Pregnancy & Birth BirthPainkilling drugs
7. Epidural
Epidural analgesia is a local anaesthetic injected into the space between two vertebra in your back. It usually removes all pain and most feeling from the waist down.
The combined spinal epidural (CSE) injection contains a low dose of pain-relieving drugs and works more quickly than an epidural alone. At the same time, the anaesthetist will insert a catheter into your bladder. When the mini-spinal injection starts to wear off, your anaesthetist will pass the epidural solution through the tube to give ongoing pain relief.
Pros
- It gives total pain relief in 90% of cases; partial pain relief in the remainder
- Top-ups can usually be given by an experienced midwife once the epidural is in place so you don’t need to wait for an anaesthetist
- You may still be aware of your contractions, and have a clear mind, but you'll feel no pain
Cons
- Epidurals are only available in obstetrician-led maternity units
- Labour may slow down as you’ll be less able to move around
- It takes about 20 minutes to insert and set up and another 20 minutes to work once injected
- You may not feel contractions or, later on, the baby moving down so there is an increased chance of needing forceps or suction (ventouse) to help the baby out
- Having an epidural will mean increased monitoring for mum and baby
- A catheter might need to be inserted to empty the bladder (as you won’t feel when you need to wee) and have a drip to help if your blood pressure drops
- Some low-dose (mobile) epidurals now contain less anaesthetic but include a small amount of fentanyl, an opioid drug. The fentanyl makes the epidural really effective without taking away all of your mobility but the fentanyl might cross the placenta and make baby sleepy
- It’s hard to say how much of a problem this is but there have been studies showing different feeding behaviours in babies born after low-dose epidurals were used
Further information
NCT's helpline offers practical and emotional support in all areas of pregnancy and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about pregnancy and life with a new baby.
Dads who are birth partners might find our online guides for them useful.
NHS Choices guide to pain relief.
Research from the Royal College of Obstetricians and Gynaecologists (RCOG) about the use of water as pain relief in labour.
Information from NHS Choices about complementary therapies during pregnancy and before birth.
Article originally on www.nct.org.uk
Do what feels best for you
Every labour is different and each woman should choose whatever she needs to help her work with the pain of labour. Most importantly, have confidence that you can do it.
Do what feels best for you
Every labour is different and each woman should choose whatever she needs to help her work with the pain of labour. Most importantly, have confidence that you can do it.