There are many ways to cope with the inevitable discomfort of childbirth, and every woman’s labor and level of pain are different.
Nonmedical options include massage, hydrotherapy, breathing and mindfulness techniques, but epidurals are also an option if these do not provide adequate relief.
What is an epidural?
An epidural is the most common type of labor pain relief. It helps to ease the pain of contractions and delivery.
After mom’s anesthesia provider numbs the skin on her back with a tiny needle, a larger needle is used to place a catheter into the space next to her spine. The catheter releases pain medication into this space until the baby is delivered.
An epidural numbs only the lower part of mom’s body below the bellybutton and allows her to feel awake and alert throughout labor and delivery. Because the medication does not enter her bloodstream, the baby experiences minimal to no effects, making epidurals a safe pain-management option.
Some risks of epidural placement include a decrease in blood pressure — which is managed with fluids and medications — along with temporary back soreness and headache.
Janette McVey, MD, an anesthesiologist with MU Health Care, said patients will experience only a brief period of discomfort before the epidural kicks in.
“We generally tell patients that the initial skin numbing feels like a bee sting,” McVey said. “We do expect you to feel a little bit of soreness at the site of the epidural placement, but we don't expect that to last long-term or cause any chronic back-pain problems.”
The epidurals at Women’s and Children’s Hospital are formulated specifically to provide an adequate level of pain management during labor and delivery. The goal of an epidural is to provide analgesia — pain relief — rather than anesthesia, which results in total lack of feeling. The amount and type of medication can be adjusted and tailored to mom’s needs.
“The perfect epidural is one where a patient can tell she's having contractions but still has satisfactory pain relief,” McVey said. “We want patients to be able to push adequately with their epidurals.”
Is an epidural right for you?
No one is required to get an epidural. The choice is completely up to mom. Her health care providers — including the anesthesia care team — can help coach her through this decision and identify which pain management options are best.
For some women, the labor and delivery process may be safer with an epidural in place because of their medical history or other medical concerns. Mom’s care team will be sure to discuss these issues with her should they arise. It’s also acceptable to change pain relief methods or to use a combination during the course of labor and delivery.
“We're here to support what you feel like your birth story is going to be at this time, but we do encourage mothers to have an open mind,” McVey said. “Our ultimate goal is keeping mom and baby as safe as possible. We never want a woman to feel defeated if she requests an epidural. After all, the reward is the same: a sweet, beautiful baby.”
A woman can request an epidural at any point during her labor. Many — including those in the Low-Intervention Birth Program — will decide midway through labor to have one. But all told, patients are encouraged to request epidurals before their pain becomes unbearable so the catheter placement process can go as smoothly as possible, McVey said.
Every woman will react differently to an epidural, and the effect it has on her body can vary from pregnancy to pregnancy. If, during her first labor, the epidural didn’t work as well as she hoped, the same epidural during her second labor could result in a completely different experience.
“Communication with the anesthesia care team is key to knowing your best options,” McVey said. “Don’t be afraid to ask questions!”