Childbirth is one of the most painful experiences many people go through in life. Pushing a baby out of your birth canal pushes your body to its physical limits. Labor and delivery can last hours or days and involve painful contractions, stretching, tearing, and pressure.
Pain management has become an essential part of childbirth. The epidural is one of the most common methods of pain management for women in labor and is given in over 70% of U.S. hospital deliveries.
What Is an Epidural?
An epidural is a pain relief procedure that’s become one of the most common pain management options for childbirth. The epidural procedure involves an injection of an anesthetic or a steroid. The doctor will inject the medication into the space around your spinal nerves. This is called the epidural space.
The epidural procedure is meant to give you pain relief or complete numbness in one region of your body. This can include your legs or stomach area.
What Happens During an Epidural?
An epidural is typically done in your labor room. The placement isn’t painful, but you may feel discomfort from numbing your skin before your epidural block is in. To do the epidural, small tubes are put in your lower back that allow a pump to slowly put the pain medicine in your lower body.
Your doctor may test a small dose to ensure the epidural is in the right place. The epidural duration is fairly short. It typically takes about 15 minutes to feel the medication start taking effect, depending on which type of anesthetic is used.
Getting an epidural anesthesia injection stops pain signals from traveling from your spine to your brain. The shot is placed in your epidural space, which is filled with fluid surrounding your spinal cord. Your spinal cord connects nerves all over your body to your brain. So when you’re feeling pain from childbirth, the epidural anesthetic blocks those pain signals from reaching your brain.
How many feelings you temporarily lose is based on these factors:
- The type of anesthetic drug used
- The concentration of the anesthetic
- The dosage or how much of the anesthetic is used
What Are Epidural Benefits and Risks?
Your OBGYN will talk to you about the right time for your epidural during labor. You may get the epidural soon after labor starts or at a point later on in labor. There may be some risks to an epidural if you’ve experienced any of the following:
- Had recent major surgery in your lower back
- Have blood-clotting problems
- Are on certain blood thinners
- Have an infection in your lower back
While epidurals are great for pain management, there are some risks associated with the procedure. In some cases, an epidural may not give you enough pain relief. In other instances, epidurals can cause a drop in your blood pressure, slowing your baby’s heart rate. Not being able to walk during labor is also a risk of epidurals.
If getting an epidural isn't a good choice for you, you can talk to your doctor about other types of pain relief or anesthesia that can help you through the labor process. You’ll want to discuss this when making your birth plan and not when you’re already in labor.
Some rare risks can come from an epidural procedure. These complications include:
- Permanent neurological damage from the spinal cord or nerve root damage
- Chronic pain from the spinal cord or nerve root damage
- Permanent paralysis from a hematoma from the buildup of blood around your spinal cord
What Are the Pros and Cons of an Epidural?
Though epidurals are a standard pain management procedure, you should consider some pros and cons.
Pros. Epidurals allow you to be awake and alert during childbirth. They also help ease most of the pain in your lower body without slowing down your labor too much. There’s also minimal to no effect on the baby from an epidural.
The epidural is a significant benefit to women in labor. Because childbirth is painful and can last hours, the epidural provides relief from the physical pain as well as some of the mental stress and anxiety.
Another pro to epidurals is that your lower body is numb if your doctor needs to perform an emergency C-section without waiting for medication to take effect. An emergency C-section may be required if your baby is oxygen-deprived. Lack of oxygen can cause brain damage, cerebral palsy, or other birth injuries.
Some studies have suggested a link between lower instances of postpartum depression and epidurals.
Cons. One of the biggest cons of epidurals is the time and effort it takes to be done. Your doctor can’t perform an epidural until your cervix is at least four centimeters dilated. This requirement can make it hard to have to wait in labor pain. In addition, if your cervix is fully dilated, it’s too late for you to get an epidural.
Another epidural con is the insertion of the needle into your spine. Some people find this painful due to the size of the needle.
One of the side effects of an epidural is being unable to walk. This is a major con for the childbirth process since delivery can take so long. Low dosages may allow some women to stand and walk with help, but the total dosage completely numbs your lower body.
Though the epidural process has not been shown to slow down the labor process actively, the fact that your muscles and nerves are numb can prolong delivery. You won’t be able to use your muscles as effectively when pushing the baby out.
What Are Epidural Side Effects?
You may notice some tenderness and bruises at the site of your epidural after delivery. There are some other side effects you may experience after delivery. These include:
- Severe headache
- Temporary difficulty urinating
- Temporary inability to walk
Epidurals during childbirth are a common, effective, and overall safe procedure that gives you quick pain relief or temporary numbness. It’s natural to feel anxious about the delivery and the epidural process. You shouldn’t be afraid to ask your OBGYN any questions you might have about childbirth. You can also talk to them about what to expect when getting an epidural and how to mentally prepare for the epidural procedure.