Epidural block

How Is the Epidural Given?

The block or shot is given into an area over your lower back or spine.

• You may lie on your side, or you may sit up.
• Either way, you will be asked to pull your stomach inwards and hunch your back outwards.

Your doctor will wash the area of your back and inject a little medicine to numb the spot where the epidural needle is placed:

• The doctor inserts a needle into your lower back.
• The needle is placed into a small space outside your spinal cord
• A small soft tube (catheter) is placed into your back, next to your spine.
• The needle is removed.

The numbing medicine is given through the tube for as long as it is needed.

Usually, you will receive low doses because it is safer for you and the baby. Once the medicine takes effect (after 10 - 20 minutes), you should feel better. You may still feel some back or rectal pressure during contractions.

You may shiver after an epidural, but this is common. Many women shiver during labor even without an epidural.

Is an Epidural Safe?

Many studies have shown that an epidural is a safe way to manage pain during childbirth. While rare, there are some risks.

Your blood pressure may drop for a short while. This might cause the baby's heart rate to slow down.

• To avoid this, you will receive fluids through an intravenous (IV) line to help keep your blood pressure stable.
• If your blood pressure shows a drop, you also may need to lie on your side to keep the blood moving throughout your body.
• Your doctor may also give you medicine to bring up your blood pressure.

An epidural block may change or alter labor and delivery.

• If you are very numb from the block, you may have a harder time bearing down to push your baby through the birth canal.
• Contractions may lessen or slow down for a little while, but labor will still move along as it should. In some cases, it may go even faster. If your labor slows down, your doctor can give you medication to speed up your contractions. It is best to wait until you are in active labor to have the epidural placed.

Other rare side effects are:

• You may get a headache, but it is rare.
• Medicine could enter your spinal fluid. For a short while, it could make you feel dizzy, or you might have a hard time breathing. You could also have a seizure. This is also rare.

What Types of Epidurals Are There?

• "Walking" epidural block: This type of epidural will lesson your pain, but it will allow you to move your legs. Most women aren't really able to walk around, but they can move their legs.
• Combined spinal epidural block: This combines both a spinal and epidural block. It provides pain relief much faster. The combined block is used when women are in very active labor and want relief right away.

Update Date: 4/22/2012

Updated by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.