Pros and Cons of Getting an Epidural During Labor

Let’s talk epidurals. 70-75% of women giving birth in the hospital use an epidural, according to Yale Medicine. It’s the most common pain relief technique used in childbirth. Some women research all the details of an epidural, while others get it because “it’s just what you do.” I want to dive into what it actually is and does to/for your body, as well as the pros and cons of getting it. Let’s start with the basics.

Mom in hospital bed looking at her newborn baby in her arms

What is an Epidural?

An epidural is made up of a local anesthetic (ie. bupivacaine, chloroprocaine, or lidocaine) and an opioid or narcotic, typically fentanyl or sufentanil, according to the American Pregnancy Association. It is injected into the low back using a needle inserting a catheter – the catheter remains to insert pain medication throughout labor (Yale Medicine).

Pros

Pain Relief – This is HUGE. And probably worth more than just one bullet point. It’s the main reason so many women use epidurals. Labor/delivery will likely be one of the (or the) most painful things you ever experience in your lifetime. And that’s saying something. So obviously getting some relief sounds very nice. If inserted correctly, you can have minimal to no pain, and maybe even smile while pushing your baby out!
Relaxation – If you’ve been in labor forever and it feels like your babe is just stuck, your body may reach exhaustion. The epidural may be able to give you the couple hours of rest you need to let your baby move on down and give you the energy to push him/her out. If you can’t relax during labor and are resisting contractions, this will also make it very difficult for labor to progress. An epidural may be helpful in this situation, allowing your body to relax and hopefully encourage labor to progress.
Dosage – The anesthesiologist (or sometimes you!) will be able to control the amount, type, and strength of the epidural throughout labor. So depending on your needs and where the baby is at, you can use minimal dosage, or crank it.
Placement – In case of emergency and you need a cesarean, you will save precious time being ready to go with your epidural already in place. They will be able to administer anesthesia through it. Also nice “if you’re having your tubes tied after delivery,” for the same reason. According to the American Pregnancy Association.

Mom and dad looking lovingly at their newborn son

Cons

Administration – There are quite a few steps involved in administering the epidural that serve as cons, in my opinion. First, they have to insert your body with fluids BEFORE active labor begins. Which means getting to the hospital quite early. Then, to insert the needle, you have to remain extremely still, with your back arched, in order to prevent problems and make sure it’s effective. It can take about 10-15 minutes, which feels like forever during contractions. They will numb the area with a local anesthetic first, and then insert the epidural catheter (so hopefully you won’t feel it as much). The catheter will be taped to your low back and remain throughout labor and delivery.
Can’t walk – Your low body will be numb! So you won’t be able to get up and move around during labor/birth and probably a little while after.
Potential Side Effects – There are many additional potential side effects to epidurals. Low blood pressure (meaning they will be routinely monitoring your blood pressure), severe headache due to leaking spinal fluid (this happens to less than 1% of women, but still). “Shivering, a ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating,” (meaning they’d have to insert a catheter) are also potential side effects, according to the American Pregnancy Association.
Affects Baby – “A baby might experience respiratory depression, fetal malpositioning, and an increase in fetal heart rate variability,” according to the American Pregnancy Association. Your babe may have difficulty latching on, which obviously isn’t ideal for breastfeeding. And it may cause them to be lethargic in the uterus, making it difficult for them to get into a delivery position. (American Pregnancy Association)
Stalled labor – Since you won’t be able to get up or move around, your labor may slow down or stop.
Less Effective Pushing – the epidural makes feeling contractions minimal or not at all. You also may not be able to tell if or how hard you’re pushing. This could definitely make the pushing process much longer, with potential need for intervention i.e. forceps.
Cascade of Interventions – If labor stalls, they may intervene by sweeping your membranes, breaking your water, or giving you pitocin to start contractions up again. If you aren’t able to push effectively, they may use forceps, a vacuum, or give you an episiotomy (small cut in your vagina to help the baby fit out), or if that doesn’t work, a cesarean.
Might not work – !! If you weren’t able to stay still, or the anesthesiologist wasn’t able to place the epidural correctly, it might not work! I’ve heard of a misplaced epidural having no numbing effect, or only numbing half of the body, so the other half feels everything!
Money – Not that you want to put a dollar sign on your birth experience, but epidurals are extremely expensive. If you have great insurance, you might not even notice it on your bill! But if you don’t, it could add thousands of dollars.

There you have it, the pros and cons of getting an epidural. I’m sure there are more I didn’t even add. And maybe I listed some that aren’t important to you. I honestly created this to help me decide what I want to do for my next birth. To give me the motivation whichever way I go. So please, make this list your own! Add what you want and ignore what you don’t care about. I hope this helps you!

I’d love to hear your thoughts on this list! Comment below what helped you decide to get an epidural or to motivated you to go without. Either way, you are amazing for growing a human inside of you, and I’m honored you’re here!

You’ll love my posts here!

Hospital Birth Plan Template For The Natural Mama

5 Practical Ways To Prepare Your Husband For Birth

Do I Need Pelvic Floor Therapy?