What to Do When the Epidural Doesn't Work

Epidural anesthesia is a common and effective form of pain relief in labor. It is a regional block, meaning that it blocks sensation in a region of your body, usually this is from your nipple to your knees. The vast majority of moms who receive an epidural are pleased with how well it works. Though sometimes, for a variety of reasons, an epidural might not provide you with complete pain coverage. Here are your options:

• Try flipping.
  Sometimes you might have one spot that isn't quite numb or isn't as numb as another side. Your labor and delivery nurse can help you move from side to side in an effort to help you get better pain relief from the epidural.

• Increase or change medication.
  Your anesthesiologist may decide that you need more of the epidural medication or a different medication. This can be done without redoing the epidural.

• Replace the epidural catheter.
  In some cases, the problem may be with the placement of the epidural. This means that by redoing the epidural, you may get better coverage.

• Use IV medications.
  IV pain medication can be used in conjunction with an epidural. You can ask your nurse what has been ordered by your doctor or midwife. These are usually not given very late in labor, so be sure to ask earlier in your labor what is available.

• Call on skills from your childbirth class.
  When all else fails, you can always fall back on the pain relief skills you learned in childbirth class, particularly relaxation and breathing. Depending on the situation with the epidural, you may or may not be able to change positions. Talk to your nurse for advice if changing positions would be helpful.

_{Source:
Labor and Delivery: Pain Medications. Mayo Clinic Accessed 1/27/11 at http://www.mayoclinic.com/health/labor-and-delivery/PR00105}