Labor Pain Medication at a Glance

Regional Blocks: Epidural

What it does: An epidural numbs sensation from the waist down -- how much depends on the drug and dosage used. It eases the pain of uterine contractions and pain in the vagina as the baby is being delivered. You'll be awake and alert. During a long labor it can prevent you from becoming exhausted or distressed.

When it's used: An epidural can be given in active labor, in the second stage of labor, and before a cesarean birth. An epidural is administered after 4-6 cm cervix dilation.

How it's given: An epidural is administered either as a single injection or a continuous flow. You'll be asked to sit or lie on your side for about 10 minutes while it's injected into a small space around your spinal cord in your lower back. You'll respond to the drug in about 10-20 minutes.

Pros:

  • You'll feel pressure, but not pain.
  • A low concentration of the drugs is used, which reduces side effects.

Cons:

  • Your legs will feel heavy, and you may have trouble moving or urinating.
  • You may lose the urge to push, which can slow down labor or increase the use of interventions such as IVs, fetal monitors, and forceps delivery.
  • Your blood pressure may drop, which may slow the baby's heart rate.
  • If the needle punctures the membranes around the spinal cord, you may develop a headache. More rarely, it can cause nerve injury or infection.
  • You may get only spotty pain relief.

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