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Epidurals
What is an epidural?
Who will insert my epidural?
An anesthesiologist, or a resident doctor
training in anesthesiology will insert your
epidural
I have a tattoo on my lower
back; can I get an epidural?
Yes, usually you can still get an epidural
if you have a tattoo on your lower back.
An epidural is a medical procedure used
to decrease pain during labour
How does an epidural decrease
pain?
ƒ
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Location of the epidural
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How is an epidural performed?
ƒ The skin on your back is cleaned
with an antiseptic solution
ƒ Freezing solution is injected to
numb the skin on your back
ƒ A needle is placed in-between the
bones of your lower back
ƒ An epidural tube (catheter) is
placed through the needle
ƒ The needle is removed
ƒ The tube stays in your back so you
can get medication
Pain in labour comes from irritation
of nerves around your uterus and
vagina
The nerves send pain signals
through the spinal cord to your brain
The medication given through your
epidural tube stops your nerves
from sending pain signals to your
brain
When can I get an epidural?
You can get an epidural any time once
you are in labour and these things have
been done:
ƒ A nurse has been assigned to your
care
ƒ
An intravenous line giving you fluids
is in place
While we try to get your epidural as
soon aspossible, you may have to wait
for your epidural if the anesthesiologist
on call is busy with other patients.
How long does it take to work?
An epidural takes 15-20 minutes to be
inserted, and 15-20 minutes for the
medication to work.
Size of the epidural needle
Will I be able to push with my
contractions?
Most women are numb from the belly
button down and don’t feel contractions
well. If this happens, the monitor on your
belly will show when you are having a
contraction and the nurses will tell you
to push.
Will the epidural prolong my
labour?
Yes, some studies have shown that
epidurals may prolong labour,
particularly the pushing stage of labour.
For women who get epidurals this stage
takes on average 15 minutes longer.
Will the epidural increase my
chance of needing a cesarean
section?
Studies have shown that there is no
increased risk of needing a cesarean
section if you get an epidural.
However, there is a small increased
chance you will need a vacuum or
forceps assisted delivery if you get an
epidural.
What are the side effects of an
epidural?
ƒ 30% of women may get low blood
pressure
ƒ 1-26% of women experience
itchiness
ƒ 15% of women develop a mild fever
What are the complications of
an epidural?
What are the advantages of an
epidural?
ƒ Epidurals provide excellent pain
relief
ƒ Pain relief can give you time to rest
until it is time to push
ƒ When you get an epidural less
stress hormones are released and
blood flow to your baby is increased
ƒ An epidural can be used for
anesthesia if you require a
cesarean section
Will the epidural affect my
baby?
Most studies have not shown any
negative effects on babies whose
mothers get epidurals.
Complication
Headache
Frequency
1 in 100
Infection
9 in 1,000,000
Bleeding
5 in 1,000,000
Permanent paralysis 4 in 1,000,000
When should I be concerned
about these side effects and
complications?
ƒ Headaches: if you have a severe
headache that gets better when you
lay down, talk to your doctor
ƒ Infection: if you develop a stiff
ƒ
neck, fever and headache, see your
doctor
Severe back pain: if you develop
severe back pain over the epidural
site see your doctor
Please speak with your healthcare team if
you have any further questions about
epidurals.
Epidurals
This pamphlet was prepared by
Chelsey King, BSc, MSc &
Dr. Dolores McKeen MD MSc FRCPC,
IWK Health Centre,
Department of Women’s & Obstetric
Anesthesia,
Dalhousie University Medical School
References:
1. Anim-Somuah M., Smyth RMD.,& Jones L.
(2011) Epidural versus non-epidural or no
analgesia in labour. Cochrane Database of
Systematic Reviews, 12, CD000331.
2. Ruppen, W., Derry, S., McQuay, H., &
Moore, RA. (2006). Incidence of epidural
hematoma, infection and neurologic injury in
obstetrics patients with epidural
analgesia/anesthesia. Anesthesiology,
105(2):394-393
3. Eltzschig, HK., Ellice, MD., Lieberman, ES.,
&Camann, WR. (2003). Regional anesthesia
and Analgesia for Labor and Delivery. New
England Journal of Medicine, 348(4):319-332
IWK Department of Women’s &
Obstetric Anesthesia, Halifax, N.S.
PL-0803 Last Update: 10/13
Next Review: October 2016