Risks and Benefits of an Epidural

To feel, or not to feel: that is the question!  

At Stork Helpers, we believe that every mama deserves a birth plan that is as unique as she is. While we are dedicated to holistic solutions and empowering home births, we also recognize that some mamas may choose or need to give birth in a hospital setting. Our role is to support you in customizing your birth plan - whether you’re at home or in a hospital - and ensuring that you’re fully informed about all your options, including medical procedures like an epidural.

Comfort during labor is key, and while we specialize in non-medical pain management techniques, it’s important for you to understand the full spectrum of choices available to you. Whether you’re considering different laboring positions, the use of a birth ball, or the option of an epidural, our goal is to help you navigate these decisions with confidence.

So today we’d like to talk to you about the risks and benefits of an epidural for labor – what it is, why so many mamas ask for one, and why so many mamas decide it isn’t for them. With the right information and support, you can create a birth plan that reflects your needs and values, no matter where you choose to welcome your baby.  

What is an epidural? 

Here’s the overview.  

An epidural is the most common type of anesthetic administered to mamas during childbirth. The term “epidural” can be used to describe both the anesthesia medication itself as well as the procedure used to administer the medication.  

The Cleveland Clinic describes an epidural procedure as, “a procedure that involves injecting a medication – either an anesthetic or a steroid – into the space around your spinal nerves known as the epidural space. The goal of an epidural procedure is to provide pain relief (analgesia) or a complete lack of feeling (anesthesia) for one region of your body, such as your legs or belly.” 

The American Pregnancy Association defines which medicines are used in an epidural: “Epidural medications fall into a class of drugs called local anesthetics, such as bupivacaine, chloroprocaine, or lidocaine. They are often delivered in combination with opioids or narcotics such as fentanyl and sufentanil in order to decrease the required dose of local anesthetic.”  

In general, there are two different ways the epidural anesthesia is administered during the childbirth journey: epidural with a catheter or a Combined Spinal-Epidural (CSE, or “walking epidural”). With either type, mamas who choose an epidural will still be awake and alert and can still feel pressure, so they can push when needed.  

Choosing an epidural can impact your birth plan, because it will limit your ability to walk around during labor. Even with a “walking epidural,” it won’t be safe for you to walk – it just means that you won’t be connected to a catheter. And choosing an epidural also means that you may not be able to choose which position you’re in to bring baby into the world.  

If you choose an epidural, there’s not really a “best time” to get it – it can be administered at any time during childbirth if you’re able to hold relatively still for the procedure, though it’s typically not administered if baby is very close to being welcomed into the world. The medication mostly stays in the epidural space and very little reaches mama’s blood supply, which means very little of it gets to baby.   

As with every medical procedure, there are benefits, risks, and side effects of an epidural pregnancy to consider, so let’s look at some more specifics.  

Epidural Benefits 

We at Stork Helpers have heard a lot of mamas laugh as they say, “Yes, PLEASE give me an epidural!” For many mamas (in fact, 70-75% of them), it’s how they choose to get through the extreme sensations which come with childbirth.   

And where there’s intense discomfort, there’s stress. Where there’s stress, there’s stress hormones. An epidural can minimize these hormones and help to control mama’s blood pressure and heart rate. 

Finally, if your birthing journey doesn’t go as planned, having an epidural in place can ease the transition into an unplanned c-section, if needed.  

Epidural Risks and Side Effects 

Epidural anesthesia is a medication, so even though it is widely considered to be a safe medication, there is always a risk of side effects. Here are some of the most common side effects that you should be aware of.  

• Drop in your blood pressure, which could lead to lowering baby’s heart rate. This side effect is made less likely by having you lie on your side or by administering IV fluids or other medications.  
  
  
• Nausea and vomiting. If your blood pressure drops, you can feel nauseous and even vomit – this is one of the first symptoms of dropping blood pressure, so if you feel it, speak up. Once your blood pressure is stabilized, you’ll start to feel better. 
  
  
• Itchy skin. This is a common effect of anesthetic medications such as an epidural and is temporary. 
  
  
• Shivering or shaking. This is a common and temporary side effect of the type of anesthesia that’s used. It doesn’t pose a risk to baby.
  
  
• Soreness in back. This soreness, different than the muscle fatigue from pushing, can be felt at the site of the injection and can last up to a few days. 
  
  
• Headache. On rare occasions, the needle used to inject the epidural anesthesia can pierce the cover of the spinal cord. This can cause a headache that can last for a few days if untreated. 
  
  
• Temporary loss of bladder control. Because you’ll be numb, you might not feel the urge to go or be able to go like normal. Sometimes a catheter is placed in your bladder to ease this. 
  
  
• Fever. This is a more uncommon side effect of the medication, but if you experience it, know that it doesn’t pose a threat to you or baby and can be treated with Tylenol if necessary. 
  
  
• Injection “hot spot” or “one-sided” epidural. Everyone’s anatomy is different, so sometimes the medication can’t get everywhere it needs to go. If mama gets an epidural and still feels the intense sensation of contractions, this may be a sign that another injection or replacement of the catheter is needed. 
  
  
• Sometimes slowing down the childbirth process. This usually gets reported if the epidural is administered very early in the process, but there isn’t credible evidence that backs up the claim.  
  
  

Though the risk is low, there can be side effects which are very rare, including:  

• Temporary nerve damage.
  
  
• Permanent neurological problems.
  
  
• Permanent, chronic pain.
  
  
• Permanent paralysis. 
  
  

These issues are caused in less than 1% of all epidurals and skilled anesthetists know how to avoid the causes of these problems and take precautions to minimize the risk.  

Depending on your specific health needs, you may not be a candidate for an epidural. Mamas with allergies to anesthesia medications, an infection, or diabetes are not recommended for epidural procedures and may want to talk with their healthcare provider to learn more about their options.  

So, what now? 

The most important thing for you to remember, mama, is that this is your choice. You can even change your mind in the moment if you want to! Every mama’s journey is different and entirely her own.

We know that "comfort" and the word labor don't often go together, but a big part of our job is providing emotional, mental and physical support to help make you more comfortable during labor. We can't make the pain of childbirth disappear, but we can help you manage it and alleviate it.  

If an epidural isn’t for you, your doula can help you find different laboring positions based on where you feel pain and baby's position to help you manage without the use of an epidural. The use of a birth ball or peanut ball can be great tools to alleviate pressure and for some, laboring in water is very comforting.

At Stork Helpers, we are here to provide you with support and to help you embrace your wellness choices.  

We are always listening, guiding, and comforting you!  Start a conversation with us today by following this link!  

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