and How Long will it Take to Kick In?

Your epidural will be placed while you are in the sitting position, or you may be lying on your side, and you will be asked to curl your back out as much as possible. Your back will be cleaned and numbing medicine will be given to the injection site. However, you may fill a sting for 5-10 seconds while the medicine is given. You will be asked to stay as still as possible for a short time while the epidural is being placed. The procedure can be paused during your contractions.

Your catheter will then be connected to a pump for constant delivery of medication. You should expect significant pain relief, but not complete pain relief. You will continue to feel pressure with contractions, and you will be given a button to push that will give extra medication if needed.

The impact of an epidural is temporary with three factors determining its strength: type of anesthetic used, concentration of the drug and the dosage.

The timing of an epidural is different for each patient. During the first stage of labor, when your uterus is dilating, your contractions will become stronger and closer together. Most patients choose to have an epidural placed when they begin having trouble managing their pain.

The procedure takes roughly 10 minutes, and it may take another 5 to 15 minutes for the medicine to start working. If you are very close to pushing, there may not be enough time to administer an epidural before the baby is born.

When Should I Ask for an Epidural?

You have the option to ask for an epidural at any point during labor. Your anesthesiologist will ask about your medical history and for your consent before the epidural can be started.

What are the Risk Associated with Using an Epidural?

Epidurals are a safe and effective options for some moms-to-be during labor. Serious complications are extremely rare, however, you could have side effects to the epidural. Some known side effects of epidural injections are:

  • Itching
  • Inability to move your legs until medication wears off
  • Patchy block
  • Decrease in blood pressure
  • Difficulty passing urine
  • Sore back
  • Headache
  • Infection

If you experience any of these side effects during labor, please let your care team know. Most side effects are recognized and treated immediately by your care team, but it is always best to communicate any changes in your health while in labor.

What Other Pain Management Options are Out There for Labor Pains?

While an epidural is the most effective way of controlling labor pain, other options are available:

  • Continuous delivery of pain medicine in your IV
  • Breathe Nitrous Oxide (“laughing gas”) through a mask
  • Have a nerve block during delivery, where numbing medicine is injected into the entrance of your uterus

These options will help with your pain but do have other side effects. It is best to speak to your OB/GYN or health care team about the best option 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 offering the most advanced and innovative maternity care available.

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Article by: Daisy Sangroula, M.D.

Daisy Sangroula, M.D., is an obstetric anesthesiologist at UofL Health – UofL Hospital. She joined our team in 2012 at UofL Hospital, where she completed a residency in anesthesiology. Dr. Sangroula also serves as an associate professor at the University of Louisville School of Medicine in the department of Anesthesiology and Perioperative Medicine.

All posts by Daisy Sangroula, M.D.
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