What is an epidural?

An epidural is a procedure where an anaesthetic is injected into your back, near your spinal cord. The anaesthetic will rapidly numb your lower body.

Epidurals offer the most complete relief from contraction pain. An epidural is usually given by an anaesthetist (a specialist doctor who gives anaesthetics for procedures).

Generally, after an epidural you won’t be able to walk but will still be awake. A few large hospitals offer a walking epidural that allows you to move around during labour. If you have had an epidural, you will still be aware during the birth of your baby and be able to push your baby out.

Having an epidural does not make it more likely that you will need a caesarean section.

What does an epidural involve?

Before an epidural, you will usually have a cannula (drip) put into your arm.

A very small soft plastic tube will be left in your back. This allows the anaesthetic to be topped up. The tube will be removed after your birth.

It usually takes between 25 and 40 minutes for the epidural to be set up and for you to feel less pain.

Why would I need an epidural?

You may want an epidural if other pain-relief methods aren’t working. Your doctor may recommend an epidural if there’s a chance you’ll need a caesarean.

An epidural may also be recommended if:

• you’re having twins
• you have high blood pressure

It’s your choice to have an epidural during labour. Your doctor or midwife can explain the risks and benefits to help you make your choice.

How will I be monitored with an epidural?

Since epidurals can cause low blood pressure, you will need to have your blood pressure monitored. You might also need to be given fluids by an intravenous drip.

You may lose feeling in your bladder, so will have a catheter (tube) inserted to drain your urine (wee).

While the epidural is in place, you will lose some feeling in your legs. This means that you will need to stay in bed to avoid falls.

Your baby will need to be closely monitored during your labour, using a cardiotocograph (CTG).

When can I have an epidural?

You can have an epidural at any stage of labour if there are no medical reasons that stop you from having one.

Who can have an epidural?

Most people can safely have an epidural, but there may be some medical reasons that mean it’s not possible. These can include:

• bleeding disorders
• infections
• history of back surgery

Epidurals are available at most hospitals, but not in birth centres or during home births.

You should think about your options for pain relief before the birth. Your doctor or midwife can help you choose pain relief options that are suitable for you.

What are the benefits of an epidural?

Epidurals have many advantages. They:

• can take away the pain of your contractions
• relieve labour pain more than other forms of pain relief
• can be started at any stage of labour
• can work for hours
• can be increased in strength if you need a caesarean

If you are having a long labour, an epidural can allow you to sleep and recover your strength.

If you need to have an emergency caesarean, you can be awake for the birth of your baby.

What are the risks of having an epidural?

While an epidural is generally safe and effective, there are some risks:

• your blood pressure may fall
• you may feel cold or itchy
• the second stage of labour may be slowed down
• your chance of needing an assisted delivery may increase
• you may get limited pain relief
• your back may feel bruised for a couple of days after the epidural

Epidurals do not affect your baby. While the drugs used do cross the placenta, they are considered safe.

What are the complications of having an epidural?

Epidurals can cause serious complications, but these are very rare.

• Rarely, people develop a bad headache 24 to 48 hours after an epidural.
• There is a very small chance of developing a skin infection.
• Very rarely, an epidural can cause permanent nerve damage or paralysis.

What should I ask my doctor or midwife about having an epidural?

You can ask about:

• the type of pain relief that might suit you best
• if there are any extra costs involved when you have an epidural
• if you can have an epidural at your chosen hospital

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

Resources and support

Talk to your doctor, midwife or obstetrician about pain relief during labour.

You can find more on pain relief during labour and making a birth plan.

Royal Women’s Hospital has information on managing pain in labour. There are also some fact sheets available in different languages.

RANZCOG has many pamphlets and resources about pain relief during labour.