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Should You Use An Epidural?

By Catie Chung, RN, BSN, MA

Should You Use An Epidural?

At a certain point in your pregnancy you start thinking, “Oh, wow, this baby is going to have to come out at the end of all this!” And soon after you probably think, “I don’t want it to hurt!” While there are personal, cultural, and physical reasons you may not be able to have the option of epidural anesthesia for pain relief, most expectant moms can.

Maybe labor pain relief sounds great, but the idea of having a needle inserted into the epidural space of your spinal column seems pretty scary. Right? What you need to know is that epidurals have been used safely for pain management in labor for several decades now.

Getting an epidural

An anesthesiologist or certified registered nurse anesthetist (CRNA) performs the procedure, which typically takes about 10-15 minutes. The goal of the epidural is to almost completely block any pain due to contractions or the stretching of your perineum when the baby is born. With an epidural, you should still be able to feel pressure when it’s time to push with your contractions.

To have an epidural you must also have IV fluids as well. Many hospitals and doctors require laboring women to have IVs, so this shouldn’t be a deciding factor for an epidural. First a local anesthetic is given by injection with a small needle in the area of your back where the epidural will be placed. Then the larger epidural needle is inserted into the epidural space between your spinal vertebrae about two-thirds of the way down your back.

With the needle in place, the anesthesiologist then inserts a tiny tube called a catheter into the space to continuously deliver pain medication until you deliver. After the catheter is in place, the needle is removed and tape is applied to hold the catheter on your back. It takes about 10 to 20 minutes to begin to get labor pain relief once the process is completed.

Side effects

Epidurals aren’t without side effects and risks so talk to your healthcare provider if you’re thinking of considering one – you may also need to pre-register your health insurance information with your hospital or birthing center as well.

The most common side effect is a drop in your blood pressure, so you will continue to have that monitored and IV fluids given to support healthy blood pressure. If a drastic drop in BP is observed, you’ll be given IV medications to boost your blood pressure back to normal. Many women worry that the epidural could slow their labor progress.

Most providers want women to wait until they have a consistent pattern of contractions and are dilated to 4 centimeters before receiving an epidural – this reduces the risks of an epidural slowing or stalling labor progress.

Finally, epidurals don’t always work perfectly for all women; know that an epidural is no guarantee of a pain-free delivery. So talk with your healthcare provider, and then wait until you’re in labor and properly contracting and dilated to make the best decision for you and your baby.

Epidural anesthesia is a spinal injection in the back. Make sure to discuss your decision with your healthcare provider if you’re thinking of considering an epidural, as there are certain side effects and risks associated with them.

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