Epidural block

When it comes to managing labor pain, some expecting moms prefer to deal with the pain of childbirth naturally, using breathing and relaxation techniques. Others decide to use pain medication to help manage labor pain. One option for pain medication during labor is an epidural block (or epidural). It's among the most effective methods of pain relief during labor.

How it works

  • An epidural can be given during active labor or just before a cesarean section.
  • The woman is given an injection in the lower back, which numbs her lower body.
  • The medication blocks pain from contractions while the woman is awake and alert.

How it's given

  • Before giving you the injection, the health provider numbs your lower back with a local anesthetic.
  • While you are sitting or lying on your side with your back curved outward, the health provider inserts the needle for the epidural.
  • The health provider then passes a small flexible tube (catheter) through the needle.
  • You will probably feel some pressure as the needle is inserted, but it usually isn't painful.
  • The needle is then removed. The tube remains in place so you can receive more medication as needed.

How it affects you

  • An epidural takes about 20 minutes to be given and another 20 minutes to take effect.
  • Although an epidural block makes you more comfortable, you may still be aware of contractions. You also may feel your health provider's examinations as labor progresses.
  • Depending on how much pain relief you need, the epidural can block pain in your lower body or just change your awareness of the pain.
  • The epidural may cause temporary numbness or heaviness or weakness in the legs. So you probably won't be able to walk around once the epidural takes effect.
  • You can also get a "walking epidural." This provides pain relief, but leaves you with enough strength in your leg muscles to walk during labor.

Pros

  • The epidural blocks pain in the lower body without significantly slowing labor.
  • It can be used throughout labor and for several hours.
  • You remain awake and alert.
  • You can receive a walking epidural, so you can walk around during labor.
  • An epidural usually has little or no effect on the baby.

Cons

  • An epidural may provide uneven pain relief, affecting one side of the body more than the other.
  • Your blood pressure can drop during an epidural. This may affect your baby's heartbeat. To prevent this, you’ll receive extra fluids through an intravenous (IV) tube. Lying on your side can improve blood flow.
  • You may feel some soreness from the epidural injection after delivery. It may last a few days. But an epidural should not cause long-term back pain.
  • If too much medication is given, it can affect your chest muscles. You may temporarily have trouble breathing. This happens rarely.
  • In very rare instances, you may get a bad headache. If not treated, this "spinal headache" may last for days.

Changing your mind about pain medication
Labor pain affects each woman differently. Some women have mild discomfort. Others experience intense pain.

If you try natural childbirth, you may think about using medication for pain after your labor has begun. It's okay to change your mind. Don't feel like you gave up or let your baby down. Only you know how strong the pain feels. It's okay to talk with your provider about medication and to do what you think is best.

October 2009

Most common questions

What is an epidural?

An epidural is the most popular and effective kind of pain relief for labor. You get a needle with a small tube attached placed in your lower back. Medicine goes through the tube while you're in labor. It numbs your lower body so you can't feel the pain from your contractions. The medicine doesn't make you go to sleep, so you can be wide awake when your baby is born!

What is fetal-scalp blood sampling?

Fetal-scalp blood sampling is a quick test your health care provider can use to check if your baby is getting enough oxygen during labor.

During labor, your cervix dilates (opens) to let your baby out. Your cervix is the opening to the uterus that sits at the top of the vagina. In order to have fetal-scalp blood sampling, your cervix must be dilated enough that your provider can reach your baby’s head.

The test may remind you of a pelvic exam. It takes about 5 minutes. You lie on your back with your feet in stirrups. Your provider places a plastic cone in the vagina that fits up against the baby’s head. Your provider pricks your baby’s scalp and takes a small amount of blood. The blood is tested, and results are ready in a few minutes.

You may feel some pressure during the test, but it shouldn’t hurt. Your baby may have some bruising or bleeding at the spot where he’s pricked.

If you have an infection, like HIV or hepatitis C, your provider may not recommend fetal blood sampling. This is because you can pass these infections to your baby through the spot where he’s pricked.

What is oxytocin?

Oxytocin is a hormone your body makes to help start labor contractions. Contractions are when the muscles of your uterus get tight and then relax. They help push your baby out of your uterus (womb).

Your body also makes oxytocin during breastfeeding. Oxytocin helps your uterus shrink back to its original size after giving birth.

If labor is slow to start or your contractions stall, your health care provider may give you a medicine called Pitocin. Pitocin acts like oxytocin and can help start contractions or make them stronger.

What is Pitocin?

Pitocin is a medicine that acts like oxytocin, a hormone your body makes to help start labor contractions. Contractions are when the muscles of your uterus get tight and then relax. They help push your baby out of your uterus (womb). Health care providers often use Pitocin to:

  • Help induce labor
  • Help labor move along if your contractions slow down, or if they aren’t strong enough

You may start having labor contractions shortly after you get Pitocin. It can make your contractions very strong and lower your baby's heart rate. Your provider carefully monitors your baby's heart rate for changes and adjusts the amount of Pitocin you get, if needed.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).