Should I Get an Epidural

The most common pain relief available to women in labor is an epidural, a continuous intravenous injection of pain medication to help reduce or eliminate the sensation of labor contractions. This short video will give you a good visual of how an epidural needle is placed in a mother’s lower back during labor.

The medication that is inserted through the needle can vary, depending on the mother’s needs at the time. It can be an analgesic, which reduces the sensation of pain without numbing the muscles, an anesthesia, which numbs the lower part of a laboring mother’s body, or, most commonly, it is a combination of the two. The American Society of Anesthesiologists explains the differences between epidurals, spinals, analgesia and anesthesia.  The American College of Obstetricians and Gynecologists explains the procedure, including the risks, in this patient education pamphlet.

When would an epidural benefit a mom in labor?

An epidural numbs the areas of the body that would otherwise feel pain during labor contractions, providing a virtually pain-free labor for the mom. This can be a helpful tool for a mother who has had a very long labor and needs to rest in order to regain her strength for the last part of her labor. It is also a useful medication when a cesarean is necessary since it allows a woman to remain awake and alert during the birth of her baby.

Generally speaking, a mother might opt for an epidural in one of these situations:

  • She needs to rest after a very long labor and a possible stall in cervical dilation
  • She wants pain relief but wants to remain awake and alert for the remainder of her labor
  • She’s going to have a cesarean birth

Are there risks to epidural medication?

One of the logistical downsides for many women is that once an epidural is placed in the mom’s back, the mother is no longer able to move out of bed. This is for two reasons: the epidural itself is connected to an IV and the mother is hooked up to two monitors that are wrapped around her belly to record contractions and the baby’s heart rate. Since mobility is one of a laboring mother’s greatest assets (conscious breathing is the other), being confined to bed is a physical and emotional downside for a mother who wants to walk, sit on a birth ball, shower, bathe, or simply move into positions that feel right for her during labor.

A second downside to having an epidural is the way the drugs interfere with the body’s natural hormone production during labor. According to Dr. Sarah Buckley, the epidural prevents the body from producing the hormones that help to push the baby out of the mother’s body in second stage labor, often leading to a vacuum or forceps delivery, or even an unplanned cesarean birth.

Other risks of epidural medications to the mother and the baby are listed here, as provided by the American College of Obstetricians and Gynecologists:

  • An epidural can cause the mother’s blood pressure to decrease, which could then slow the baby’s heart rate.
  • The mother’s back may be sore at the injection site for several days after the birth.
  • Some mothers experience a bad headache if the covering of the spinal cord is pierced at the time of injection.
  • It may be hard for the mother to bear down and push the baby through the birth canal.
  • If the drug inters a vein, the mother could become dizzy or have a seizure.
  • If the anesthetic enters the mother’s spinal fluid, it can affect her chest muscles, making it hard to breathe.

Excerpted from ACOG’s Patient Education Pamphlet: Planning Your Childbirth: Pain Relief During Labor & Delivery

Can a woman cope with labor without an epidural?

Many women go through some or all of their labors without using an epidural. Their ability to do so depends on how well they prepared for labor through childbirth classes, the severity of the contractions, and the length of the labor.  In Happy Birth Way classes, expectant parents learn hands-on non-medical coping techniques that are quite effective in helping a laboring mom handle contractions.  These include labor positions, specific massage techniques and conscious breathing, all of which are practiced in class.

Are there other drugs that can reduce pain in labor?

Narcotics are sometimes used to help reduce a mother’s sense of pain in labor, but, as with epidural medications, there are risks to both mother and baby. The American Pregnancy Association has put together a list of pros and cons to help you decide what is right for you during your labor.

Click here for information about natural pain relief.