An epidural is a method of pain relief for your labour that is performed by an Anaesthetist. It involves placing a very small plastic tube into your lower back, which allows low-dose local anaesthetic and pain killers to block the pain nerves so you don’t feel the pain of your contractions.

You will still be able to move your legs. It doesn’t harm your baby and works very well for 95% of mothers. It is the most effective form of pain relief in labour. With an epidural, you will be able to sleep through your contractions if you want to.

• You will be reviewed by an Anaesthetist who will talk to you about your health and medical history, then explain the epidural procedure to you.
• A drip will be placed in your hand or arm before the epidural; this allows fluids and medications to be given if required.
• You will be asked to sit with your lower back as curved as possible and it will be cleaned with a cold antiseptic solution. Your Anaesthetist will inject a very small amount of local anaesthetic into the skin, which numbs the area before placing the epidural. This is not a painful procedure.
• It is important that you stay as still as possible during the procedure, so let the anaesthetist know when you are having a contraction. The epidural will then be taped to your back and you will hardly notice.

• It is the “gold standard” for relief of labour pain, especially backache and contraction pain.
• Epidural medication does not make you sleepy, so you can be awake and participate in your baby’s birth.
• Fewer drugs are needed than other forms of pain relief and they are less likely to cross the placenta and thus will not affect your baby.
• Stronger medication can be given via the epidural should you require an emergency caesarean section.

• Your legs may feel heavier than usual which makes it more difficult to walk to the bathroom. You may need to use a bedpan or your midwife may place a catheter to empty your bladder.
• Occasionally, an epidural may temporarily make your blood pressure decrease. (1 in 50 women). This is easy to detect and treat and it is why you will have a monitor and a drip as long as the epidural is in place.
• You may develop a headache 48-72 hours after you have given birth, but this is treatable. (1 in 100 women)
• You may have tenderness in the area where the epidural was placed for a day or two but epidurals do not cause long term back pain.
  
  Your Anaesthetist will discuss your specific risk of very rare complications and side effects before placing the epidural.

Some medicines given to you during labour can cross the placenta however those used in your epidural that cross the placenta have little to no effect on babies.

If there is a large decrease in your blood pressure, it may cause the baby’s heart rate to decrease. This can be quickly treated by asking you to lie on your side, or by giving fluids/medication through your drip.

As long as your epidural is working well, it can usually be topped up with stronger medication which will make your abdomen and legs heavy, and very numb. This avoids a general anaesthetic and you will be awake for the birth of your baby.

Most mothers can safely have an epidural during labour, but there are some medical conditions that may require additional tests before an epidural can be performed. You can talk to your Obstetrician to make your appointment with an Anaesthetist before you are in labour, as it may be difficult to have this important discussion between contractions.

If you have met with an Anaesthetist during your pregnancy, it does not mean that you have to have an epidural during your labour, but it does ensure that this pain relief option is available to you.

Remember this information is only a guide. There are other options for pain relief, and understanding the choices is an important part of getting ready for the birth of your baby. More information is available from your midwife, group antenatal education classes and your Anaesthetist.