Getting the Most out of an Epidural in Labor

Mixed race nurse examining pregnant patient's belly

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About 70% of women in the United States will choose an epidural for their labor pain relief. Many of them will be completely satisfied, while there is also a portion of women who receive no benefits of the epidural. Here is what you need to know to have the best experience possible with an epidural:

1. Learn About Epidurals

Knowing what happens when you get an epidural will make you less fearful of the process. You should also know about the added monitoring of mom and baby so that this prospect does not frighten you when they bring it in. You will also learn how to use positions with an epidural to help your labor progress, like how to use a peanut ball. You can learn about epidurals in childbirth classes.

2. Be Realistic

Epidurals are not simply a medication that provides the same relief for everyone. Some women report feeling nothing in their legs, while other women have some sensation of the contractions but no pain. The epidural and how it works will be partially based on your body, your medications used and your anesthetist’s technique. There are also a small handful of women for whom the epidural doesn't work well.

3. Try to Relax

While getting the epidural, try to relax. If you are tense or fearful, it can make getting the epidural a more difficult experience for you and the anesthetist. Knowing about the process and who can stay with you when getting an epidural can help.

4. Know Your Hospital’s Policies

Every hospital has a slightly different policy about when you can get an epidural, what procedures need to be done before an epidural (IV fluids, blood work, etc.) and what needs to happen immediately after getting an epidural. Know what these are to prevent surprises in labor. You may also ask how having an epidural will change your postpartum care while at the hospital.

5. Use the Epidural Wisely

For a while, some women were trying to turn off the epidural in order to feel the pushing phase. Because of the disruption of the body’s endorphins to help prevent pain once the epidural is in place, turning it off removes all pain relief including that from the body, making it more painful for mom. This is not recommended. 

6. Know How to Push With an Epidural

The best practice for pushing with an epidural is called laboring down. This means that you won’t push, even when you are completely dilated until your baby is very low in your pelvis. This can help lower the cesarean rate and also saves you from maternal exhaustion. Let your body do the work, you can help at the end. Your doctor or nurse will advise you on when you should start pushing since you're not likely to feel an overwhelming urge. 

7. Epidurals Have Limits

While an epidural may take away your physical pain, some mothers find that they become more anxious after the pain is gone. You can still use the things you learned in class to ease this anxiety, like visualization and relaxation.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.