Labor Epidurals

An epidural delivers continuous pain relief to the lower part of your body while allowing you to remain fully conscious. It decreases sensation but doesn’t result in a total lack of feeling.

Medication is delivered through a catheter – a very thin, flexible, hollow tube – that’s inserted into the epidural space just outside the membrane that surrounds your spinal cord and spinal fluid. An epidural is the most commonly used method of pain relief for labor in the United States.

What is the procedure like?

To allow the catheter to be inserted, you lie curled on your side or sit on the edge of the bed while an anesthesiologist cleans your back, injects the area with numbing medicine, and carefully guides a needle into your lower back. (This may sound painful, but for most women, it’s not.)

The anesthesiologist then passes a catheter through the needle, withdraws the needle, and tapes the catheter in place so medication can be administered through it as needed. You can lie down at this point without disturbing the catheter.

First you’re given a small “test dose” of medicine to be sure the epidural was placed correctly, followed by a full dose if there are no problems. Your baby’s heart rate is monitored continuously, and your blood pressure is taken every five minutes or so for a while after the epidural is in to make sure it isn’t having any negative effects.

The medication delivered by the epidural is usually a combination of a local anesthetic and a narcotic. Local anesthetics block sensations of pain, touch, movement, and temperature, and narcotics blunt pain without affecting your ability to move your legs. Used together, they provide good pain relief with less loss of sensation in your legs and at a lower total dose than you’d need with just one or the other.

You’ll start to notice the numbing effect about ten to 20 minutes after the first dose of medication, though the nerves in your uterus will begin numbing within a few minutes. You’ll receive continuous doses of medication through the catheter for the rest of your labor.

You may also have the option of patient-controlled analgesia, which means that you can control when you get more medication via a pump that’s connected to the catheter. (The amount of medication you can give yourself is limited, so there’s little chance of overdose.)

After you deliver your baby, the catheter will be removed. (If you’ve had a c-section, sometimes the catheter is left in to administer postoperative pain medication.) Having the catheter removed doesn’t hurt at all beyond the sting of having the tape pulled off.

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