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Are you having back pain with any of the following?
- Severe pain, weakness or tingling in your leg(s).
- Difficulty stopping urination or loss of control of bladder or bowels.
- Unexplained fever, nausea or vomiting.
- A history of cancer or unexplained weight loss.
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Epidural for Labor [Read/Print full article]
Overview
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Epidural anesthetic involves the injection of medication into the epidural space, the area surrounding the nerves of the spine. The spinal nerves transmit physical sensations to the brain, and the anesthetic temporarily blocks these nerve signals, thereby preventing pain.
If you are thinking about your anesthesia options during childbirth, it may be helpful to know that more than half of women giving birth in hospitals request and receive epidural anesthetic. Even if you receive an epidural during labor, you can continue to push and actively participate in giving birth.
Epidural anesthetic carries some risks, including a sudden drop in blood pressure and an "epidural headache." However, it is generally extremely safe. People with certain conditions – such as blood infections, low platelet counts, or bleeding disorders – cannot be given epidural anesthetic for safety reasons.
Types
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There are 2 basic types of epidural anesthetic for pain management during labor and delivery:
A regular epidural lessens pain and causes some numbness from the waist to toes.
A walking epidural is a lighter anesthetic option that is given less frequently. This reduces sensation and pain from the pelvic region, but the laboring mother can feel more of her contraction and has more strength in her legs than with the regular epidural. Ironically, it is important to understand that in most hospitals mothers laboring with the lighter epidural are not allowed to walk due to the risk of falling.
Some physicians and midwives believe that the lighter epidural will allow more control and mobility, which may help to shorten labor or avoid the need for a cesarean birth, or C-section.
Choosing an epidural does not increase your chances of having a C-section.
What You Can Expect
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To begin the process, we will place an intravenous (IV) line in your arm. The IV will deliver fluids to keep you hydrated throughout the procedure. Next, an antiseptic solution will be applied to your lower back to protect you against infection, and a local anesthetic will be injected into this area to prevent pain as we administer the epidural anesthetic. The local anesthetic injected does however, sting briefly when it's injected in your skin.
The epidural catheter itself will be inserted into your lower back after the insertion area has become numb from the local anesthetic. You will probably feel a pressure-type sensation. In some cases, you may feel a tingling or warming sensation as the medication is discharged into the epidural space.
In most cases, as the epidural needle is removed, a very thin flexible tube called a catheter will be threaded through the needle into the epidural space. This catheter remains in place after the needle is removed, so that more injections of anesthetic medication can be administered as needed throughout the procedure. Because you will not be able to control your bladder while under the effect of the anesthetic, a bladder catheter may be placed to drain urine.
If you receive an epidural during labor, you will probably still be able to feel your contractions, but with minimal or no pain. Although the epidural anesthetic usually does not cause your labor to slow down and make your contractions less forceful, you may be given the medication pitocin to cause your contractions to return to the force that the had before the epidural was placed.
Throughout the procedure, we will carefully monitor your heart rate, blood pressure, blood oxygen level, and other vital signs. If you are in labor, you will also be attached to an electronic fetal monitoring (EFM) device to monitor your baby's heart rate.
Women in labor are generally able to move around in their hospital bed while under the effect of epidural analgesia.
Risks
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Epidural anesthesia is very safe, but no procedure is without risks. If the epidural anesthetic does not relieve pain, we may either try another epidural or move the injection to a different location, which happens in about 1 out of 10 cases.
One common side effect is a headache (less than 1 percent of the time), which can last up to 3 weeks. The headache can be treated with pain relievers.
If the headache persists, we may recommend a procedure known as an epidural blood patch. This procedure uses a small amount of your own blood to close up a possible leak of spinal fluid. We will also ask you to drink caffeine and may recommend appropriate pain relievers.
Blood pressure may drop sharply as a result of epidural anesthetic, but because we continually monitor your blood pressure, we can treat this condition immediately with IV medications and fluids. Other possible side effects include:
- Nausea and vomiting
- Shivering
- Temporary bladder dysfunction
- Infection
- Nerve damage
- Bleeding
- Increased body temperature of the mother and baby
- Difficulty breastfeeding
Women who have an epidural anesthetic during labor have a slightly greater risk that a vacuum will be used to assist the delivery. The use of a vacuum is common in all deliveries, including deliveries in women who do not have epidural anesthesia. The use of epidural anesthesia does not increase the risk of C-section.
After Your Delivery
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If you have a normal vaginal delivery, you usually will stay in your labor and delivery room, and later will be moved to a family care room. After a C-section, you will be taken to a recovery room for at least an hour, then moved to a family care unit room.
As the anesthetic wears off, you may feel a tingling in your legs and you may feel a little weak. If you have just given birth, you may also experience a burning sensation around the birth canal. After the epidural anesthetic wears off, you will be encouraged to walk and move about.
Related Health Tools:
Podcasts
- Healthy Pregnancy and Successful Childbirth Healthy Pregnancy and Successful Childbirth
Prepare for Your Procedure
- Childbirth (Emmi) Childbirth (Emmi)
- Pain Relief for Childbirth (Emmi) Pain Relief for Childbirth (Emmi)
- Vaginal Birth After C-Section (VBAC) (Emmi) Vaginal Birth After C-Section (VBAC) (Emmi)
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.