Epidurals: Things to Consider
When it comes to pain management in labor, epidurals are one of the most common tools people turn to. For some, it feels like a relief just knowing the option is there. For others, it’s something they want to avoid unless truly necessary. Like anything in birth, it comes with benefits, limitations, and a whole lot of personal choice.
What an Epidural Is
An epidural is a form of regional anesthesia, which means it numbs part of your body without putting you fully to sleep. Here’s how it’s typically done:
A provider will first clean your lower back and numb a small area of skin with a local anesthetic. This numbing medicine may sting for a few seconds.
Next, a needle is carefully inserted into the space just outside the spinal cord (called the epidural space). Through this needle, a thin, flexible tube called a catheter is placed.
The needle is then removed, leaving the catheter in place. That little tube is taped to your back so medicine can be delivered throughout your labor without needing multiple pokes.
The medication used is usually a mix of a local anesthetic (to block pain signals) and an opioid (to enhance comfort). The effect is that the nerves carrying pain from your uterus and cervix are numbed, and contraction pain is significantly reduced.
Most people notice relief within 10 to 20 minutes. Depending on the dosage and how your body responds, you may still feel pressure during contractions and pushing, but the intensity of pain is often much less.
Why Some Families Choose an Epidural
Relief from intense pain: Labor can be long, exhausting, and overwhelming. An epidural can give you a break and make the process more manageable.
Rest and recovery: If you’ve been laboring for many hours without progress, an epidural can allow you to get real rest. This can sometimes even help your body relax enough for labor to move forward.
Support in complicated situations: In some high-intervention births, like inductions or cesareans, an epidural may be recommended or even necessary. For example, if a cesarean becomes the safest option, having an epidural already in place can make the process smoother.
Things to Keep in Mind
Movement is limited: Once the epidural is in, you’ll usually be confined to the bed, though some hospitals offer “walking epidurals” that allow a bit more mobility. These aren’t available everywhere.
Pushing can feel harder: Because you may not feel contractions as strongly, your care team may need to guide you through pushing. This can make the pushing stage longer, or in some cases, increase the need for tools like forceps or a vacuum.
Side effects: Some people experience drops in blood pressure, shivering, fevers, or longer labors. Not everyone does, but they’re important to be aware of.
Extra monitoring: With an epidural, you’ll likely have continuous fetal monitoring, IV fluids, and sometimes a catheter placed to help with urination.
My Take
As your doula, I’ll never say epidurals are “good” or “bad.” They’re one tool in the toolbox, and the decision is yours to make. What matters most is that you feel informed, respected, and supported in whatever choice you land on.
For some families, the epidural is exactly what they need to rest, regain focus, and meet their baby with more calm. For others, trying comfort measures like movement, water, massage, or breathing techniques first feels important before considering medication. Both are valid. Chat with your provider and ask lots of questions to find out what is best for you!
Birth doesn’t come with one right answer. Every family, every labor, and every body is different. My role as your doula is to help you understand your options ahead of time, remind you of them in the moment, and support you fully, epidural or not.
Watch the Epidurals episode of Contractions and Controversy here! https://www.instagram.com/reel/DObQClckVAx/
