Pregnancy guide > Labour and birth > Pain relief > Pain relief in labour: Epidural

Pain relief in labour: Epidural

Useful information, including the advantages and disadvntages of the epidural as one method of pain relief during labour.
An epidural is an injection of a mixture of drugs into the space just before the spinal nerves. In labour the epidural is placed so that the nerves which carry messages from your womb, your lower back, pelvis and perineum are bathed in a combination of local anaesthetic and pain relieving drugs.

Epidural and spinal anaesthetics, which are similar, are the only available methods of pain relief used in labour that can potentially relieve all your pain.

In order to have an epidural you need the services of an anaesthetist. Most large hospital units have an anaesthetist on call 24 hours a day, but this will vary in smaller units.

The anaesthetist will first explain the procedure to you and make sure you understand it. He will then site a canula, this is a small, hollow, flexible tube placed in the back of your hand or lower arm to allow a drip to be started if it is needed. You will then be asked to either lie on your side or sit up and curve your back out. The anaesthetist will place some local anaesthetic in the skin and muscle of your back. He will then put a needle in your back to find the epidural space. A fine, flexible tube is pushed through this needle, which is then removed. The drugs are given through the tube, which is known as a catheter.

The epidural is usually working within 10 to 20 minutes. It remains in place until after you have delivered your baby.

A measured amount of drugs may be given each hour or your epidural may be topped up using a syringe. In some places you are able to control the amount of pain relief you receive yourself by pressing a button.

Occasionally epidurals do not give good pain relief, if this happens to you your epidural may need to be repositioned, a different combination of drugs used or possibly replaced.

Advantages of epidurals
  • Epidurals nearly always give good pain relief
  • Because the drugs used are injected into your back, very little goes through to your baby.
  • An epidural can help to control your blood pressure if it is a little high while you are in labour. (if you have very high blood pressure and your blood clotting is affected then it may not be safe for you o have an epidural, but this is rare).
Disadvantages of epidurals
  • Your blood pressure may drop, which can make you feel sick and dizzy. If this happens you will be asked to turn onto your side, you may be given fluid through a drip and might possibly need an injection to bring your blood pressure up again.
  • Your labour may slow down. You are three times more likely to read a drip to speed things up.
  • Your mobility is likely to be limited this will vary so it is a good idea to ask your anaesthetist what to expect.
  • You may not be able to pass urine. If this happens a small tube (catheter) will be used to empty your bladder.
  • You may feel itchy, sometimes the combination of drugs used can be altered to help relieve this.
  • You may feel itchy, sometimes the combinations of drugs used can be altered to help relieve this.
  • A small number of women develop a severe headache following an epidural, usually this can be treated effectively fairly quickly, but it can sometimes last for a number of weeks.
  • You may develop a high temperature which could lead to an abnormally fast heart rate in your baby. This may lead to you and/or your baby being treated with antibiotics and screened for infection.
  • There is an increased risk of your baby being delivered by forceps or ventuse.
Some of the disadvantages of having an epidural are less likely to be a problem if the epidural is not commenced in early labour. It is a good idea to try out some coping strategies first and see how you get on.

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Anyone know how many cm dilated you can get too before they say it's too late for an epidural?
by pots 17th May 2011, 5:31pm
I am currently pregnant and due in 8 weeks time I have my midwife today and im going to see about having an epidural as a lot of people say its the best pain relief to have and i don't c why woman should go through the pain if they don't have to..a close friend of mine have 2 epidurals with her children and she said its the best thing she has ever done it makes ur labour more enjoyable knowing your not in pain and hse has had no side effects either I am nervous about getting it but more nervous about going into labour as its my 1st baby..
by debbiexkaci 17th Dec 2010, 4:32pm
I delivered my baby girl one and half year before, at that time i was injected by midwife on my request for pain relief, but after get injected i feel more pain than before.I don't know weathar she gave me epidural or something else,because the procedure for epidural was not the same she just inject me. MY question is, is there any thing else except epidural for labour pain relief or not?and still i have backach n viginal discharge, that made me so irritative n tired . please hlp me to sought out this phisical problem.THANKS
by tayyab 4th Oct 2010, 1:08pm
I would definately NOT recommend the epidural, my son is 8months old and since having the epidural i have suffered from back pain! I had a horrible time in labour and opted for the epidural, they gave it to me and i had a bad spasm down my back, he had actually gone to far and caused a dural tare! This then caused me to have a bad headache and i was laid up on my back in hospital and couldnt move! i had trouble breast feeding at the beginning because of this and couldnt even change or cuddle my son! after having the epidural it took 12 hours untill my son was delivered ( 37 hour labour altogether ) because it had slowed everything down and i couldnt push him out so he was forcep delivered. Also after i got a raging temperature and was very poorly! Please try everything else first, i just dont want anyone else to have the experience i had...I now suffer from panic attacts and cant leave the house on my own due to the complete lack of care i received during labour and the traumatic time that i went through! And also receive physio for my bad back!
by Kaysha 14th May 2010, 4:59pm
During my First Labor with my son I was going to go all natural. I was induced so everything was scheduled for me. I Arrived at the hospital at 7 in the morning and they started the medications to make me go into labor. I sat and watched T.V. no medications at all. About 4:30 PM I asked my nurse for mydol for the cramping she told me that she would give me tylenol. About one our later small tears started rolling down my face. My mom asked me are you in that much pain I just nodded my head. She said if you want medication you can have it I just know that natural is best. The gave me something in my IV drip that immediatly caused me to vomit. So they asked if I wanted an epidural. I said yes. So the brought in the people to do the epidural and the quickly placed the epidural. The hardest part is when they tell you don't move during a contraction. My husband just watched and finally had to leave before he passed out. Once the epidural was placed immediate relief. WOW. A few hours later the broke my water then had to replace the water and put me on my hands and knees while I had a epidural. That was not fun. They did this because my son was smashing his umbilical cord. Later in the night around 10 PM or so I fell asleep which was nice then around 1:00 am I woke up ready to push. This was the worst part of my whole experience because I had severe cotton mouth they did not allow me anything to drink only ice so during the entire pushong part is was I would ask for ice, then push, then vomit, ice, push vomit, ice, push, vomit. 2 and a half hours later the had to use forcepts to get my stubborn son out because he apperently had superglue all over his body because he had only move a inch. Then the stubborn boy when the forced him out he refused to breathe until they almost pronounced him. Then he just opened his eyes and looked around and did not cry at all. I did not scream once, and when it was all finished everyone congraduated me but all I could say was Well Thank you for helping me ;).

