Your Guide To Having An Epidural In Labour

If you are pregnant then you have probably heard about the possibility of having an epidural in labour, which is a pain relieving procedure that’s often given during childbirth.

But what happens during this procedure? How long does an epidural last? And what are the pros and cons of an having an epidural in labour?

Here are the answers to all of these questions - and more – in our guide to the epidural.

What exactly is an epidural?

An epidural is a pain-killing injection into the lower back, which blocks the nerves carrying the pain messages from the uterus.

What happens during an epidural?

If you have an epidural in labour in an obstetric unit, an anaesthetist will be there to set up the procedure. This is how it works:

• You will first have a drip popped into your arm. This is so you can be given fluids while you're having the epidural
• Then you’ll be asked to sit down and lean forwards - or lie on your side with your knees up to your chest – so you can have an injection of local anaesthetic in your back
• Next the anaesthetist will use a thin plastic tube to insert an epidural catheter into your back
• The needle will then be taken out, so you just have the catheter in your spine, which carries the drugs (a mixture of local anaesthetic and opioid pain killers) into your system. The epidural drugs will take about 20 minutes to take effect.
• Your midwife can top up the epidural, or you may be able to give yourself doses of the epidural drugs using a patient-controlled epidural analgesia (PCEA) pump
• Baby's heart rate and your contractions will be continuously monitored and your blood pressure checked regularly

Currently used epidurals allow women to have some mobility and avoid total numbness or heavy legs, which can help during the birth.

What are the epidural risks and side effects?

Epidurals are normally perfectly safe, but – as with any medical procedure – there are some possible risks and side effects.

Possible side effects of an epidural include low blood pressure, headaches, itchiness and temporary loss of bladder control. Temporary tingling or a pins and needles sensation in the leg can sometimes occur. An epidural can result in an infection, which may need to be treated with antibiotics. Rarely, permanent nerve damage or other serious complications ensue.

What are the pros and cons of an epidural?

An epidural is not without its risks and side effects. And some women don’t want to have one, as they feel it’s more natural to give birth without this sort of pain relief. But on the plus side an epidural is the best possible pain relief during labour.

An epidural may make babies slower to move into the correct position, so could result in labour taking longer. You also may not be able to push as strongly making an assisted birth with forceps or ventouse more likely. However, epidurals do not increase your chance of having a caesarean section. 

Don’t forget that the choice of whether or not to have an epidural is yours. Before it happens, you will usually discuss it with your doctor or midwife and you shouldn’t feel pressure either way. But it’s good to think about your attitude to epidurals – and other forms of pain relief – before you go into hospital, and also discuss this with your birthing partner. Epidurals are only available in hospital obstetric units and are not available if you plan to give birth in a midwife-led unit or have a home birth.

Will an epidural affect my baby?   

When you have an epidural, the drugs do enter your baby’s blood stream through the umbilical cord – as does any medication you take during pregnancy and labour. But there aren’t any known long term-effects on your baby from an epidural and you will be able to breastfeed your baby after birth as usual.

How long does it take to recover from an epidural?

After you stop having medication through your epidural, it will take a few hours before the numb feeling finally stops.

While the medicine wears off, you'll usually be advised to rest – either in a lying or sitting position - until the numbness subsides and the feeling in your legs returns. This can take a couple of hours, and you may feel a slight tingling sensation in your skin as it happens.

If you do start feeling pain at this stage, tell a doctor or nurse and they will give you some medicine to help.