Your Complete Guide to Epidurals During Labor: What You Really Need to Know

By Emily Ramirez, Parenting and Pregnancy Writer, Mom of Two

If you're pregnant, you've probably already heard strong opinions about epidurals, whether it's from your sister who swears by them to your yoga instructor who avoided one entirely. An estimated 70-75% of women giving birth in the United States choose epidural pain relief, making it the most common form of medication-based pain management during labor. But popularity doesn't make the decision any easier.

After experiencing two completely different epidural births myself – one textbook perfect, one not so much – I've learned that making this choice requires understanding both the medical facts and your own needs. Here's what you actually need to know.

What Is an Epidural, Really?

An epidural delivers pain-relieving medication into the epidural space in your lower back through a carefully placed needle and catheter. Think of it as creating a band of numbness from your belly button to your upper legs, allowing you to stay awake and present during labor without feeling the pain of contractions.

The medication cocktail, determined by an anesthesiologist, typically combines a numbing agent like lidocaine with an opioid such as fentanyl or sufentanil. This combination provides both immediate pain control and longer-lasting relief.

Two Main Types: Standard and Low-Dose

Standard Epidural: An anesthesiologist inserts a catheter that stays in place throughout labor, delivering medication continuously or as needed through a pump. You'll be in bed with limited mobility and little to no feeling in your lower half. For some women, this complete pain relief is exactly what they want. For others, the lack of sensation and movement feels unsettling.

"Walking" or Low-Dose Epidural (Combined Spinal-Epidural): This option delivers medication into a different area (the intrathecal space) with a finite timeline, allowing more sensation and potentially more movement. The term "walking" can be misleading – not all women who receive this type can actually walk around. A catheter is still placed in case you need additional medication later.

Both types are typically administered when you're 4-5cm dilated and in active labor.

Does Getting an Epidural Hurt?

Honestly? It varies. The area is numbed first with a local anesthetic (using needles), and women report experiences ranging from feeling virtually nothing to describing it as "10 bee stings." The challenging part is often holding still during strong contractions while the epidural is placed, but hospital staff are experienced at guiding you through it.

Pain relief should begin about 15 minutes after receiving the epidural, which takes about 10 minutes to administer.

The Real Benefits of Epidurals

Beyond the obvious benefit of pain-free labor, epidurals offer several advantages that might surprise you:

When You're Exhausted: Labor can last hours or even days. Getting pain relief allows your body to rest and recharge before you need to push, which can make all the difference in having energy when it matters most.

Stress Relief: Pain creates stress, and stress can stall labor. Removing pain from an already intense experience can help you focus and even enjoy aspects of your birth experience you might otherwise miss.

Staying Present: An epidural can provide pain relief without making you drowsy or "out of it." You remain awake, alert, and able to participate actively in your labor and delivery.

Backup Plan for Complications: If your labor requires unexpected interventions or a cesarean section, you can likely stay awake for the procedure rather than needing general anesthesia. This also provides immediate access to post-surgical pain relief.

New Research on Maternal Health: A 2024 Scottish study analyzing over 567,000 births found that epidurals were associated with a 35% reduction in severe maternal morbidity during birth and in the first six weeks postpartum. The benefits were even greater for those who delivered prematurely, showing a 47% reduction in serious complications.

The Risks You Should Know About

Every medical intervention comes with potential downsides. Here's what the research shows:

Common Side Effects:

Low blood pressure occurs in about 13 out of 100 women, which can lead to dizziness or nausea
Fever develops in about 15 out of 100 women with epidurals, compared to 6 out of 100 without
About 18 out of 100 women have difficulty urinating and may need a catheter
Itching affects about 3 out of 100 women

Labor Progression: The relationship between epidurals and labor length is complex. Research shows epidurals can increase labor by about 32 minutes in the first stage and 15 minutes in the second stage. However, some women report labor progressing faster once they're able to relax, so individual experiences vary significantly.

Modern Research on Delivery Method: Older studies showed increased rates of forceps or vacuum-assisted deliveries with epidurals, but when researchers looked only at studies from 2005 onward, this increased risk disappeared. Modern techniques using lower doses and patient-controlled delivery have reduced many side effects that were common in the past.

Rare But Serious Complications:

Severe headache from spinal fluid leakage (affects about 1 in 100 women)
Temporary or permanent nerve damage (extremely rare: 1 in 4,000 to 1 in 200,000)
Breathing difficulties (very rare)

For Your Baby: Medications do cross the placenta to your baby, but in much smaller amounts than if you received pain medication through an IV. Epidurals aren't associated with any known special risks or long-term negative effects for the child.

My Personal Experience: Why I'd Still Choose an Epidural

With my first baby, my epidural was perfection. I went from screaming through contractions to having a calm, present birth experience where I could actually focus on meeting my daughter. I pushed effectively, felt the pressure without the pain, and emerged from labor feeling empowered rather than traumatized.

My second epidural didn't work as well. One side numbed completely while the other side barely felt relief. After trying adjustments and repositioning, we made it work, but it wasn't the smooth experience I'd hoped for.

Despite that second experience, knowing my own panic response to pain, I'd probably still opt for an epidural if I had another baby. But that's me. Your pain tolerance, mental state, birth history, and what feels right for your body are different.

Making Your Decision

There's no wrong choice here. Some questions to consider:

How do you typically respond to pain?
What does a positive birth experience look like to you?
How do you feel about medical interventions in general?
Do you have any medical conditions that might benefit from or contraindicate an epidural?
What are your backup plans if labor doesn't go as expected?

Talk with your healthcare provider about your specific situation. Ask your anesthesiologist about their experience and success rates. And remember, you can change your mind during labor. Starting without an epidural doesn't mean you can't get one later if you need it (although there is a bit of a point of no return if the baby is crowning or delivery is imminent)

The Bottom Line

Epidurals are effective, relatively safe, and can make labor a more manageable experience for many women. Recent research suggests they may even reduce serious maternal complications. But they come with side effects and risks that deserve consideration.

Whatever you decide, know that choosing pain relief doesn't make you weak, and choosing an unmedicated birth doesn't make you superior. The best birth is the one where you feel supported, informed, and respected, whether that includes an epidural or not.

About the Author: Emily Ramirez is a parenting and pregnancy writer and mom of two. She's experienced both types of epidurals firsthand and believes every woman deserves accurate information to make the birth choices that are right for her.

Last updated: January 2026