Epidurals for childbirth
What is an epidural?
Childbirth can be painful and you may be offered an epidural to help relieve pain during labour.
An epidural is an injection given in your back to numb nerves that carry feelings of pain from the birth canal to the brain.
During your preadmission clinic appointments you will be assigned an anaesthetist as part of your antenatal care. Anaesthetists are specialists in pain medicine.
During your appointment your anaesthetist will talk to you about epidurals and other pain relief options. They will ask if you have any major medical problems or allergies to medicines, as this may affect the medicine used in the epidural.
Benefits of an epidural
- Relieve labour pain more than other forms of pain relief.
- You can still move and push your baby out.
- Can be started at any stage of labour.
- Are very safe.
Preparation
- A drip is inserted into your arm before you are given the epidural.
- It will take about 5 minutes to set up and a further 5 to 15 minutes for you to feel the pain medicine.
- You are positioned in a sitting up position (as in the photo), and asked to lean over a pillow with your feet on a chair.
- Your back is swabbed with an antiseptic solution (that will feel cold) to clean your back.
- A local anaesthetic injection is given in the area the epidural needle will be inserted. This may cause a stinging sensation.
- It is important to stay still. Your anaesthetist will insert the epidural needle around your contractions. Make sure you tell the anaesthetist if you are about to have a contraction.
- The needle is not left in your back during labour, only a very small plastic tube which gives you the pain medication. The tube is removed after the birth and will not hurt.
What happens during an epidural?
You will be administered the pain medication. There are different ways to do this:
- you will be given control of how much you need with a push button device
- your midwife will administer the medication for you.
Your baby will be closely monitored for the rest of your labour. Two belts will be placed around your middle to record:
- your baby's heart beat
- your contractions.
Let your midwife know if your epidural is not working properly and remember, an anaesthetist is available day or night to help.
Possible side effects
- Your blood pressure may fall. This does not mean there is a problem and your midwife will monitor your blood pressure closely.
- You may need a catheter to be inserted in your bladder if you have difficulty passing urine.
- You may feel itchy and shiver for a short time after the epidural is finished.
- The second or pushing stage of labour may be slowed down.
- The chance you will need a forceps or vacuum birth is slightly increased if it is your first labour. It does not increase your chance of needing a caesarean.
- You may feel numb and not be able to walk for 2 to 3 hours if stronger medicine is administered.
- You may have a bruised feeling in your back for a couple of days after the procedure.
Occasional complications
- A small amount of women develop a bad headache, usually 24 to 48 hours after an epidural. This headache feels different from the normal common headaches.
- There is a very small chance of developing a skin infection.
- Epidurals can very rarely cause nerve damage.
After an epidural
The day after the birth of your baby someone from the Department of Anaesthesia will check there are no major problems and answer any questions you may have.
Costs of an epidural
For an Australian patient in a public hospital in Western Australia:
- public patient – no cost to you unless advised otherwise
- private patient – costs can be claimed through Medicare and your health insurance provider.
Where to get help
Remember
- An epidural can be used to relieve pain during labour.
- Epidurals relieve labour pain more than other forms of pain relief.
- Your anaesthetists will discuss pain relief options with you.
Acknowledgements
Department of Anaesthesia and Pain Medicine
King Edward Memorial Hospital for Women
This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.