What is it?
An epidural is a regional anesthetic that is injected into the space surrounding the spinal nerves.

How does it work? 
The medicine blocks nerve signals causing temporary pain relief or loss of sensation from the point of injection to the feet.

How will it make me feel? 
Physically, mothers will lose most feeling in the abdomen, hips and legs and will not be able to feel contractions.  Mentally, mothers may feel relieved at the reduction of pain, but some mothers feel disconnected to their labor – as if they have lost control of the labor.

How long does it last? 
An epidural can last the length of labor and birth and some can be turned up or down depending on the mother’s needs.  If a Cesarean section is needed, the epidural is turned up for the procedure so the mother will have complete loss of sensation for the surgery.

What are the side effects? 
Possible side effects include numbness, itching, spinal headache, nausea, vomiting, drop in blood pressure (which causes baby’s heart rate to drop), paralysis, and least likely, death.  Some mothers will not feel complete relief from the medicine, still feeling windows of pain or pain on one side of the body.

How will it affect my labor? 
There is much debate around how epidurals affect labor.  Although some women can get an epidural and have a wonderful birth experience, typically getting an epidural results in more interventions leading possibly to a Cesarean section.  Because a mother cannot feel her contractions, she may not have the urge to push, or she may not be able to feel her muscles to push her baby out.  In these cases,  the doctors must pull the baby out with a vacuum or forceps.  As noted previously, sometimes epidurals lower a woman’s blood pressure which in turn reduces the baby’s heart rate.  If the baby’s heart rate drops too far the medical staff will most likely want to begin internal fetal monitoring or the medical staff will suggest an emergency Cesarean section.  Although epidurals are generally a safe option for mother and baby, they have consequences.

How will it affect my baby? 
Although doctors previously believed that epidural medications did not reach the fetus, studies have now shown that babies are affected by the medication.  They show temporary neurological differences that may take up to 24 hours to subside. 

How soon can I get it? 
You can get an epidural as soon as the anesthesiologist is available, however most doctors suggest waiting until you have reached 5cm dilation to attempt to avoid the slowing of your contractions.  Keep in mind that it may take from 30 minutes to 2 hours or more to reach an available anesthesiologist and you may need to use other coping techniques until one is available.

When is the latest I can get it? 
You can get an epidural up until the point you are pushing your baby out; however,  at that point most of the work is done and you are almost finished.