When it comes to managing labor pain, an epidural is one of the most well-known and widely used options. If you’re considering one or just curious about how it works, you’re in the right place!
Epidurals can make a huge difference in your comfort level during childbirth, but there’s a lot of mystery and even some myths surrounding them. Let’s break it all down in a friendly, easy-to-understand way, so you can make the best decision for your birth experience.
What Is an Epidural?
An epidural is a regional anesthesia that numbs pain from the waist down while allowing you to stay awake and alert during labor and delivery. It’s designed to block pain signals from reaching your brain while still allowing you to feel some pressure and movement.
It’s administered by a trained anesthesia team, which may include a Certified Registered Nurse Anesthetist (CRNA), an anesthesiology resident, and an attending anesthesiologist, all working together to ensure both safety and comfort for you and your baby.
How Is an Epidural Given?
Getting an epidural might sound intimidating, but the procedure is actually quick and straightforward. Here’s what to expect:
1️⃣ Positioning: You’ll either sit up and lean forward or lie on your side in a curled-up position to allow the provider access to your lower back.
2️⃣ Cleaning and Numbing: The area on your lower back will be cleaned, and a small numbing injection (like what you’d get at the dentist) is given to minimize discomfort.
3️⃣ Epidural Catheter Placement: A thin, flexible tube (catheter) is inserted into the epidural space of your spine. You may feel a little pressure, but it’s usually not painful.
4️⃣ Pain Relief Begins: Medication is delivered through the catheter, and within 10-20 minutes, you’ll start to feel relief. The catheter stays in place, allowing for continuous pain relief throughout labor.
Who Administers the Epidural?
In most hospitals, your epidural will be managed by an anesthesia care team, which includes:
- A Certified Registered Nurse Anesthetist (CRNA): A highly trained advanced practice nurse specializing in anesthesia, including labor pain management. CRNAs are skilled in placing epidurals, monitoring your pain relief, and making necessary adjustments during labor.
- An Anesthesiology Resident: If you’re delivering at a teaching hospital, a resident (a doctor in training under supervision) may administer your epidural under the guidance of an attending anesthesiologist.
- An Attending Anesthesiologist: A fully trained doctor specializing in anesthesia who oversees the entire process, working with both the CRNA and resident to ensure your safety and comfort.
Your attending anesthesiologist plays a crucial role in making sure everything is done correctly. They provide oversight and expertise, ensuring that the CRNA or resident administering the epidural follows best practices. This team-based approach helps ensure safe, effective pain relief throughout labor.
What Does an Epidural Feel Like?
Once the epidural kicks in, most women describe feeling:
✔️ A warm, tingly sensation in the lower body.
✔️ A gradual loss of pain, but still some awareness of contractions and pressure.
✔️ Heavy or numb legs, depending on the dose.
You won’t be completely paralyzed—just comfortably numb from the belly down!
Can You Walk With an Epidural? Why Some Hospitals Allow It and Others Don’t
Whether or not you can walk with an epidural depends on the type of epidural given and the hospital’s policies.
- Some hospitals offer a “walking epidural”, which is a low-dose epidural that provides pain relief while preserving some movement in your legs. This means you may be able to stand, shift positions, or even walk with assistance.
- Other hospitals require you to stay in bed after an epidural, even if you receive a lower dose. This is due to safety protocols, staffing availability, or concerns about fall risks.
Why the difference?
- Hospital Policies & Staffing: Some hospitals require continuous fetal monitoring and won’t allow ambulation after an epidural. Additionally, walking epidurals may require more hands-on nursing support, which not all hospitals can provide.
- Type of Medication Used: The specific combination of anesthetic and narcotic used in an epidural affects how much movement you retain. Some mixtures allow for partial leg control, while others cause more numbness.
- Fall Risk Concerns: Even with a low-dose epidural, you may still feel weak or unsteady, which increases the risk of falls. Some hospitals choose to be extra cautious and limit mobility.
If walking with an epidural is important to you, ask your provider ahead of time whether it’s an option at your hospital.
When Can You Get an Epidural?
You can typically get an epidural once you’re in active labor, which is usually around 6 cm dilated. However, the timing is flexible. Some hospitals allow them earlier, while others may encourage you to wait until labor is well-established.
There’s also no “cutoff” for getting an epidural—many women even get one during the pushing stage if labor has been long and exhausting.
Does an Epidural Affect the Baby?
Epidurals are considered very safe for both mom and baby. The medication stays localized to the spine and only a tiny amount reaches the baby. Some babies may be slightly sleepy after birth, but this is usually temporary and has no long-term effects.
What Are the Benefits of an Epidural?
🌿 Significant Pain Relief: Makes contractions more manageable and allows you to rest during long labors.
🌿 Can Help You Stay Calm: Reduces stress and tension, which can help labor progress more smoothly.
🌿 Allows You to Stay Present: You’re awake, alert, and able to focus on the experience rather than the pain.
🌿 Can Be Adjusted: The anesthesia team can tweak the dosage if needed, ensuring the right level of comfort.
Are There Any Downsides to an Epidural?
Like any medical procedure, epidurals aren’t for everyone and do come with potential side effects, including:
🔸 Lower Blood Pressure: Your provider will monitor you closely to ensure baby gets enough oxygen.
🔸 Limited Movement: You’ll likely need assistance changing positions in bed.
🔸 Longer Pushing Stage: Since you don’t feel contractions as intensely, it may take a little longer to push.
🔸 Spinal Headache (Rare): A very small percentage of women experience a post-epidural headache that can be treated with medical intervention.
Despite these possible side effects, epidurals remain one of the safest and most effective options for pain relief during childbirth.
Trusting Your Birth Team
If you choose to get an epidural, you can feel confident knowing that a skilled anesthesia team—including CRNAs, anesthesiology residents, and attending anesthesiologists—will be there to ensure your safety and comfort. They monitor you closely throughout labor, adjusting the medication as needed to keep you comfortable but still involved in your birth experience.
The Takeaway
Epidurals are an amazing tool for managing labor pain, allowing you to stay calm, comfortable, and focused on bringing your baby into the world. Whether you choose one or not, understanding how it works helps you feel more prepared and in control of your birth experience.
Remember, there’s no right or wrong way to give birth—only the way that’s best for you. Whatever you choose, you’ve got this!
