You'll be given an injection of local anaesthetic to numb the skin where the epidural will be inserted. A needle is used to insert a fine plastic tube called an epidural catheter into your back (spine) near the nerves that carry pain messages to your brain.
The anesthesiologist will numb the area where the epidural is administered, which may cause a momentary stinging or burning sensation. But because of this numbing, there is very little pain associated with an epidural injection. Instead, most patients will feel some pressure as the needle is inserted.
Your provider will inject local anesthesia with a small needle near the area where they'll insert the epidural. This is so you won't feel as much pain when they insert the epidural needle, which is larger than a standard shot needle.
A fine catheter (tube) is inserted in the epidural space, near your spinal cord. Local anaesthetics and other painkillers are injected down the catheter into the epidural space to numb your nerves.
The epidural creates a band of numbness from the belly button to the top of the legs, allowing women to stay awake and feel the pressure of labor but without the pain.
For women with epidural anesthesia who do not feel the urge to push when they are completely dilated, delay pushing until the urge to push is felt (up to 2 hours for nulliparous women and up to 1 hour for multiparous women).
You can still feel some pressure of contractions, but you don't have constant pain going through your entire body. Study participants said having an epidural had a positive impact on their birth experience, changing their challenging situations into something manageable and even enjoyable.
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.
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.
After the tube is placed, you will be able to lie on your back, turn, walk, and do other things your doctor says you can do.
Epidurals are usually placed during the first stage of labor when you are having regular contractions. Epidurals are usually placed while you are in a sitting position, or you may be lying on your side. Epidurals for labor are placed in your lower back, known as your lumbar spine.
How Long Does an Epidural Last? Don't worry if you're planning on getting an epidural early in labor; the pain medication won't suddenly stop working or wear off. The epidural stays in your back so you can continue to receive the medicine throughout labor.
The epidural space, where the doctor injects the steroid, is small. The introduction of steroid fluid into this space, where nerves are already inflamed, may temporarily increase pressure, irritating spinal nerves.
Your chest, tummy and legs may feel numb while the epidural medicines are being used, and your legs may not feel as strong as usual. While the catheter remains in your back, it can be used to top up your pain relief medicines manually or using an automatic pump.
Nerve damage is a rare complication of spinal or epidural injection. In the majority of cases, a single nerve is affected, giving a numb area on the skin or limited muscle weakness. These effects are usually temporary with full recovery occurring within days or a few weeks.
Occasionally there are circumstances where women can't get an epidural. Occasionally we see this in women who have a low platelet count. Additionally, women who are taking blood thinners (such as heparin) to prevent a blood clot during pregnancy should not receive an epidural within 12 hours of taking that medication.
Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated. In a 1st pregnancy, the time from the start of established labour to being fully dilated is usually 8 to 18 hours.
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.
Since you are restricted to the bed while laboring with an epidural in place, you will not be able to get up to use the bathroom. Once the epidural medication has numbed your lower body, you can expect to have a urinary catheter placed to keep your bladder empty.
Epidural Injection
The anaesthetist injects the epidural anaesthetic into a catheter which has been placed into the epidural space. This method usually provides pain relief for 1-2 hours, and once it starts to wear off, you can have a top up.
However, if you're later in your labor or if you have an epidural and can't really feel things and you suddenly feel a ton of pressure, like you need to have a bowel movement, you need to call your labor nurse ASAP.
Most women will feel increased pressure in their perineum, rectum, and low back at this stage. For many women, the rectal pressure feels the same as having a bowel movement. As the baby's head begins to appear, you may feel a stretching or burning sensation.
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.