Epidural for Pain Relief in Labour

Epidural is now the most commonly used option for pain relief in labour, especially for 1st time mothers.  It’s the strongest form of pain relief that we can offer to you.

There’s a persistent myth out there that epidurals lead to more caesareans – not true! – and also to more instrumental births, which is no longer the case with modern epidural techniques.  Read through to the end for a recap of the evidence.

Epidural Anesthesia - dr colin walsh

What does an epidural involve?

An epidural involves injecting strong pain-relief medication into your lower back.  You’ll become numb from the waist down and the pain of your contractions should ease significantly.  You won’t be able to walk around but you’ll still be wide awake.

An anaesthetist inserts the epidural.  Usually, you sit on the side of the bed and your lower back is cleaned with antiseptic solution.  Local anaesthetic is injected to numb your skin.  Once the skin is numb, a needle is inserted into a space near the spinal nerves.  Strong medication is injected and begins to take effect within 10 minutes.  A really thin, flexible tube will be left in place so your epidural can be topped up later.

The anaesthetists at The Mater and North Shore Private Hospital are all Consultants who are very experienced in placing epidurals.

What are the benefits of an epidural?

Epidural is the strongest and most effective form of pain relief available to labouring women.

Labour can be very painful.  If you are in distress because of severe pain, this can affect how the labour progresses, how you experience and remember the birth of your baby, and how you recover mentally and physically.  Adequate pain relief can make a huge difference to your birth.

There is no place in a modern birth suite for the idea that women must “tough it out” or somehow “prove” themselves by avoiding pain relief.  It’s also important not to compare yourself to other women – many factors affect pain, including the recent discovery of a genetic mutation that influences how some women feel labour!

What are the downsides to an epidural?

  • An epidural makes your legs heavy and numb, so you can’t walk around while it’s working
  • You’ll need an IV drip and fluids before and during an epidural, to prevent a sudden fall in blood pressure
  • You’ll need catheter (a thin tube) in your bladder to allow you to pass urine (because the nerves to the bladder are numbed)
  • 1-in-100 women may get a bad headache in the days after delivery
  • Serious complications are very rare – your anaesthetist will discuss these with you on the day.

Will having an epidural cause me to end up with a Caesarean or a forceps birth?

In 2018, the world-renowned Cochrane team reviewed the scientific evidence for epidural births, and the findings were very reassuring.

  • An epidural had no effect on the chance that a woman would need a Caesarean
  • In the past, epidurals were known to increase the chance of a forceps or vacuum birth.  However, when Cochrane looked at the modern studies – since 2005 – that no longer applied.  Modern epidurals (which use a different concentration of medication and give women more movement and sensation) did not increase the chance of having an instrumental birth.
  • Epidural had no effect on baby’s Apgar scores or admission to the NICU