An epidural is a safe, effective, and popular pain relief method for women in childbirth. The epidural rate in the UK is approximately 60% — meaning six in ten women opt for an epidural in labour .
But while an epidural can deliver very effective pain relief in labour, there are some drawbacks which mean it’s not the right choice for everyone. In this guide, you’ll learn everything you need to know about getting an epidural in labour, so you can decide if it’s the right pain relief option for you.
Table of Contents
- What is an epidural in labour?
- The process of placing an epidural
- How does an epidural help in labour?
- Who can have an epidural in labour?
- Recovering from an epidural
- Epidural in labour: risks and side effects
- Is an epidural in labour right for you?
- Get epidural recovery support from Harley Street Specialist Hospital
What is an epidural in labour?
An epidural is a type of pain relief offered to women in childbirth. Not to be confused with an epidural steroid injection, which is a type of injection for back pain, an epidural in labour involves inserting a catheter into your spine so anaesthetic and pain relieving medications can be given and topped up as needed.
Epidurals offer near-total pain relief in labour. So they’re often chosen by women who have had long or particularly painful labours. Getting an epidural can help you rest (and even sleep) in preparation for the physical pushing phase of labour.
Does getting an epidural hurt?
Getting an epidural can be uncomfortable, as the needle is slightly larger than for other injections. But your medical team will do everything they can to make it a bearable experience.
You’ll usually be given a local anaesthetic before the larger needle is used to insert the catheter. This will reduce how much pain you feel when the epidural is placed.
When the catheter is in, you won’t feel any pain or discomfort when your medication is topped up.
The process of placing an epidural
A standard labour epidural usually follows these steps:
- Assessment — Your midwife, doctor, and/or anaesthetist will check your suitability for having an epidural.
- Fluid drip — You’ll be given an IV drip to keep you hydrated throughout the rest of your labour.
- Positioning — Lie on your side or sit down and lean forward to allow the medics access to your spine.
- Numbing the area — A regular needle will be used to inject local anaesthetic into the area where the epidural will be given.
- Catheter insertion — When you feel numb, a larger needle is used to place the catheter in your spine. A catheter is a small plastic tube through which other medicines can be given.
You might feel a little soreness in your back as the anaesthetic wears off, but this is likely to be much less intense than the pain of contractions.
How does an epidural help in labour?
An epidural should give you fast, near-total pain relief from labour contractions. Numbing agents and pain relief medication are given via the catheter to stop the nerves sending pain signals to the brain.
This can help you by:
- Reducing or even eliminating pain.
- Allowing you to rest throughout your contractions, giving you more energy to push when needed.
- Giving you pain relief that lasts throughout the rest of your birth.
However, there are some drawbacks to getting an epidural in labour, so discuss this with your midwife before you decide whether it’s right for you.
Is labour faster without an epidural?
Some research has found that getting an epidural can slow labour down if it’s given in the early stages . However, other studies have found that it won’t prolong active labour, so getting an epidural at the right time can give you effective pain relief without stalling your baby’s birth .
How far dilated is too late for an epidural?
In general, you can have an epidural when your cervix has dilated anywhere from 3cm to 9cm. But research suggests 6cm is the optimal dilation for getting an epidural .
Bear in mind that extra staff are needed to give you an epidural, so the more notice you can give that you’d like an epidural, the better.
Can an epidural harm your baby?
Different studies have come to different conclusions around the impact of an epidural on your baby. A 2020 study found that an epidural could increase the likelihood of admission to the neonatal intensive care unit, birth injuries, foetal distress, and breathing difficulties in the first 24 hours of life .
However, a 2022 research review disputed this, stating there’s little to no evidence that having an epidural can affect your baby’s heart rate, APGAR score (the assessment your baby receives one and five minutes after birth), or how likely they are to be admitted to the neonatal intensive care unit .
One study found a link between epidurals and autism, but this has since been discredited .
Discuss the risks and benefits with your midwife. In many cases, the benefits of having an epidural will outweigh the risks, so it could still be a safe and effective pain relief option for you and your baby.
Who can have an epidural in labour?
Almost all women who are having a vaginal birth can have an epidural in labour. If you’re at risk of certain complications, you may be advised to avoid an epidural, but your midwife and anaesthetist can help you determine this.
If you’re having a Caesarean section, you may be offered a spinal block instead of an epidural. But if you’ve already had an epidural and need to have an emergency C-section, your epidural may be topped up instead of having a spinal block.
Recovering from an epidural
It takes a few hours for an epidural to wear off, so you probably won’t be able to move much or walk during this time. (This includes going to the toilet, so you’ll be given a bladder catheter to drain your urine).
When the feeling comes back to your legs, your midwife or medical team can help you get up and about.
You won’t be able to drive for at least 24 hours after an epidural. You should also avoid alcohol throughout this time.
Epidural in labour: risks and side effects
Though generally considered a very safe procedure, there are some risks and side effects to be aware of with an epidural. Side effects include:
- Low blood pressure, which can lead to nausea and dizziness
- Loss of bladder control
- Itchy skin
- Limited pain relief
- Intense headache
There are also risks to think about, including the possibility of developing nerve damage, breathing problems, and infection. These only happen in rare cases, and are treatable with fast intervention.
Is an epidural in labour right for you?
It’s important that you feel empowered to make the right pain relief decisions for you. If you’re considering an epidural, speak to your midwife about the benefits and risks in your specific situation, and raise any concerns you have.
Keep in mind that although you’re encouraged to make a birth plan, you don’t have to make any firm decisions until the day of birth.
Get epidural recovery support from Harley Street Specialist Hospital
At Harley Street Specialist Hospital, we offer pre- and post-pregnancy support in our private gynaecology clinic. If it’s taking you longer than expected to recover from your epidural (or any type of birth), book an appointment at our London hospital for advice and support to aid your recovery.