Epidurals in labour

Setting up your epidural

  • You will need to have an intravenous cannula and maybe a drip.
  • While the epidural is being put in, it is important that you keep still and let the anaesthetist know if you are having a contraction.
  • Usually takes 20 minutes to set up and 20 minutes to work.
  • Some epidurals do not work fully and need to be adjusted or replaced.

Advantages of an epidural

  • Usually provides excellent pain relief.
  • Sometimes a spinal is given first for a quicker effect.
  • The dose or type of local anaesthetic can sometimes be altered to allow you to move around the bed. This is a low-dose (or mobile) epidural.
  • In general epidurals do not affect your baby.
  • They can be topped up for caesarean section if required.

Possible problems with your epidural

  • Repeated top-ups with stronger local anaesthetic may cause temporary leg weakness and increase the risk of forceps or ventouse delivery.
  • The epidural may slow down the second stage of labour slightly.
  • You may develop low blood pressure, itching or a fever during the epidural.
  • The epidural site may be tender but usually only for a few days. Backache is NOT caused by epidurals but is common after any pregnancy.

Risks of having a spinal or epidural to reduce labour pain

Type of risk

How often does it happen?
Significant drop in blood pressure One in every 50 women
Not working well enough to reduce labour pain so you need to use other ways of lessening the pain One in every 8 women
Not working well enough for a caesarean section so you need to have a general anaesthetic One in every 20 women
Severe headache One in every 100 women (epidural), One in every 100 women (spinal)
Nerve damage (numb patch on a leg or foot, or having a weak leg) Temporary - one in every 1,000 women
Effects lasting for more than 6 months Permanent - one in every 13,000 women
Epidural abscess (infection) One in every 50,000 women
Meningitis One in every 100,000 women
Epidural haematoma (blood clot) One in every 170,000 women
Accidental unconsciousness One in every 100,000 women
Severe injury, including being paralysed One in every 250,000 women

The information available from the published documents does not give accurate figures for all of these risks. The figures shown above are estimates and may be different in different hospitals.