Epidural for Labor

Labor

What is an epidural?

An epidural procedure is common method for pain relief during labor and delivery. It consists of placing a smooth and thin plastic tube (catheter) into your lower back area by using a special needle. Once the catheter is placed, you will receive a mixture of local anesthetic (pain medicine) and a strong painkiller to help decrease labor pain throughout your labor using programed pump.

What are the benefits?

  • It can be used throughout you labor and delivery
  • Usually provides good to excellent pain relief to allow labor progress more comfortably
  • Provides pain relief if you need instrumental delivery or a Caesarean section
  • Sometimes a spinal anesthetic is given first for a quick effect

How is it performed?

  1. Your anesthesiologist - a doctor who is specially trained to provide pain relief and sleep medication - will explain the benefits and possible risks of the procedure. The procedure takes about 20 minutes
  2. You will need to sign a consent form before starting the procedure
  3. A drip of fluids will be put into your hand or arm
  4. You will be asked to sit up or lie on your side
  5. It is very important to keep perfectly still during epidural to avoid any damage to the nerves in your spine
  6. Let your anesthesiologist know when you have a contraction, so that he/she can pause the procedure during this time
  7. Your back will be cleaned with a cold antiseptic solution to avoid the chance of infection
  8. You will be injected into your back with local anesthetic to numb the skin. This can sting for few seconds
  9. The anesthesiologist will guide the epidural needle into your lower back. You will feel a pushing sensation during this step
  10. Then he/she will pass a soft catheter through the needle which may feel as an electric shock in your back and down your legs. This will last for a moment and then go away
  11. The anesthesiologist will remove the needle and will tape the catheter in place so you can lie down without worrying about disturbing the catheter
  12. Once the anesthetic is given down the catheter, it will take a further 20min to take effect
  13. The epidural pump will be programmed to give you small additional amount of medication at regular times. You will also be given a button to press to get additional pain relieving medication if you are in pain. The pump controls the total amount of medication given to ensure you do not receive too much

What to expect after the procedure?

  • Your legs may feel heavier and numb
  • Your second stage of labor may be longer and may increase the need to use forceps or suction to help your baby’s birth
  • You may lose the feeling of your bladder and need a urinary catheter to help you pass urine.
  • You may feel shivery, feverish or itchy
  • Injection site may be tender but only for few days. Backache is NOT caused by epidurals but is common after any pregnancy
  • Your blood pressure can drop and make you feel light-headed or nauseous
  • If your epidural does not take full effect, your anesthesiologist may suggest making an adjustment to the catheter, medications or repeat the procedure

What are the Risks?

Epidural is usually safe. However, you might experience the following side effects:

  • Few get little or no pain relief. Other methods of pain relief may have to be used
  • Epidural may not work well enough for Caesarean so you need to have a General Anesthetic
  • Some women develop severe headache which is treatable

 
 Very rare risks:

  • Temporary or persistent numbness or weakness of leg or foot
  • Infection of the spinal cord, brain or bleeding around the spinal cord
  • Unconsciousness or accidental injection of local anesthetic into a vein
  • Severe injury including paralysis

Will this affect My baby?

 A labor epidural should not harm or affect your baby.