How Many CM Do You Need to Be to Get An Epidural?

You’re hoping to get an epidural while you’re in labor — but how far “along” do you need to be to get one? Today I’m going to share the two MOST important things you need to get an epidural and how far along has proven to be the best!

This is part of my Complete Guide to Epidurals — so if you have more questions don’t miss that!

Before we get going — grab my labor pain management cheat guide:

What do you need to get an epidural?

There are two things you HAVE to have to get an epidural.

The first is a doctor’s order. Early on in my career many providers wouldn’t allow an epidural until a baby was a certain station in your pelvis or you were a certain # of centimeters before they would “allow” an epidural.

Pro Tip: This is a reminder that a nurse can’t actually do things that the provider doesn’t order. It’s just part of the hospital protocols. 🙂 Meaning, if they don’t order a diet we can’t provide you food — but that doesn’t mean anything about your own choices in labor. 🙂

This doesn’t tend to be the case anymore — but I think it’s always a good question to ask your provider — if they have any specific qualifications you’ll need in order to get it. You never know. 🙂

The other thing is that you need to actually be in labor.

Meaning, when I was miserable, still working before my second baby I wasn’t able to get an epidural even though I was walking around at 3 cm. I needed to actually be in labor.

And yes, when I was working, pregnant and 37+ weeks I’d sometimes get jealous of moms who were getting their epidural. I just really wanted to stop feeling the aches and pains below my bra line too. 😉 But I digress….

Understanding the epidural is important, and understanding how to mange your pain before/after the epidural can be important as well. That’s why I recommend this for everyone, so you can understand your options regardless of how labor happens for you.

It’s easy to think that only centimeters matter, because often that’s all your provider will tell you — but a vaginal exam includes a whole lot more. Sometimes how high/low baby is in your pelvis matters more.

If you have questions about exams and how all of that works I have a few articles for you:

• What do the Cervical Exam Numbers Mean?
• Signs Of Labor
• Signs You Are Dilating: Symptoms Of Cervical Dilation
• How To Induce Labor At 2 Cm Dilated?
• Can I Refuse Cervical Checks In Labor? Declining Cervix Exams In Pregnancy.

Ok, once both of those are in place — let’s talk about how many CM you need to be to get an epidural.

How Many CM Do You Need to Be to Get An Epidural?

Here’s the important part: Studies really show that once you’re into active labor you can get the epidural whenever you request it. Here’s the Cochrane Review most people refer to.

But the reality is they do want you to be in labor — meaning that your cervix is actively dilating. Meaning if we check you now, and then we check you an hour later things have changed. During early (or latent labor) sometimes you’re contracting but your cervix isn’t actually changing (or changing VERY slowly).

If you’re being induced things gets a bit trickier. Some providers will allow a very early epidural because we will continue to push the medications for the induction. I have a whole post on if you can get an epidural before they start the induction.

My Thought on When to Get an Epidural

As someone who’s helped thousands of patients get an epidural I have a few things I want to share about when to get an epidural:

Promote Movement Before the Epidural

Prior to the epidural I’m a HUGE fan of moving as much as possible. That can mean:

• Moving in the bed if you want/need to stay in the bed
• Moving around the bed if you need to stay by the monitors
• Using wireless (also called telemetry) monitors if available to allow more movement

I have labor movement cards available in The Online Prenatal Class for Couples that can help give you ideas. I think they’re a great resource in early labor.

BUT, your nurse is also a great resource. When we know how baby is presenting it can give us some ideas to help baby slide into the best position — so definitely ask them. Something along the lines of “Hey, any thoughts on positions that would be helpful for labor to progress?”

You’d think it would be normal for us to just suggest stuff like this, but so often patients just want to lay in bed. We’re never sure what to suggest or what you want — so ask us, and we’ll likely have some good ideas for you!

This is a good reminder to KEEP asking questions of your labor nurse. They’re a wealth of resources, but often only provide them if you’re interested — so stay interested!

And, now a reminder to:

Promote Movement AFTER the Epidural

So, once you get the epidural — movement is going to look different, but it still needs to happen!

That means using things like peanut balls or pillows to prop up your legs while you’re in bed, rotating frequently.

Again, ask your nurse best ways to move. This is also a good time for your partner to get involved. When you’re not asleep I always recommend trying to move about every 30 minutes. If your partner helps the nurse move you it’s WAY easier for the nurse to do it safely.

Sometimes if you have a heavy epidural it takes two of us to safely move you — so if one of those is your partner it’s a big win!

I am also a fan of a lighter epidural that helps you move a bit better. I talk about that in my post on the walking epidural.

Want more info on the epidural — check out these posts:

• Weird Side Effects From The Epidural That No One Talks About
• What To Do If You Can’t Decide If You Want An Epidural Or Not?
• Should You Get The Labor Epidural Before They Break Your Water?
• How Long Does It Take for the Labor Epidural Anesthesia to Wear Off?
• Do You Feel the Ring of Fire With an Epidural
• What Does Having an Epidural Feel Like?

My Best Tip on When To Get an Epidural

My best tip is to get it when you want it based on the pain right now. Don’t get it based on the fear of what pain will be in a while.

BUT if you’re heading into 6 cm I’d consider getting it soon if you’d like it. It’s hard to guess how labor is going to go past that point. It could be super fast, or super slow — so having the epidural in can be nice.

If you’d like more information on the epidural I go over ALL of in The Online Prenatal Class for Couples. I even have a video where I “put” an epidural in a Raggedy Ann doll, helping you know just what to expect.

It really is the easy way to get prepared for birth, and involves your partner so they can be a teammate with you!

Want to do a vibe check before diving into the whole thing with me? — check out my free labor pro tips. It’s your first step toward getting in the driver’s seat of your birth.