What is an epidural?

Epidural is a kind of anaesthetic (medication to block pain). It is commonly used during labour and delivery because it numbs your lower body while allowing you to remain awake. During an epidural, anaesthetic is injected into the area around your lower spine. Within minutes, your body becomes partly numb from about the waist down. You may lose muscle control in your legs, but you can usually still push during contractions. Little, if any, of the anaesthetic reaches your baby.

An epidural can be used for both vaginal delivery and caesarean (C-section) delivery. An anaesthetist (a medical doctor) starts the epidural and monitors you throughout your labour and delivery. He or she will talk with you about the anaesthetic and what to expect.

Anaesthetic is injected into the epidural space - the space between the spinal column and the covering around the spinal cord, in the lower back

During labour and delivery

An epidural is usually not started until you are in active labour. You'll be asked to sit on the edge of the bed or lie on your side. First, a small area around your spine is numbed with a local anaesthetic. The anaesthetist then inserts a needle into the epidural space. A tiny plastic tube (catheter) is threaded through the needle. The needle is removed, and the anaesthetic is delivered through the catheter.

Sometimes a pump is attached to the catheter. The pump gives you a constant level of anaesthetic throughout labour and delivery. During this time, your blood pressure and heart rate and your baby's heart rate are also closely watched.

If you have a caesarean (surgical) delivery, the same catheter can be used to give you anaesthetic during surgery. This anaesthetic is usually stronger. Pain medication can also be given through the catheter after delivery.

Risks and possible complications

Your anaesthetist will discuss the risks and possible complications of epidural with you. These include:

• a sudden drop in blood pressure, which may slow the baby's heart beat for a short time
• severe headache
• very rarely, dizziness, seizures, breathing problems, allergic reaction to the anaesthetic, nerve damage or paralysis.

After delivery

The epidural catheter is removed shortly after delivery, unless you need more medication after a caesarean delivery. You'll need to rest in bed until the anaesthetic has worn off and you have normal feeling in your legs again. This usually takes two to four hours. Until you have fully regained the use of your muscles, you may need a urinary catheter in your bladder.

How pain is blocked

The spinal cord is the main pathway for pain signals. These signals travel from nerves in your body through the spinal cord to your brain. The brain then registers them as pain. Anaesthetic is injected into the epidural space - the space between the spinal column and the covering around the spinal cord, in the lower back. Anaesthetic blocks the signals in the spinal cord before they reach the brain. That way you don't feel pain.

Numbing your lower body

An epidural blocks the nerves that enter your lower spine. Anaesthetic is injected into the space between the bones in the spinal column (vertebrae) and the covering around the spinal cord. This called the epidural space. The anaesthetic partly numbs your body from about the waist down into your legs. You stay awake, and you still have feeling in your upper body.

Going home

You may be ready to go home 24 to 48 hours after delivery. If you had a caesarean delivery, you may need to stay in hospital longer. You may feel some pain around the injection site for a few days. In rare cases, this can last a month or more. If you have a continuing headache or numbness in your legs, call your lead maternity carer or general practitioner. As you recover from delivery, you can look forward to bonding with your new baby.

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