Doctors have to wait until the cervix is at least 4 centimeters dilated before doing an epidural. Otherwise, the epidural will slow the process down too much. However, once the cervix becomes fully dilated it is too late for an epidural to be given.
An epidural can generally be performed at any stage; it is never too late. This is, however, not the case if baby's head is crowning (within the birth canal).
The epidural catheter lies near the T10–L1 nerve roots, providing excellent coverage for the first stage of labor. The sacral nerve roots lie further away from the epidural catheter and therefore second-stage analgesia may be less effective.
Placing the epidural takes about 10 minutes, with good pain relief starting in another 10-15 minutes. In patients who are obese or have scoliosis, more time might be required to place the epidural.
The cervix must be 100% effaced and 10 cm dilated before a vaginal delivery. The first stage of labor and birth occurs when you begin to feel persistent contractions. These contractions become stronger, more regular and more frequent over time.
Doctors have to wait until the cervix is at least 4 centimeters dilated before doing an epidural. Otherwise, the epidural will slow the process down too much. However, once the cervix becomes fully dilated it is too late for an epidural to be given.
Although it is the shortest phase, the transition phase is the most challenging. Transition typically lasts 30 minutes to 2 hours as your cervix fully dilates from 8 cm to 10 cm. Contractions will last roughly 60-90 seconds with only 30 seconds to 2 minutes between.
You'll likely still feel the pressure of your contractions (which will be helpful when it's time to push) and be aware of (but not bothered by) vaginal exams during labor. And you'll still be able to feel your baby moving through the birth canal and coming out.
Phew. It used to be common for doctors to turn down or stop the pain medication flowing in an epidural during labor if progress slowed down. This practice was particularly common if the pushing stage of labor was prolonged.
Does labor still hurt if you have an epidural? It's normal to worry that you'll still feel some pain even after you've been given an epidural. Most women experience great pain relief with an epidural, but it won't be 100 percent pain-free.
Recent research has suggested that 6 cm of cervical dilation should be the threshold for the active labor phase, and it has confirmed that epidural analgesia (EA) is a safe method of pain relief during labor.
Most of the time, you can walk within a half hour or so of your epidural injection. However, you will not necessarily be walking normally at this point. Most clinics and hospitals monitor you for 15 minutes to an hour after an epidural injection. During this time, they will likely ask how you feel.
The needle or epidural tube can damage nerves, but this is uncommon. Nerve damage can cause loss of feeling or movement in parts of your lower body. The most common symptom is a small, numb area with normal movement and strength. This usually gets better after a few days or weeks, but can sometimes take months.
“There isn't a minimum cervical dilation. I have done epidurals at one centimeter and when a woman is fully dilated at 10 centimeters,” Dr. McGuire says. A common concern is that having an epidural early in labor slows down labor and delivery.
Active labor
This is when you head to the hospital! Active labor usually lasts about 4 to 8 hours. It starts when your contractions are regular and your cervix has dilated to 6 centimeters.
When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.
Until recently, women have been asked to start pushing as soon as the cervix has dilated to 10 centimeters, but as long as you do not have a fever and your baby's heart rate is normal, there are many benefits to waiting to push until you feel the need to push.
But if you're close to 10 centimeters dilated the research suggests it's not an issue. Evidence suggests it's more of a theoretical fear that just adds additional stress and in some cases results in an epidural (or a higher dose of epidural) to mask that urge.
What's the ring of fire in pregnancy? The ring of fire refers to the burning, stinging sensation you may feel when your baby's head presses on and stretches your vaginal opening. (You may not feel it if you have an epidural.) Though it's painful, the ring of fire lasts just a few minutes.
When your baby's head crowns, you will experience a burning or stinging sensation, often referred to as “the ring of fire,” as your baby stretches the vaginal opening. As soon as you feel this sensation, stop pushing!
“Labor often intensifies after your water breaks, since there isn't a buffer between your uterus and the baby.” The act of your water breaking doesn't hurt (and if you've had an epidural, you likely won't feel it at all, unless the water reaches up your back), but expect those contractions to ramp up almost immediately ...
In figure D, the cervix is 90% effaced and 4 to 5 cm dilated. The cervix must be 100% effaced and 10 cm dilated before a vaginal delivery.
During the transition phase of labor, the cervix dilates to the following sizes: 8 cm, the size of an apple. 9 cm, the size of a donut. 10 cm, the size of a large bagel.
A fully dilated cervix is 10 centimeters open.
This is about the size of a bagel, and means that when your cervix is measured with two fingers, they can be stretched 10 centimeters across.