Epidural Side Effects After Birth

I talk a lot about what to expect with the epidural as you have it, and how to make the choice to get it, but today I want to talk about the AFTER effects of it. It’s important to know that the epidural involves some pretty strong drugs that can stay in your system for a bit. There’s also a lot of myths about what the epidural can do to you, so I’d like to clear those up too.

One of the hardest parts about the epidural is how tricky it can feel to get correct information about it in advance. In most places, you’re unable to speak with an anesthesiologist until you ask for it in the hospital. At that point you’re miserable and you just want it to take away the pain. This means you don’t listen very well and any info you DO get isn’t absorbed. Many people rely on social media rumor mills to fill in the gaps.

I hate that system. Quality information on epidurals is important. While this article will give you some good info, it’s important to get prepared for what an epidural might look like. I recommend this.

I also think it’s important to think about what you’d like for your birth ahead of time. I walk you through an easy way to do that right here:

Before we get into the effects, it’s important to know….

What happens to the Epidural After Baby is Born?

So, once we make sure baby is out and you’ve had any tearing repaired, we turn the epidural off.

Epidural Pro Tip: The epidural is normally put on a pump that injects medication very slowly during the duration of your labor. This allows you to have a good amount of pain relief as your labor progresses. If you want more info on epidurals in general << check out that post. Tons of good info here, but this article will focus on what happens AFTER baby is born.

At this point, the epidural is no longer infusing and the effects of the drugs start to wear-off.

At some point after baby is born when it’s convenient for you, we often take the epidural tubing out of your back. This is a lot of tape and it can feel a bit like a back wax. We make sure that the whole tube is intact and you’re good to go.

This doesn’t mean the drugs are out of your system though. They are still being processed in the epidural space for 1-3 hours after birth.

Ok, onto those side effects you might experience THEN:

Postpartum Epidural Side Effects

Hard to Move Legs

I think most people just think pain is taken away, but in order to do that, we also weaken those muscles while the drugs are taking effect.

This means you’ve got less movement while you’re in labor, but also as the drugs wear off after birth.

You should NOT be getting up to walk during labor (unless you have a walking epidural which I talk about here << but those are rare). You should also not get up to walk after baby is born for 1-2 hours.

When we do get you up to walk, your nurse will “test” your legs with you at the bedside for a bit.

For many people their legs will still not be as strong as feels safe, so we’ll use a device to wheel you into the restroom to help you pee and clean you up after baby is born.

For some people that numb feeling can last for quite a while. On my last baby I had one numb leg that remained pretty numb for about 12 hours after I had her. Honestly, I don’t think I process numbing agents very well. It’s similar when I have stitches — it takes a while to numb me, but once it is numb it takes a VERY long time for it to wear off.

Everyone’s different in how that process works. Just know that lack of movement and strength in your legs can be very normal and isn’t a sign that something went wrong with the procedure.

As a note, other effects of the epidural like shaking and itching can still also continue for a bit even after we turn it off. Check out my post about some of the weirder side effects of the epidural.

Want to know more about epidurals? — check out these posts:

• The Benefits of an Epidural No One Talks About
• Epidural Myths vs. Facts: What Social Media Gets Wrong About Labor Pain Relief
• Why People Get An Epidural Even When They’re Not Planning On It
• 3 Tips to Using Movement During Labor WITH an Epidural
• Do You Need a Birth Class if You Plan to Get an Epidural

Pro tip: To give you the cliff notes to that article I linked just above — Yes, I think every pregnant patient needs good information on both an epidural and natural pain management options. This class goes over both << it’s a winner!

Hard to Pee

So, after you have an epidural it can be difficult to pee.

It’s important to know that most patients will get a urinary catheter when they have an epidural.

Just having a catheter in can sometimes make peeing tricky after it is pulled out.

But, when you also add in the numbing of that area due to the meds (similar to how your legs can’t move) and it can sometimes be really tricky to pee after you have an epidural.

Now, it’s easy to think — well, if you can’t pee — just move on with your life. And I agree with that in most scenarios — but, after you have a baby it is really important that you not let your bladder fill up. It can prevent your uterus from properly cramping down to stop bleeding from where the placenta was attached to it.

So, postpartum peeing is important. If we note your bladder is filling, and you’re unable to pee we may use a quick catheter again just to get the urine out, and then give your body some time to let the medications wear off and you can try again in a bit.

As a note, the whole postpartum peeing thing is much more complicated than most people imagine. Just getting up and walking, in addition to taking care of a sore bottom is a lot. Honestly, most of postpartum is this way — again, preparation is key in that area as well. This class also includes 2 full chapters on life after baby (when most birth classes just stop).

