An epidural is a type of regional anesthesia, a drug that numbs a large area of the body. In this case, the numbness extends from the waist down. Its most common use is during normal labor and childbirth, although it is also used for other deliveries such as induced labor, vacuum delivery, and caesarean sections.
Epidural anesthesia is optional; some women choose not to get it for safety or personal reasons. Some doctors recommend using an epidural only in cases of extreme pain or when complications arise that require surgery. In normal deliveries, the pain serves as the signal for the mother to push, so an epidural can actually prolong the process.
The drug is injected into the lower part of the spine, usually with the patient lying on her side and curled up tightly. This gives the anesthesiologist the clearest view of the spinal column possible. The area is first injected with a local anesthetic, which will numb the pain from the actual epidural injection. A test dose is then injected to make sure the epidural is being administered in the right place, then the full shot is delivered through a catheter. Along with the epidural, the patient is given a range of other medications according to her specific needs, delivered through the same catheter.
Epidural injections can be painful, not least because they are usually delivered during contractions and require an uncomfortable position. Some women feel a sharp pain or jerk in their legs during the injection; this means the needle has nudged a nearby nerve, but is no cause for concern.
When the epidural anesthesia is in effect, the patient will feel the contractions but not the pain that would normally come with it. In some women the numbness extends up to the chest or down to the knees. Most patients can discuss the scope of the medication with the anesthesiologist beforehand, choosing how much they want to feel during the birth.
The risks of an epidural are usually minor, such as fetal distress and a drop in blood pressure. Rare complications include nerve injury and paralysis. Also, not all patients can be given an epidural—some conditions make the risks outweigh the benefits. People with heavy bleeding, back infections, low platelet counts, and hard-to-locate spinal features are usually turned down for an epidural. The drug can also react negatively to other medications the patient is taking. If you’re considering an epidural for your birth, make sure to give your doctor your full medical history so any potential reactions can be ruled out.