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You are here: Home - Pregnancy - Labor & Childbirth

Epidurals - What You Need to Know

by Katlyn Joy | March 2, 2009 12:00 AM

Epidurals are the most popular form of pain relief, and are used in over half of all hospital births. They are regional anesthetics, not total pain blockers, but rather meant to be pain relievers. They work by blocking nerve impulses in the lower half of the body. They are not meant to block all sensation, however.

How is an epidural administered?

Typically, an IV is started before active labor begins, and an anesthesiologist will administer the epidural. The mother will usually be instructed to either lie down on her side, or sit up, arching her back and must lie very still. An antiseptic wipe will be used on the lower back to prevent infection from occurring. Then a local anesthetic will be used prior to the needle being inserted into the epidural area of the spine. A small tube or catheter will be threaded through the needle into the epidural space, the needle removed, and the catheter taped down.

Most often the drugs used include bupivacaine, chloroprocaine, lidocaine and often added to the mix are narcotics such as fentanyl and sufentanil. The narcotics are added to achieve pain relief while limiting the side effects. Sometimes fentanyl, morphine, epinephrine, or clonidine are added to prolong the epidural's effect or to stabilize the mother's blood pressure. The medication is delivered either with periodic injections, or by continuous infusion.

What types of edpidurals are there?

There are two types of epidural, the regular kind described previously, and the so-called "walking epidural," which involves injecting the medication into the membrane covering the spinal cord, the intrathecal area. This type of epidural allows more freedom of movement and the ability to change positions independently. If the pain relief is not to the level desired, a regular epidural can then be performed.

What are the benefits of having an epidural?

What are the disadvantages of having an epidural?

The disadvantages of an epidural include:

Questions to Ask Your Doctor

  1. What drugs will be used?
  2. How long will it take before I feel the medication working?
  3. What side effects are possible?
  4. How will the baby be affected?
  5. Can I eat and drink following the epidural?

Reasons an Epidural Cannot be Performed

Katlyn Joy is a freelance writer, and just graduated with a Master's of Arts in Creative Writing. She is mom to seven children and lives in Denver, Colorado with her family.

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Kristen Apr 18, 2013 12:31:26 PM ET

I had my son sep. 18 2010 and went into a normal labor around midnight. i decided to get the epidural which did relieve all the pain i was in, however, 45 minutes later i fell asleep and went into cardiac arrest and died with my son still in me. my sons heart rate dropped to 30 beats per min. i was dead, had no pulse for about a minute my doctor told me. what the doctors and nurses did was hit my chest to jump start my heart and i eventually woke up (with stickers on my chest) but was very weak. i was literally fighting darkness, death. i was very very tired. i was still passing out in the process of trying to push my son out but they had him out within 2 min after they called code blue. luckily i was fully dialated and they could suck him out as i tried my best to push. i spent the first 12 hours after i had my son in icu hooked up to all these ivs and tubes. so uncomfortable and worst of all, i couldn't see or hold my son. i couldn't breast feed or anything. so i'm not saying don't get an epidural, the doctor said he doesn't know exactly what happened to me but it is a miracale me and my son are here today. i suspect an allergic reaction to the epidural or an overdose. but i'm not the one to try and diagnose myself, ill just say i had some angels looking after me. 0:) & to this day i don't think ill ever get an epidural again, if i'm even allowed to now.

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diana Mar 2, 2010 11:06:03 AM ET

Well i had my daughter in 2007 and in california. and i was offered my epidural at 2 cm. dialiated, and i took it. but by the time the really painful part of labor started the medication was uneffective so i felt everything. my advice is wait as long as you can to have an epidural to ensure you have some pain management when the hard part comes. thats my plan with baby #2 (due in 7 days)

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