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Linda Murray: An epidural is a procedure that delivers pain medication to you continuously through a small tube inserted into your back. The medicine blocks pain in your lower body. Here’s how it works. An anesthesiologist or nurse anesthetist will numb a small patch of skin on your lower back. Then you’ll stay very still while he inserts a tiny tube between 2 of your vertebrae into the space near your spinal cord.
This small area is called the epidural space, which is where the procedure gets its name. Once the tube is inserted, it’s taped into place so it won’t move. The tube stays in your back throughout labor, but you won’t feel it. The medication delivered through the tube is usually a combination of a local anesthetic and a narcotic. It can take about 15 to 40 minutes from the time the procedure begins to feel full relief. On the plus side, an epidural provides very effective long-lasting relief. You might be able to rest or even sleep through contractions. You’ll probably be more alert than with systemic medications. And the dose can be adjusted as your pain levels change through labor. Very little of the medicine reaches your baby, since hardly any of it enters your bloodstream. Most of it stays in the epidural space and works directly on your nerves. However, an epidural can make you lose sensation and some strength in your legs. And your caregiver may tell you it’s no longer safe to walk around and that you a have to stay in bed. You’ll need an IV, frequent blood pressure monitoring, and continuous fetal monitoring. An epidural can make the pushing stage of labor longer partly because the loss of sensation in your lower body makes it more difficult to push. Getting an epidural also raises your chances of needing an assisted delivery.
In some cases, your epidural may give you only partial or spotty pain relief or cause some itchiness. Rarely, women who have had up an epidural end up with a bad headache afterwards.
By and large, epidurals are safe and effective. It’s not surprising, then, that nearly 8 out of 10 women who use pain medication during labor choose an epidural or some other form of spinal anesthesia.