Labor Epidurals: What You Need to Know

Q: What is a labor epidural?

A: This form of regional anesthesia is a delivery of drugs through a catheter placed into the lower part of your spine. Epidurals cause both a loss of sensation and a loss of pain by blocking the transmission of signals through nerves in or near the spinal cord.

 

Q: How is an epidural administered?

A: After labor has progressed sufficiently, your board-certified anesthesiologist inserts a needle in the lower part of your back until it reaches the epidural space within your spinal canal. A catheter (soft plastic tube) is threaded through the needle to deliver the anesthesia. You can comfortably lie on your back after the procedure.

 

Q: How will I feel after an epidural is administered?

A: The medication reduces labor pain and some sensation, but a sense of pressure and muscular activity usually remains so that labor progresses easily.

 

Q: Is an epidural always successful?

A: Not always. Sometimes it may produce only partial relief of labor pain. However, Lake Forest Hospital works with some of the best anesthesiologists in Chicago who are experts in pain management.

 

Q: If epidurals reduce labor discomfort, why don’t all mothers request them?

A: More than 80% of vaginal deliveries at Lake Forest Hospital employ epidurals to relieve pain and discomfort associated with labor pain. However, some mothers prefer to undergo labor and delivery without major anesthetic involvement. A labor epidural can add expense and risk.

 

Q: What risks are involved with an epidural?

A: Significant problems rarely occur with labor epidurals, and in the event they do, we have the means to minimize or eliminate the problem. In general, the risks of epidural anesthesia for labor and delivery include the following:

• Lowering of the mother’s blood pressure that could cause adverse effects on the baby and the mother.
  
  
• Puncture of the covering that separates spinal fluid from the epidural space. If this occurs, you may experience a “spinal headache” that can be severe or prolonged, but is treatable.
  
  
• Increased need to use other medicines to stimulate labor.
  
  
• As with any injections, bleeding or infection can occur at the needle site, which could cause lasting neurological damage if medical care were not sought. The likelihood of nerve damage is less than 1 in 200,000.

 

Q: Can anyone request an epidural?

A: You should discuss the epidural with your obstetrician. Your medical or physical condition, or the condition of your unborn baby, may affect your choice to have an epidural. In a small number of cases, your obstetrician or anesthesiologist may recommend against it.

 

Q: Are there additional costs for an epidural?

A: Yes. In addition to the hospital charges for sterile supplies, your anesthesiologist charges a fee that depends on your epidural’s duration. How much you owe the anesthesiologist depends upon your insurance plan. Insurance with obstetric coverage pays the anesthesiologist’s fee, though you are responsible for co-payments and deductibles.

 

For more information, contact Lake Forest Hospital's Anesthesia Department at (847) 234-5600.