Today, more than 60% of people giving birth in the US have either an epidural or a spinal block during labor.  A small needle goes into your epidural space in your spine, and over on top of that needle is a small catheter that’s a small plastic tube.  Drugs given through that small plastic tube or catheter can help with pain during labor.  The drugs used in an epidural are opioids combined with local anesthetics:

After the plastic tube is inserted in your back, the needle is removed and the thin plastic tube remains in your epidural space. An epidural takes about 10 minutes to set up and takes about 10 to 15 minutes to start working. It doesn’t always work well at first, and sometimes your medications may need to be adjusted so that you get the pain relief during labor you’re looking for.

Informed Choice About Interventions

SEE MY POST -You Have No Options if You Don’t Ask Questions

Talk about common labor interventions with your care provider well before labor. Make sure you understand how often and for what reasons they are likely to use them. If your provider tends to use an intervention, your risk of having that intervention is greatly increased. Knowing this information beforehand can help you choose a caregiver who will help you have a safe and healthy birth.

Benefits of Regional Anesthesia: Epidural, Spinal, or Combination Spinal-Epidural*

  • Effective pain relief
  • Less likely to need additional pain relief
  • Commonly Available
  • Can be used throughout labor
  • Pitocin can be used in conjunction with anesthesia to speed up contractions when they slow
  • Fewer side effects for mothers and babies compared to injected or IV opioids
  • Serious complications are rare

Maternal RisksFetus/ Newborn Risks
Longer 2nd stage & greater risk of needing forceps or vacuum extraction to help pull baby out.Bruising caused by forceps or vacuum extraction
Hypotension, motor-block (inability to move lower body)Low oxygen if maternal hypotension (low blood pressure)
Fever is common - mothers and babies will possibly be treated for infection even though a fever is just a side effect of an epiduralAbnormal fetal heart rate which may lead to unplanned Cesarean)
Pitocin needed because medication can make contractions slow, stop, or less effective.Respiratory depression
Unplanned Cesarean for fetal distress caused by pain medication and/or pitocinLow apgar score which measures muscle tone, pulse, reflex irritability, skin color, respiration.
Itchy skin, nausea, urinary retention (thus the need for urinary catheter to keep bladder empty)Difficulty breastfeeding with high doses of Fentanyl more than 150mcg.
Negative neurological effects
Spinal headache
Respiratory depression, drowsiness, skin infection, sore back, tingling or numbness in back that lasts weeks.

The most common side effects of an epidural are listed in the illustration, below.