Labor & Delivery

Epidural During Labor: What to Expect

An epidural is the most widely used form of labor pain relief. About 70% of people giving birth in the US receive one. Understanding how it works and what to expect removes the fear factor.

How an Epidural Works

An epidural delivers local anesthetic and/or opioid medication into the epidural space — the space just outside the membrane surrounding the spinal cord. A catheter (thin flexible tube) is left in place so medication can be continuously delivered or topped up. You remain conscious and can usually move your legs somewhat.

The Placement Procedure

What happens when you get an epidural:

  • You sit on the edge of the bed or lie curled on your side
  • Your back is cleaned with antiseptic
  • A local anesthetic numbs the skin (the main sharp sensation)
  • A needle guides the catheter into the epidural space — this takes 5–10 minutes
  • You must stay very still during placement (hardest during a contraction)
  • Full effect is felt within 10–20 minutes
  • The catheter stays in — the needle is removed

Side Effects and Risks

Common side effects:

  • Low blood pressure (hypotension): Most common. Managed with IV fluids and position changes. Usually brief.
  • Itching: Caused by opioid component. Antihistamines can help.
  • Fever: Epidurals are associated with a slight increase in maternal fever, which then triggers newborn fever workup.
  • Difficulty urinating: A catheter is usually placed.
  • Limited mobility and sensation in legs
  • Rare (<1%): Spinal headache if needle punctures the dura. Treatable.
  • Very rare: Infection, nerve damage, inadequate coverage

Frequently Asked Questions

Is it too late to get an epidural?

You can typically get an epidural until it's time to push (or there's not enough time to place it). There's no cervical dilation cutoff. It takes about 15–20 minutes from request to taking effect.

Will the epidural affect my baby?

Epidurals have very little effect on baby compared to IV opioids. The medication primarily stays in the epidural space. Some studies show slight fetal heart rate changes, which are monitored.

Can I get an epidural if I have scoliosis or back tattoos?

Scoliosis can make placement more challenging but is rarely a contraindication. Back tattoos are generally not a problem — anesthesiologists use an untattooed area if possible or proceed through the tattoo if necessary.