Now 8 weeks Pregnant with number two and would most defiantly recomend a epidurial because despite everything else it removes all pain.
by sumaiyya 14th May 2010, 4:26pm
im 21weeks pregnant and i have scoliosis (curved spine). I was just wondering if anyone knows if i will be able to have the epdiural ??
by helsmith1 14th May 2010, 3:54pm
i dont handle pain very well so have been thinking about having the epidural but ive heard good things about it & bad things too so i really dont know what to do. any comments?
by collette30 14th May 2010, 3:51pm
My baby is now 4 months old.I am now almost recovered back from all pains. I want to share that i had a very terrible experience of having epidural. I just escaped death. My delivery was going very smooth and handled by a midwife. I was given an epidural on my request. At the time when baby was about to come out midwife asked to push which obviously i couldn't as my body was numb but i still tried until got exhausted, then midwife had to call the doctors who then did forcep delivery, they had to give me so many stitches ( i am not told the no of stitches) as soon as baby was delivered, i got fainted, they could not stop the bleeding, my blood pressure was almost gone, i could hear the emergency noise, they took me to operation theatre and treated me for few hours , i was given 6 units of blood. and for next 7 days i could not walk properly, used catheter for urine. it was very horrible experience. I think one should consult doctor about the pushing techniques before going for epidural
by Meriam 8th Feb 2010, 9:26am
i had an epidural with my first child 10 weeks ago. despite complications in my labour i really would recommend an epidural to anyone debating the methods of pain relief during childbirth. i started with gas and air when i got to the hospital, i point blank refused at first -i didn't want anything that would take me out of control or cloud up what was happening, but as you might know, the hell of contractions quickly changes your mind for you. after horror stories from friends and family, the last thing i wanted was pethidine or diamorphine.
it took a doctor and then a consultant 5 attempts to get the epidural in right, at this point the gas and air wasnt leaving my mouth... but as soon as the epidural was done it was instant relief. i just felt so relaxed and back in control.
the labour progressed slower than the midwife would have liked to i was then put onto a syntocin drip to induce me and speed things up. within 5 minutes and the drip at '1 unit' the midwive pulled the emergency button and a team of doctors rushed in. the baby's heartrate had quickly dropped and they turned me on either side, stabilised the baby and prepped my for an emergency c-section as a precaution.
it was a big shock, but luckily it was over as quickly as it started and the syntocin was up to '10 units' by the time i was ready to push.
i presonally didnt find it difficult to push although there was very little feeling below my waist. the midwife explained that i should bear down as if i was trying to go to the loo, and my husband was looking at the monitor, telling me when the contractions were coming and when to push.
i really don't think that the epidural prolonged that stage of the labour as i only pushed for 30 minutes and the baby was born at a healthy 7lb 8oz with no problems at all despite all the previous drama!

the best and most suprising thing for me is that i didn't tear at all nor did they have to cut me, which i know is more likely with first time mothers. i really honestly put this down to having an epidural. because i couldnt feel the contractions at all i wasnt tensing up or fighting against them. i would recommend an epidural to everyone! in my experience it was a god send and the best thing for me as i really wanted to stay aware, and still know what was actually happening instead of throwing up and being totally spaced out!
by sarahynes 17th Nov 2009, 2:43pm
Gas & air did nothing for me I personally wouldn't recommend it! but everyone is different!
When I got the pethadine jag it really helped me alot but when is weared off i couldn't get another...
so i asked for an epidural and that did it for mee! i was so realivddd because I was contracting for 2days nd i was was in labour for 6 hours!! I RECOMMEND EPIDURAL!
BUT AFTA HVIN A C SECTION. I WAS A SIZE 14 FOR ABOUT 6DAYS ( before i was prgnant i was a size 8) then i went down to a size 10! which i'm happy about because i'm naturaly skinny and i've always wanted to put on weight. but luckly for me i have a flat stomach afta 2weeks frm givin birth.

