What does an Epidural involve?

An intravenous cannula is first placed into a vein in your hand or arm, which may then be connected to a drip (intravenous fluid). Your anaesthetist will then ask you to curl up on your side, or sit on the edge of the bed bending forwards, and your back will be cleaned with antiseptic. Local anaesthetic will be injected into the skin of your back, which may sting briefly, but this will stop you feeling the epidural needle. The epidural catheter is threaded through the epidural needle into your back, near the nerves in the spine. Your anaesthetist has to be careful to avoid puncturing the bag of fluid surrounding your spinal cord, as this may give you a severe headache afterwards. As a result it is important to keep still while the epidural is being placed, but if you feel that you have to move (eg during a contraction) you must tell your anaesthetist first. After the epidural catheter is fixed in place you will be free to move again. Painkillers will then be injected through the catheter to make you comfortable.

While the epidural is starting to work, your midwife will take your blood pressure regularly. Your anaesthetist will also check that the epidural is working properly. Sometimes it doesn't work well at first and needs to be adjusted. You can also have extra doses of painkiller through the epidural, to keep you comfortable as your labour progresses.

Some women prefer to have some feeling during the delivery, so they have a better idea of how to push the baby out. The epidural cannot be adjusted exactly, so if you want some feeling when your baby is delivered there is more chance of having some discomfort as well. You should discuss with your midwife and anaesthetist what your expectations are.

An epidural will have only minimal effects on your baby. You will be able to breastfeed your baby after having an epidural.