Spinal and Epidural Pain Relief for Childbirth

How They Are Done

You may need to sit up and curl your body forward to round your lower back. Or you'll lie on your side and curl your knees up to your chest. First you'll get a shot to numb the skin on your back. Then the doctor or nurse will put a needle into the numbed area.

For a spinal, you'll probably get a shot of numbing medicine near your spinal cord. For an epidural, usually a thin tube (catheter) is placed through a needle into the space next to the spinal cord. Then the needle is removed. The tube stays in your back to supply the numbing medicine. Sometimes a spinal and an epidural are combined.

An epidural catheter may be placed but not used unless it is needed. This is done in case you need one right away. An example of this is if you need a cesarean (C-section). Or it may be used if you decide you want it for pain relief. It's safer to place the catheter early in labor.

The medicine will fully or partly numb your belly and lower body. The amount and type of medicine you get will affect how numb you are. For labor and vaginal birth, a lower dose is often used to ease pain. But it usually will allow enough feeling and muscle strength so that you can push during contractions. For a C-section, a higher dose and stronger medicine is used to block your pain. You will still feel pressure.

You may need to stay in bed during labor. You will also have an I.V. placed in a vein. Plus, you will have a fetal monitor.

The specialist sets the amount of medicine you will get through an epidural tube. Sometimes you will be able to push a button for more medicine when you need it. This is called patient-controlled epidural analgesia (PCEA).

What to Tell Your Doctor

Tell your doctor about your health history. Let them know if you or a family member has had problems with anesthesia in the past. You can also talk to the doctor about medical and nonmedical pain relief options for childbirth. Plan for what you want. But be aware that things can change during labor.

Depending on your health conditions, your doctor may want to have an epidural catheter placed early in labor. This would only be used if needed. For example, you may plan to use nonmedical pain relief but then decide later that you want medicines. Or the catheter would be used to give you anesthesia if you need a cesarean (C-section) for your or your baby's health and safety.

Risks

Serious problems aren't common. Some side effects may happen, such as a headache or nausea. The injection site may be sore. Your heart or breathing can be affected by the medicine. In rare cases, nerve damage can cause long-term numbness, weakness, or pain. Risks to the baby are rare.