Everything you need to know about epidurals
If you’re getting close to giving birth – or you have friends who have gone through it – chances are you’ve heard the word epidural. Some women swear by them as the only saving grace of childbirth, and some aren’t so keen on them and prefer to avoid them if possible. So here are some facts on them so you know what you’re dealing with when making the decision of whether or not to use one for your own birth.
What is an epidural?
An epidural is a form of local anaesthetic offering pain relief during childbirth (used in both vaginal and caesarean section deliveries)
How is it administered?
An epidural is performed by a qualified anaesthetist and involves them inserting a local anaesthetic into your lower back before inserting a hollow needle into the “epidural space” in your spine, which will then feed a catheter tube into place which delivers the anaesthetic either via an injection with top-ups as required or a continuous drip.
It can take anywhere from 5 to 30 minutes for you to feel pain relief.
Before you have the injection, you will also be hooked up to a drip for fluids and also a catheter in your bladder for passing urine.
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At what stage of labour can you have an epidural?
Epidurals are usually administered during active labour, depending on the situation and the mother but often when the cervix is between 4 and 7 cms dilated.
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What are the benefits of an epidural?
- Pain relief from contractions
- Take effect relatively quickly for most women
- Can help lower blood pressure if it is high
- Helps you remain calm and relaxed throughout labour and pushing
- Allows you to be present and enjoy the moment rather than focusing on the pain
- If you have a long labour it can help you get some rest and regain strength for when you need to push
What are the disadvantages of an epidural?
- It may slow down your labour – meaning you will be offered drugs to speed up your labour via (another) drip
- May not always work straight away or only in certain parts
- You can suffer from itchiness, fever, chills
- You cannot walk around, you are confined to your bed – as you have to have continuous fetal monitoring and a drip
What are the side effects/risks?
There are some things to consider when opting for an epidural, such as:
- You have a higher chance of needing an assisted birth, eg forceps or vacuum due to inability to push
- You may not be able to walk around for a few hours after the birth
- A small number of women feel little to no relief from an epidural
- Small risk of suffering a severe headache for 24-48 hours after the epidural wears off
- Small risk of temporary nerve damage (approximately 1 in 1000) and smaller risk of permanent nerve damage (approximately 1 in 13,000).
Can an epidural affect my baby?
- As epidural can lower your blood pressure but you will be closely monitored to ensure it doesn’t drop too low, that your baby isn’t receiving enough oxygen
- The drug can pass through the placenta, and in high doses can possibly leave your baby sleepy or drowsy but there are no long-term effects associated with an epidural
How to decide whether or not an epidural is right for you?
- Always speak with your doctor or midwife about your own personal situation and whether you are able to have an epidural
- If you would like/not like an epidural make this clear to your partner and on your birth plan
- Don’t be afraid to change your mind in the moment, there is no shame in it
- Don’t let anyone else’s opinions or beliefs sway your decision, do what is best for you and your baby
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- Entonox (gas) for pain relief during labour
- The best positions during labour
- 12 tips to make you more comfortable during early labour
Dr Christine Catling Follow +
Dr Christine Catling, a midwife for over 25 years, is the Director of Midwifery Studies at UTS. She believes research, innovation and good quality midwifery are pivotal to the well-being of mothers and young families. Christine has extensive experience in antenatal education, policy development and research, and has published on workforce issues, homebirth, vaginal birth...
