An epidural is a type of local anaesthetic, which means that it can be used to completely block pain while you are awake.
This has the advantage of allowing you to avoid the common side effects of general anaesthetic, such as feeling sick and dizzy.
Epidural anaesthesia can be used to numb sensation and provide pain relief in a number of situations including:
- during natural childbirth
- during a Caesarean section, where a baby is delivered through a cut that is made in the abdomen
- after surgery that has been carried out under general anaesthetic
- during other types of surgery, such as knee surgery, hip replacement surgery, rib or chest fractures and amputation of the lower limbs
Epidurals are most commonly associated with being used to reduce pain and discomfort during labour and childbirth. This topic focuses mainly on this use of epidural anaesthesia.
Labour and childbirth
Some women decide to have an epidural during labour and childbirth. Your midwife will be able to advise you about having an epidural and whether they think it is necessary. However, remember that the final decision will be yours.
An epidural is usually recommended to help relieve pain during:
- a particularly painful, complicated or prolonged labour
- the delivery of twins or triplets
- a Caesarean section delivery
- an assisted delivery – where the use of forceps is required
- a ventouse delivery – where a suction cap is attached to the baby’s head to help with the delivery
Read more about pain relief during labour.
Mobile epidurals
Mobile epidurals, also known as walking epidurals, are low-dose epidurals that are often used during labour. A small amount of local anaesthetic is used in combination with painkilling medication.
As your nerve sensations will not be completely blocked, a mobile epidural provides pain relief without as much of the numbness or heavy-legged feeling that is experienced during a full epidural.
Another advantage of having a walking epidural is that you will be able to feel the contractions and the need to push during the final stages of labour.
As you will still have some sensation in your legs, you will also be able to move around if you need to, although it is not always recommended.
When epidurals are not used
In some, rare cases, an epidural is not recommended. For example, it may not be suitable if you:
- are allergic to local anaesthetic
- you are taking medication to thin your blood, such as warfarin
- have a blood-clotting abnormality that increases your risk of developing a haematoma (a collection of blood within the tissue).
- have previously had back surgery, or you have other problems with your back
- have a spinal deformity or severe arthritis in your spine
- have a neurological condition that affects your nervous system, such as spina bifida
