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Should epidural anesthesia be used during labor?

, medical expert
Last reviewed: 04.07.2025
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In order to cope with the pain during childbirth, you need to control it mentally and physically. Prepare in advance: ask someone to support you during childbirth, master the breathing technique of pain control, learn everything about painkillers and anesthesia that are used during childbirth.

Pain during labor is unpredictable: often a woman can easily cope on her own, but sometimes the pain becomes severe and unbearable. Pain that is difficult to control leads to muscle tone and prolongs labor. Although pain relief can speed up labor, complete numbness slows down the process. It is important to find a middle ground so that the woman can move and change positions during labor, as well as push when necessary. Even if you want to give birth without painkillers, you should still think about their possible use.

  • Epidural anesthesia is considered the most effective and easily administered method of pain relief during labor.
  • A small dose of epidural anesthesia does not completely numb the area below the waist and allows you to move and push during contractions.
  • A low dose of epidural anesthesia reduces the risk of labor termination when forceps, vacuum extraction, or cesarean section are required.
  • The drugs administered during epidural anesthesia do not harm the baby. However, in parallel with this anesthesia, the fetal heart rate is monitored to determine the baby's condition during labor.

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What is epidural anesthesia?

Epidural anesthesia is the most effective and easily controlled method of pain relief during labor.

It is used either to partially numb the lower body, allowing the woman to feel contractions in order to push, or to completely block all sensations during a cesarean section. At a low dose, the woman is able to move around, which makes her feel more comfortable. Epidural anesthesia is administered through a special epidural catheter in the spinal cord, from where the drug is distributed to all the spinal nerve endings of the lower body. However, the woman is conscious, since the drug does not affect the brain and central nervous system.

Epidural anesthesia does not enter the bloodstream, so it does not harm the baby. In comparison, drugs that are administered intravenously or intramuscularly enter the fetus's bloodstream within an hour through the placenta. If the baby is born before the drug wears off, side effects may occur, such as difficulty breathing and intoxication. A combination of spinal and epidural anesthesia is more suitable for childbirth. A special catheter is inserted into the space between the dura mater of the spinal cord and the vertebrae (the epidural space) through a needle used to perform the puncture, and a local anesthetic is injected through it.

Benefits of Epidural Pain Relief

  • An epidural can be given quickly and continuously during labor and delivery.
  • In some maternity hospitals, the mother herself can control the amount of painkiller by simply pressing the pump button.
  • Epidural anesthesia does not affect the central nervous system, so both the woman and her baby are conscious.
  • If an emergency cesarean section is needed, the effect of epidural anesthesia will be immediate, and the woman will immediately lose sensation in the part of the body below the chest.

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Risk factors and disadvantages of epidural anesthesia

When using an epidural, a woman is unable to move around or shower, so before using it, the following should be discussed with a doctor:

  • ask to use a small dose of the drug to walk or at least stand, and this is important for the woman's comfort.
  • Ask if you will be able to walk during fetal monitoring.

Epidural anesthesia with a regular pain reliever increases the risk of:

  • prolonged labor (usually when using epidural anesthesia, a woman gives birth for an hour longer);
  • a decrease in blood pressure (hypotension), which can lead to a slowdown in the fetus's heart rate (this is why the woman is given intravenous fluids in advance and is advised to lie on her side, which promotes blood circulation);
  • loss of sensation in the lower body and the inability to push during contractions (then there is a need for vacuum extraction, forceps to extract the fetus, or a cesarean section);
  • movement of the fetus into an abnormal position (due to weakness of the uterine and abdominal muscles), this increases the risk of vacuum extraction or the use of forceps to extract the fetus; some experts believe that it is the abnormal position of the fetus that provokes pain, and the woman is forced to ask for the use of epidural anesthesia;
  • seizures as a reaction to a medication (happens very rarely).

Consequences of epidural anesthesia

  • During the recovery period, there may be some soreness in the area of the back where the catheter was inserted, but this is uncommon. Some women worry that epidurals cause chronic back pain, but this has not been proven.
  • Severe, prolonged headache after childbirth when the spinal cord is accidentally injured during the procedure (this happens in 3% of cases). 70% of women experience headache after childbirth.

Spinal anesthesia carries the same degree of risk as epidural anesthesia.

Before labor, learn all possible pain control methods. Labor pain is unpredictable, so it is important to have several alternative methods in reserve.

  • In addition to medical painkillers, you can use special breathing exercises, change your position, do massages and distract yourself with more pleasant topics.
  • Conventional light epidural anesthesia can be combined with spinal anesthesia.
  • An injection of opium provides short-term relief and reduces the pain of contractions.

Pudendal block relieves pain for an hour or a little more and is considered the safest anesthesia during childbirth.

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