Epidural - a way to relieve pain during childbirth
An epidural is a local anaesthetic injected into the space around the spinal nerves in the lower back, which relieves pain during delivery. Here you can read about the treatment, effect, and side effects. The information might be overwhelming so if you have any questions, it may be a good idea to discuss these with your midwife or obstetrician.
Prepare yourself for the epidural
It will almost always be possible to set up an epidural
An exception to this may be if you are treated with blood-thinning medicine. If you have tattoos on the back, had a herniated disc or if you have previously had a caesarean section, it is usually still possible to set up an epidural.
We often recommend an epidural if you have an increased risk of complications which may lead to an acute caesarean section if you e.g., are giving birth to twins, if you are significantly overweight (BMI>35) or have high blood pressure.
You must be active during the delievery
We assess if the delivery process has started. This will typically be the case when your cervix is dilated 3-4 cm. The epidural can be set up earlier in the process if this has been agreed beforehand.
The epidural will relieve pain and give you rest if you experience your pain is intolerable or if you are exhausted by the contractions.
About the treatment
A thin catheter will be placed between the vertebrae in your spine
We place the catheter in the part of the spine where the nerves are located. You will have a local anaesthetic infused through the catheter during the entire delivery. An epidural is a highly effective way of relieving pain. If there is a need, you can also have laughing gas.
An iv access is established and a catheter will be placed in your spine
An iv access is established in your arm. At the same time, we check your blood pressure and your temperature. You will sit on the delivery bed bending forward or lie down on the side in a curved position to make space for setting up the epidural. A local anaesthetic will be applied to the disinfected skin.
It takes approximately 20 minutes to set up the epidural (performed by an anaesthesiologist). Occasionally, the catheter must be replaced if the epidural does not have the effect intended.
Your pain will decrease after 10-15 minutes
We monitor your baby’s heart rhythm and your contractions with a CTG while the medicine gets time to work. You will have an elastic belt placed around your stomach and you cannot move around freely. After approximately 30 minutes we assess if it is possible to remove the belt and stop the monitoring.
Risks and side effects
You may experience temporary discomfort in your legs and lower part of your body
You may feel your legs are heavy or “numb” but most often it is possible to get out of the bed with support. A few experiences temporary sensory disturbances such as tingling in legs or hips. This will pass in a few days or weeks.
An epidural to relieve pain during delivery may decrease your sensation of a full bladder. We ask you to try to urinate every two-three hours after the delivery. We can empty your bladder with a catheter if you cannot urinate yourself.
You may feel tenderness at the injection site in the back in the days following the delivery. Long-term back pain is normally not caused by the epidural but by the strain of pregnancy and delivery.
Rare complications are infection, accumulation of blood and permanent nerve damage.
You may experience skin itching or headache
Skin itching is experienced by 10% and is unharmful.
You may get a severe headache, typically one-two days after the delivery, if the epidural has penetrated the membrane surrounding your spine (the risk is less than 1%). In this event, we will offer you treatment for your headache.
You can get fever and experience a sligthly low blood pressure
Setting up an epidural may cause fever. If your temperature exceeds 38 degrees Celsius we will often treat you with antibiotics because we cannot exclude that your fever is caused by an infection. If you have fever, we may have to admit you and your child for observation up to 48 hours after the delivery and we may have to take blood samples.
You may experience that your blood pressure drops slightly just after the epidural is set up (happens to approximately 2%). If your blood pressure gets too low, you will be treated with medicine to increase your blood pressure.
Your delivery may be slightly prolonged
It may take a little longer for you baby to descend into the pelvis and the pushing stage may thus be slightly prolonged. This is because the epidural inhibits the body’s natural production of hormones stimulating contractions. The epidural also relaxes the muscles “pushing” your baby down the birth canal. Your urge to push is only very slightly affected.
There is a slightly increased frequency of irregular birth presentation (e.g., your baby is born in a stargazer position with face turning up as if looking at the stars). Your risk of caesarean section is not increased.
We can give you medicine to stimulate your contractions to ensure progression in the delivery and and/or vacuum-assisted delivery at the end of the pushing stage. Vacuum-assisted delivery has a slightly increased risk of lesions.
We do not know if an epidural affects breastfeeding
Breastfeeding is influenced by many factors, and it is difficult to isolate the effect of an epidural. Existing studies show conflicting results; some indicate the epidural negatively affects breastfeeding while others find no association between breastfeeding and epidural.
Check our website if you want to know more
Get an overview of what happens from the time you are referred until you have finished your treatment or given birth at our Danish website: graviditet.auh.dk. Here you also find information about our department (safety, research, projects etc.).
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Find out more about pregnancy, delivery and childcare in Denmark at a website in English from The Danish Health Authority: sst.dk.
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