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Epidural Block
Sylvia Wood, RN, CNM, MSN
An epidural block (also called an epidural) is the most effective and popular method of pain relief. It is used by more than half of all laboring women in the United States. An injection given near the nerves in the lower back numbs your lower body. It blocks pain from contractions, while allowing you to be awake and alert. An epidural can also be used for a cesarean delivery. It usually has little or no effect on your baby.
An epidural is generally given by:
- An anesthesiologist: A doctor who specializes in pain relief or
- A nurse anesthetist: A registered nurse with special training in pain relief
Before giving you the injection, the doctor or nurse will wash your lower back with an antiseptic and apply a local anesthetic to numb the area. While you are sitting or lying on your side with your back curved outward, the doctor or nurse will insert the needle, then pass a small flexible tube called a catheter through it. You will probably feel some pressure as the needle is inserted, but it should not be painful. The doctor or nurse then withdraws the needle, leaving the catheter in place so you can be given additional medication as needed, without getting another injection.
You should begin to feel pain relief within 5-15 minutes, though you still may feel some pressure during contractions. You probably won't be able to walk around once the epidural takes effect, but you should be able to push during delivery.
Drawbacks
An epidural has some drawbacks. A few women experience a drop in blood pressure that can temporarily slow the baby's heart rate. Your doctor will give you extra fluids through a vein and may have you lie on your side. Some women also experience mild itching, shivering or a fever. If this occurs, the health care staff may want to test the baby for infection and treat him or her with antibiotics. Serious side effects in the mother are rare but include:
- Severe headache that can last for days or weeks
- Breathing problems
- Dizziness
- Seizures
An epidural can change the course of your labor and delivery. It sometimes results in more medical procedures. Women who have an epidural tend to have longer labors and more vaginal deliveries in which the doctor uses instruments to help the baby out. Because an epidural sometimes slows contractions, you may be more likely to receive oxytocin, another drug that is given intravenously, to speed them up. However, women who are especially anxious or tense may find that their contractions pick up after an epidural because they're more relaxed. An epidural can make it difficult to urinate, so you may need a catheter to drain your bladder. Use of other drugs and IV fluids and frequent electronic fetal monitoring are also common with an epidural.
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Information specialists at the March of Dimes answer your questions by e-mail and online chat.
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