anyway i do recommend pethadine jag and EPIDURAL!! gas and air did nothing for me.!!!

by callies 19th Oct 2009, 9:58am
i had codine gas n air n a epidural at jessops hospital in sheffield i had a man with disabilities who looked very nervous around me wen i was in labour shouuting for my epidural i think it must of been my southern accent or summit that made him even more nervous but i tell ya what epidural yeah is fantastic if it worked long enough and if u didnt hav to endure threee attempts to get it in i have never felt pain like it the man was hitting the needle against my spine and i was screaming that much in agony that a irish lady had to come and do it wish i had her 1st off because now my baby is 4 half months old im still in that much pain were my spine was that bruised i hav attended my doctors who is thinkin bout refering me for pyhisio if it dont improve and as i write this im in agony so yeah gals it can be fantastic but ther are risks which u take but i can still smile threw the pain and look at my daughter taiya and say but it was bloody worth it xxx
by taiyatai 4th Aug 2009, 12:35pm
i had codine , gas and air and pethadine i was violently sick through the whole labour i had the epidural aswell as i thought gas and air was makin me sick and the pethadine i never felt any releif , the epidral was fantastic i never felt a thing they kept topping it up for me , i never felt the contractions , my labor turned a bit nasty tho , i was not gettin contractions and baby was already there with her head showiing , she was there 5 hours before they acted , they had to cut me , and use ventuse suction to deliver my baby , i also had a high tempretre and they wold not let me ot of hospital for 2 days , they never even told me this all may of happened from epidral , i jst read it now on here , but id have epidral again , the screams i heard from women on the delivery ward was horrifiying and mine was pain free , even tho i ended up having sticthes and was not able to move for a day because of my legs so numb , but i tell ya the pain the women sounded like they was in was out of this world
by EMM4SCARLETT 29th Jun 2009, 9:56am
i had an epidural with my 1st son after having gas & air which made me so sick, then also had a jag of pethidine which made me feel sick, dizzy and also to hallulicate a tiny bit. i had all this until the anathestic was free for an emergency birth, when i finally had my epidural my son was born within about 3 hrs. i was in labour for a total of 16 hrs with him.
my 2nd son on his arrival i opted for gas & air which again made me feel very very sick, i then had an epidural which didnt work so was offered another one or a spinal block. i opted for the spinal block and my 2nd son was born 45 mins later. my labour was 6 hrs with son number 2.
i am currently 10 weeks pregnant with baby number 3 and an not either going to consider another epidural am just going to try and manage on pethidine again. i think having epidural's slows ur labour down and also the effects of it make baby very drowsy and slower to feed. with such a bad experience of epidurals with son num 2 i am very tempted not to try again with baby num 3 when time arrives. xx
by kellyf 8th Jun 2009, 9:22am
i had an epidural with my first child and my labour only lasted 6 hrs from start to finish.I got the pethadine jag which made me very sick and the gas and air was disgusting. After the epidural kicked in my baby was delivered after 12 pushes with no stitches or help. I went back up to ward 2hrs later and was having a bath and walking about waiting on my visitors. I am now expecting my 2nd and will have another epidural which i recommend as i believe no women should go through this unnecesary pain xxxx
by parywary 17th Apr 2009, 9:22am
Mine is a warning on the permanent side effects of epidurals! Went into labour before my scheduled C-section and whilst having contractions 'anaesthetist' attempted to insert epidural 3 times - each time my right leg had a spasm (obviously he was hitting a nerve) - he had the cheek to tell me to keep still! Ever since then I cannot lie on my right side for more than a few seconds before I get a 'dead leg' with 'pins and needles' sensastion. Now I have started suffering from 'sciatic' problems and this has been going on for 6 years.
by suzy69 16th Mar 2009, 9:16am
with my first baby i had epidural i found it to be very effective i didnt have any side effects tho i did need help with pushing
by bernie83 27th Oct 2008, 8:57am
i had an epidural with both my children with no complications at all. they were both fit and healthy. i will again with my 3rd baby have an epidural and i can say that for me its really helpful form of pain relief. it doesn't cost anything either unlike the TENS machine.
by babynumber3 19th Aug 2008, 8:38am
I was thinking to go for epidural on delivery,i was wondering,does it cost anything?cos tense mashine costs £25!
by sienaazis2003 15th Aug 2008, 2:50pm
My concerns of the epidural is that the're far greater disadvantages than advantages.It mendsions that it may harm the baby which is properbly not the best way to have pain relife.
by langtree93 27th May 2008, 8:35am