If you choose to have an epidural, the procedure will be carried out by an anaesthetist. An anaesthetist is a doctor who is specially trained in providing patients with pain relief during medical procedures.
Having an epidural
Nowadays, most epidurals are given while the patient is sitting down and leaning forwards. Alternatively, an epidural can be carried out while you are lying on your side with your knees drawn up and your chin tucked in.
Lying or sitting in these positions opens up the spaces between the vertebrae (bones of your spine) and allows the epidural needle to be passed through them into the epidural space. This is the area in your back that is close to your spine, through which the nerves from your spine to your body pass.
Before the epidural needle is inserted, a sterilising solution, such as alcohol or a solution that contains iodine, will be rubbed into your back. Sterile drapes will be placed over your back, leaving the injection site exposed.
You will have an injection of local anaesthetic to numb the area where the epidural anaesthetic is to be given, which helps to reduce any discomfort. A hollow needle is inserted into the numbed area and an epidural catheter, which is a thin, plastic tube, is passed through the middle of the needle and into the epidural space. The epidural anaesthetic is then injected through the tube.
If you are having an epidural during childbirth, you will need to have a drip in your hand so that medication can be given to help prevent low blood pressure. The drip may restrict you from moving around freely.
Effects of an epidural
While you are having an epidural, you may experience a brief stinging sensation while the local anaesthetic is being given and some slight discomfort in your back when the epidural catheter is being inserted.
As the epidural catheter is inserted, you may experience some pain or an electric shock-like feeling. If you do, tell your anaesthetist because the epidural catheter may be pressing up against the root of a nerve in your back and may need to be repositioned by the anaesthetist.
Shortly after having an epidural you will start to experience a warm, numbing sensation in your lower back and your legs may feel heavy and be difficult to move. It usually takes about 20 minutes for the epidural to take full effect.
The nerves in your bladder are also likely to be affected by the anaesthetic, which means that you won't know when your bladder is full and whether you need to go to the toilet. Therefore, a thin plastic tube (catheter) will be used to drain urine from your bladder instead.
Read more about the side effects of an epidural.
After having an epidural
Following epidural anaesthesia, you will probably be advised to rest in a lying or a sitting position until the feeling in your legs returns.
It usually takes a couple of hours for the feeling to return your legs. As the feeling returns, you may experience a slight tingling sensation on your skin as the anaesthetic starts to wear off. You may need some help getting out of bed.
If you start to feel any pain, you should tell the doctor or nurse who is treating you. They will be able to give you medication to help control it.
After having an epidural you will be able to breastfeed your baby.