The Truth About Epidurals During Labor: Benefits and Risks for You and Your Baby

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When you’re expecting, it feels like there’s one big decision after another: which stroller to purchase, whether or not to breastfeed, how to decorate the nursery -- and the list goes on and on.

But when the time finally comes to deliver your little bundle, many women struggle with another big decision: epidurals.

Chances are, if you’re pregnant, then someone has already asked you if you plan to have a natural childbirth, by which many people are asking whether or not you plan on getting an epidural. An epidural involves injecting a numbing agent into and around the spinal nerves in the lower back. A sterile guide needle and a small tube (like a catheter) are inserted into the epidural space of the spinal cord.

Many women choose to get an epidural as an effective form of childbirth pain relief, as it completely numbs the area above and below the point of injection, allowing them to remain fully awake during the delivery. Administered by an anesthesia specialist, it can be used for both a vaginal birth and a Cesarean delivery.

Due to all of the common myths and inconsistent information floating around out there about epidurals, many women find themselves confused and conflicted about the procedure. We consulted Dr. Steve Santi, anesthesiologist at Centennial Medical Center in Nashville, to help us get to the bottom of this sometimes-controversial medical procedure so that you’re able to make the decision that’s best for you and your baby.

What does it feel like? 
“The first sensation during insertion of an epidural is a small needle stick and mild, brief burning sensation when numbing the skin at the insertion site in the lower back,” Dr. Santi explains. "As the epidural needle is inserted the normal sensation is one of pressure or a mild ache. When the epidural catheter is inserted through the needle the patient may feel a brief tingle sensation in the buttocks or legs similar to ‘hitting your funny bone.’”

Much to the mother’s relief, once the epidural is dosed with local anesthetic she will usually notice a decrease in intensity of contractions within five to ten minutes, and the sensation in her legs may range from warm and tingling to very numb and heavy.

What are the pros of receiving an epidural?
“The most obvious benefit of an epidural is being able to experience [labor and delivery] without severe pain,” Dr. Santi says. “The indirect benefit is a decrease in the stress response to pain which can benefit both the mother and baby.” And another benefit for the baby? The exposure to medication is minimized as compared to oral or IV pain medications with epidurals.

Of course, labor is a very individual experience and some women have an excellent experience with natural childbirth, too.

Can the epidural be harmful to the mother or baby?
“In the rare event of an adverse reaction, such as a seizure, to the local anesthetic in the epidural, the baby could be affected along with the mother. The most common side effects affecting the mother are decreases in blood pressure. This is why patients are monitored closely and changes in their vital signs are treated promptly," Dr. Santi explains.

Detractors of labor epidurals will also argue that it deprives the mother of the full experience of birthing and that they slow down or prolong the labor process.

But Dr. Santi describes this effect as temporary. "While contractions may decrease initially after the epidural is dosed, the overall duration of labor is not affected."

As with any procedure, there are a few complications that can occur with an epidural: bleeding, infection, neurologic injury, or headache associated with a spinal puncture. But should you decide an epidural is right for you, know that Dr. Santi assures us though significant, these risks are extremely uncommon and far outweighed by the benefits of epidural pain relief.