Everyone’s labor and delivery story is different, and that is wonderful! Part of your story is how you plan to manage your pain during labor and delivery. Labor pain can be intense, and you have many choices for how to control it, including breathing and mindfulness techniques, inhaled nitrous oxide, pain medications through an IV, or an epidural.
Epidurals are a safe and effective way to help control labor pain. Each year, millions of women worldwide get an epidural—it is the most common type of pain relief used during childbirth. In the U.S. More than 60% of women in labor choose to get one.>
Understanding what an epidural is and its benefits—as well as possible side effects—can help you make more informed decisions about your pain care. Choosing to manage your pain with an epidural isn’t failing or giving up. You can have an epidural as part of any type of birth plan. No matter what you decide, we will honor and respect your choice.
Unfortunately, there is a lot of misinformation out there about epidurals. Here are the truths behind eight common myths about this labor pain control option.
Myths & Truths About Epidurals
Truth: Complications are extremely rare. The risk of paralysis is 1 in 1 million. The risk of permanent nerve damage is 1 in 23,500-50,000. We have a specially trained anesthesiologist available 24 hours a day, seven day a week on our Labor and Delivery unit.
Truth: Most medications given to the mother in labor can reach the baby, but the medication in an epidural stays almost entirely in the spine and the amount that gets into the mother’s circulation is too small to cause harm. Having an epidural does not increase the risk of birth defects, developmental problems or autism in your child.
Truth: The needle is long—around 9-11 cm, but only so that it can reach from the skin into the correct area of the spine. Even though it’s long, it is very thin: only about 4 times the width of a strand of hair, and the tube that holds the medication is the width of a pencil lead.
Truth: Epidurals successfully control pain 95% of the time. When the medication doesn’t work as expected, it’s usually because of the position of the tube next to the spine, or way the medication spreads out around the spine. Some women still feel pain. For others, it seems to work better on one side of their body compared to the other. Our health care experts will do whatever we can to ensure you have a safe, positive birthing experience.
Truth: You can get an epidural at any time while you are in labor—early, middle, or near the end. We do need to give the anesthesiologist time to get to you and give it. Getting an epidural requires you to sit still for about 10 minutes. The medication can take up to 30 minutes to take effect. If you come to the hospital close to delivery or decide too close to giving birth, there may not be enough time for it to work before your baby is born.
Truth: Getting an epidural doesn’t prevent you from pushing. You will be able to feel pressure during contractions and you will be able to push. Your labor partner, a nurse and your midwife or doctor can help hold your legs up for leverage when it is time to push.
Truth: There is no credible evidence that supports having an epidural increases your risk of needing a cesarean section (C-section) delivery. You still feel contractions, but they won’t hurt. This can help you feel more relaxed as you push.
Truth: while many women have back pain from pushing after giving birth, the risk of post-delivery back pain from an epidural is very, very low: about the same as taking other pain medications during childbirth. You are more likely to have back pain from lifting and caring for your new baby.
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What to Expect & How Epidurals Work
If you decide to get an epidural, an anesthesiologist will numb your lower back, which often feels like a brief burning or stinging sensation. Once the area is numb, they will insert a thin needle into your back. Through this, they will place a thin tube called a catheter. After that, labor pain will begin to subside. The catheter will stay in place to keep giving you medication. We adjust the strength and amount of medication while you are in labor, as needed.
The medication helps relieve pain by decreasing the feeling in the lower half of the body, from your belly button to your upper legs. Within 10 to 20 minutes, you should be fully numb. You will remain awake and alert, but you will not be able to get out of bed until the epidural wears off.
For many women, getting an epidural helps them relax and focus on pushing. You may still feel contractions, but they won’t hurt as much. This allows you to feel when it is time to push —your doctor or midwife can help tell you when to push and for how long.
As with any medication, epidurals have potential side effects. The most common side effect reported is skin itchiness. Other side effects may include a low-grade fever, soreness at the injection site or a headache in the rare case that a little spinal fluid leaks when you get your injection.
Related Reading: Want a Natural Childbirth? Know Your Pain Relief & Support Options
Most women can safely have a natural childbirth, and there are many options for support and pain management.
Is an Epidural Right for You?
Not every patient can get an epidural. If labor goes too fast, there may not be enough time to give one. If you have any of the following medical conditions, an epidural may not be an option:
- Blood clotting issues and/or using blood thinners
- Blood infection
- Brain or spine problems
- Hemorrhaging or shock
- Known anesthetic drug allergy
- Low blood platelet counts
Tell your doctor about any medical conditions or known allergies. We will determine whether an epidural is a safe option for you and your baby. Then it will be your choice whether to get one.
Epidurals are generally safe and choosing how to manage labor pain is a personal decision. Whatever you decide, we will listen to you, and we won’t judge you. If possible, think through your pain relief options and a birth plan before you go into labor. Then, once your contractions begin, you can focus all your attention on bringing your baby into the world.