Pain During Childbirth

Sit or lie on your side, with your back pushed out like the letter C. The anesthesiologist will numb your skin before inserting a needle. He or she then places a small tube, called an epidural catheter, into the epidural space of your back. The catheter is like very thin IV tubing. You will have the catheter in your back until your baby is born.

Your anesthesiologist injects medicine through the catheter, which relieves your pain in 10-20 minutes. The medicine will often make your leg muscles weaker for the duration of the block.

After you are numb, your nurse will place a tube in your bladder. You may not eat until your baby is born and you will need to stay in bed until the block wears off after delivery.

Epidurals keep you comfortable throughout your labor. The nurse may give you a device with a button to click. Clicking the button gives you another dose of numbing medication up to a safe level.  

• Low blood pressure.
• Nausea.
• Light-headedness.
• Fever.
• A hole in your spinal sac from a deep needle stick. If this happens, we can place the catheter through the hole to relieve your pain. You may get a headache the next day, which may require treatment.
• Nerve problems in your legs caused by the baby's head pushing on the birth canal. This side effect is just as common in women who do not have epidurals.
• Nerve damage, paralysis or infection, which are extremely rare (less than 1 in 20,000 cases).  

Women who use epidurals do not appear to be more likely to need a C-section. Epidurals may prolong the pushing stage of labor for some women.

Women who use epidurals are more likely to need a vacuum extractor put on their baby’s head to help pull the baby out of their body. This may make your perineum (area between the vagina and the anus) more likely to tear during delivery. 

C-sections are performed safely under epidural, spinal or general anesthesia. Choices depend on your medical condition, your baby’s condition and, when possible, your preferences. If you are at a higher risk, you may be encouraged to have an epidural placed. This would provide the safest care for you and your baby.

Epidural anesthesia is usually used when a patient has had an epidural catheter placed for attempted vaginal delivery. The patient has been unable to deliver vaginally, and her physician has chosen to deliver the baby by C-section. A much stronger drug can be injected in the epidural catheter. This will allow you to have a pain free cesarean section while remaining awake throughout the procedure.

Spinal anesthesia is given with a very thin needle that is advanced between the bones of the lower back into the spinal sac, below the end of the spinal cord. A small amount of medication injected into the spinal fluid quickly numbs your body from your toes to your chest. Since the spinal needles used today are so thin, the hole made in the spinal sac is small and the chances for a headache are very low.

General anesthesia is used most often when an emergency cesarean section is needed. It can be started very quickly by giving medications into your vein to put you to sleep. Once you are asleep, a breathing tube is placed through your mouth into your windpipe (trachea). It is important that you do not eat anything after your active labor pains begin. This is because stomach contents could come up and go into your lungs causing a life-threatening pneumonia.