What is involved with an epidural?
To have an epidural, your obstetrician must call an anaesthetist to discuss your situation. Often, an anaesthetist is readily available to provide you with an epidural. Sometimes however, there may be a delay in their attendance. This can be due to multiple reasons – usually the anaesthetist is attending another emergency or anaesthetic.
Following the initial request, preparation for the epidural begins. If an intravenous (IV) line is not already present, this will be inserted in your hand or arm. IV fluid is given in preparation prior to the epidural.
Your anaesthetist will then ask you to curl up on your side, or sit on the edge of the bed bending forward, and your back will be cleaned with antiseptic solution. Local anaesthetic is then injected into the skin of your back. This stings briefly and then goes numb, so that you do not feel the epidural needle. The epidural catheter is threaded through the epidural needle into your back, near the nerves in the spine. It is important to keep still while the epidural is being placed, but if you feel that you need to move, you must tell your anaesthetist first. After the epidural catheter is fixed in place (and the needle has been removed from your back), you will be able to move again. Medication (usually a combination of local anaesthetic and an opioid eg fentanyl) is then injected through the epidural catheter to begin the numbing process.
Epidurals do not work instantly – they usually take about 15 minutes from the initial dose to start having a noticeable effect. Sometimes the epidural needs to be adjusted and rarely the epidural has to be repeated. In terms of ‘how numb’ you feel varies from person to person, but the main aim is relief from pain.
While the epidural is being established, your midwife monitors your blood pressure closely and inserts a urinary catheter, as you lose sensation to your bladder not knowing when it is full. You will not feel the urinary catheter as you will be numb from the epidural.
Epidurals have minimal effects on your baby. You will be able to breastfeed your baby after having an epidural.
The main aim of the epidural is for you to have adequate pain relief for the duration of the birth.