Epidural analgesia is an option for pain relief during labor. It involves placing a needle in the back near but not in the spinal canal. Unlike a spinal it does not pierce the spinal sac and does not go into the spinal fluid. It is placed with the patient either sitting up or lying down. Numbing medicine is used so that the procedure is not painful. It takes 5-10 minutes to place the epidural. The needle is removed and replaced with a soft plastic catheter. It is then set up to run as long as needed for labor. The epidural can be hooked up to a pump to make it a continuous epidural. The medicine is slowly infused during labor to keep the patient comfortable. The catheter is removed after the baby is delivered.
Most women are candidates for epidural analgesia during labor. Some reasons that someone may not be able to get an epidural are: previous back surgery, history of bleeding problems, women on blood thinners, or low platelets.
Some women may experience some tenderness at the site of the epidural for a few days after delivery. Epidural analgesia does not increase the risk of significant back pain or injury. Some women do get back pain from delivery of the baby but this is true in women that do not have epidurals as well.
A rare complication of an epidural is an inadvertent spinal. In this case the epidural needle goes into the spinal sac. The spinal cord is not present at the level that the epidural is placed so spinal chord injury is not a risk. A spinal headache can occur in this case and is easily treated with a spinal blood patch.
One common myth is that epidurals increase the risk of c-section; this is not true. Studies have shown that for first babies epidurals can decrease c-section rates.