Epidural During Labor: How Does It Work?

As you count down to the big day when you get to meet your baby, you may be thinking about your pain relief options for labor. One common method you might have heard about is the epidural injection. Read on to find out more about what an epidural is, how it works, and what the risks and side effects can be.

What Is an Epidural?

An epidural block is one of the most common types of pain management used during labor.

The chief benefit of an epidural is that it allows you to remain alert and awake throughout labor and delivery while eliminating most of the pain by numbing your lower abdomen and birth canal. Once you're on the epidural, you can still move and push, but you may not be able to walk. You will still be aware of your contractions.

If you think you might like to have an epidural, you should ask your healthcare provider at one of your prenatal sessions whether it is available at the hospital or birthing center where you will be giving birth. If you're working on a birth plan, you might like to include your pain relief preferences. Of course, when the time comes, it's perfectly normal to change your mind; just let your medical team know.

When Is an Epidural Given?

The epidural is often administered during active labor but can be given earlier in the process, such as when your contractions begin, or later on, such as during the second stage of labor when you push your baby out. Discuss the timing with your provider to figure out what's best for you.

Your provider may recommend you have an epidural if your vaginal birth is induced, because contractions can sometimes be more painful in this case.

Epidurals are sometimes used during cesarean sections, too. For example, you may be given an epidural during a planned vaginal delivery only to find out that you'll need to undergo a cesarean section. In this case, with the epidural catheter already in place, your anesthesiologist can administer more medication to prepare you for surgery. A quick-acting spinal block can also be given if you have an unscheduled cesarean section and you haven't been given an epidural.

Labor isn't the only time when you may be given an epidural. If you have a pelvic exam any time after week 37, and your provider determines your baby is in a breech position (not in a head-down position), she may attempt to turn your baby using a procedure called ECV, or external cephalic version. In this case, an epidural can help relax your uterus to make turning the baby easier and less uncomfortable.

How Is an Epidural Given?

A small area on your lower back called the epidural space will be cleaned and numbed using a local anesthetic. Then, you'll need to sit or lie on your side while an anesthesiologist inserts a needle into this epidural space. The anesthesiologist will then insert a catheter and remove the needle. The pain relief medication is delivered through this catheter, which remains in place during your labor and delivery. You won't need another injection once the epidural catheter is in place.

When Does an Epidural Start to Work?

It typically takes about 10 to 20 minutes for the epidural shot to start to work. Your anesthesiologist can adjust the amount of medication as you need it, meaning the pain relief can last as long as you need it to. In some hospitals, you may be able to control your own dosage by pressing a button programmed to release safe amounts of medication at your command throughout your labor.

Epidural Risks and Side Effects

Epidural blocks have a low level of risk, but it's worth being aware of some of the potential side effects:

  • Reduced blood pressure (If you have an epidural, you'll also be placed on an IV fluid drip to help prevent a drop in your blood pressure.)
  • Fever
  • Soreness at injection site
  • Back pain after the epidural
  • Difficulty urinating
  • Severe headaches
  • Dizziness
  • Rapid heartbeat
  • Labor lasting longer than it might without an epidural.

Does Getting an Epidural Hurt?

Having a needle and a catheter inserted into your lower back may sound like a painful procedure, but before you get an epidural inserted into the space outside your spinal cord, your doctor will give you a local anesthetic to block this pain.


Other Types of Pain Relief During Labor

An epidural is one of several types of regional anesthesia you may have access to during your labor. Other types include spinal blocks and combined spinal-epidural blocks. Your provider can help you decide which type might be right for you.

  • Spinal block. In this case, the epidural medication is injected as a shot directly into the spinal fluid in the spinal cord. It generally takes effect more quickly than an epidural block, but the pain relief wears off more quickly, too (usually after one to two hours), because there is no catheter in place to continuously administer the medication.
  • Combined spinal-epidural (CSE) block. As its name suggests, this method of pain relief can give you the benefits of both the spinal and epidural block. The spinal block is given first to provide fast pain relief, and the epidural catheter is inserted later to provide more long-lasting comfort throughout your labor.

There are other, non-medical types of pain relief you can try, too, and you may have learned about some of these in a childbirth class. These labor comfort measures can be used whether you've had an epidural or not. Some of these options include:

  • This is a relaxation technique that can help reduce fear, anxiety, and pain during labor.
  • Massage therapy. Your birthing partner can gently massage your lower back or shoulders, which may help relieve some of the pain of contractions.
  • Breathing exercises. Controlled breathing, such as the techniques taught in Lamaze classes, can also help you relax and decrease painful sensations during labor.


  • When is an epidural not recommended?

Your provider may advise against an epidural if you

  • have had major surgery on your lower back
  • take blood-thinning medication
  • have a blood clotting disorder.
  • How is an epidural administered?

First, a spot on your lower back will be numbed using a local anesthetic. Then, a tiny tube called a catheter is inserted into your lower back with a needle. The epidural medication flows through the tube and is absorbed by several nerves in your lower back.

  • Will I feel anything at all with an epidural?

The epidural helps to manage labor pains, but you may still be able to feel contractions. You’ll be awake and alert, but you may not be able to walk around once the epidural medication takes effect.

  • What’s the difference between an epidural block and a spinal block?

For an epidural, a tube is inserted into your lower back, just below the spinal cord, and remains there during your labor and delivery. After about 20 minutes, the pain starts to go away, and the pain relief is continuous. With a spinal block, the pain medication is administered as a shot directly into the spinal fluid; the pain relief starts sooner but may only last an hour or two.

  • How long does an epidural last?

As long as you need it to last. The anesthesiologist can top up your medication through the catheter as needed throughout the duration of your labor.

Before your baby's arrival, explore all the pain relief options available to you to find the one you feel most comfortable with. Remember that you can also change your mind once you're in labor. For some moms-to-be, an epidural is the best option, while others may also consider alternative ways to be more comfortable during labor.

Although giving birth can seem daunting and there's a lot to think about, before you know it your baby will be home and you'll be focused on what comes next. Make sure you're nice and prepared for what's ahead by having all the diapers and wipes you'll need for those first few weeks with your little one. Plus, download the Pampers Rewards app to start earning gifts and discounts now.


Preparing for childbirth

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