Bruising/Pain at the Epidural Site

As with any time a needle punctures your skin, there can be bruising and pain at the site of insertion.

You’ll likely also notice this on your IV site (btw, you’ll NEED an IV to get an epidural — just FYI).

I noticed it most when I was in the shower and water would hit my epidural site or my IV site. It just feels bruised.

One of the biggest myths out there is that the epidural causes long-term back pain. And while I am sure there there are people who have had a complication, the studies show that those who had an epidural-free birth have just as much postpartum back pain as those who did get an epidural.

I have a whole post on if an epidural causes long term back pain that you might find helpful. It dives more into the studies.

The reality is that pregnancy, labor, birth, and postpartum is HARD on a woman’s back.

I believe the standard of care should be a visit to physical therapy for every woman postpartum. Currently, it is not — but you can always ask your provider for a referral.

AND, if you’re pregnant, and in a lot of pain I’d ask to start a relationship with a physical therapist now, so you’ll already have that after baby is born.

Want more postpartum tips? — check out these posts:

• First Poop After Delivery: Make it less-hard (literally)
• Your Guide to Your Postpartum Plan with Free Template
• Self Care During Postpartum & Pregnancy
• C-Section Recovery: Tips You’ll Need
• Postpartum Essentials for a Great Recovery

Breastfeeding

I’ve been hearing this a LOT lately — that the epidural effects breastfeeding after birth.

I actually hope to do a full post on what the studies say, but in my research, most studies show that it does not have an effect on it.

Here a few facts and the links to where you can learn more:

This article reviewed several studies. Showed there was no difference in fentanyl epidurals on breastfeeding (I hear that one a LOT), there may be some correlation in some other drugs they use, but they don’t demonstrate causation.

It’s really important to know that when we use pain management drugs in labor (like fentanyl) it is not going directly into your blood stream. It’s going into the epidural (or spinal in the case of a spinal) space. This makes it’s effects only happen on the nerves in those spaces vs systemic like I were to put it in your IV. While a very small amount does get into the blood stream it is NOT anything like when we give it as an IV pain medication. I can testify to this after seeing thousands of epidural and seeing hundreds of patients get the same drug IV — the effects are very different.

Evidence Based Birth has an article on breastfeeding and epidurals. They said that they encouraged lactation support especially in patients who’ve had an epidural. They also had some outdated guidance like no pacifiers or formula in the room (I’m a big believer in patient choice rather than just restricting things). Personally, I believe every patient deserves a lot of lactation support after birth.

This article showed that people who had an epidural had lower milk supply. Honestly guys — I don’t get this one at all. It really makes no sense. It also studied synthetic oxytocin (Pitocin)…. which is beyond just an epidural. I dunno on this one, didn’t give me the vibes that I would trust this one. I also asked several qualified lactation consultants to see if they saw supply issues more in those with an epidural, and they did not. So, take that all for what it’s worth.

As we often see in these studies the data is mixed. I think it’s important to know this type of data to make the best choice for you when the time is right. And, also know that if breastfeeding is important to you, that you should have some lactation help postpartum. I always think a post hospital discharge appointment with a lactation consultant (usually an IBCLC) is best (and often covered by insurance).

This site reviews a study in which they compared different medications and dosages of fentanyl to breastfeeding rates (they did women who’d previously breastfed and hoped to breastfeed again). They did see a small decrease in breastfeeding with larger doses of fentanyl in the epidural, but otherwise didn’t see a difference in rates. They also concluded that fentanyl in the epidural did NOT make baby extra sleepy and unable to feed in the first hours after birth.

This study showed there was no effect from epidurals on breastfeeding.

A few thoughts I had in reviewing these:

1. Try to use the lowest dose of epidural that gives you the pain relief you need. I talk more about this in my post on the walking epidural or my video on customizing your epidural.
2. Plan to ask for lactation help as soon as you can after birth. Their support can help your breastfeeding journey. Plan to also make an appointment after you leave the hospital too to make sure things are going well.
3. Breastfeeding is wildly complicated to study (and often people’s own thoughts and values enter these studies too much).

People who get an epidural (as most aren’t planned) often have:

• More complications
• An induction due to those complications
• Longer births

And all of that may decrease breastfeeding rates in general. There’s just a lot of confounding factors.

As I said at the beginning. Epidurals are complicated, not a lot of education is given in advance because your OB or Midwife does not do the epidural, and anesthesiologists won’t do consults ahead of time (annoyig).

So, getting prepared for what an epidural really does, how it can work for you and how to make the best choice in advance is key to making your labor the best it can be.

I recommend this to do just that. I think you’ll love it (in fact, it’s guaranteed).

What did you learn about epidurals? Tell us in the comments!