Requesting an epidural is an important choice — and choosing it too early or too late can have consequences. When is too late to get an epidural? Can you request an epidural at 7 centimeters (cm)? Let’s find out.
First off — who am I, and why do I know this? Hi, I’m Hilary — The Pregnancy Nurse 👩⚕️. I have been a nurse since 1997 and I have 20 years of L&D nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. 🩺 I’ve given probably THOUSANDS of epidurals, and seen even more than that at this point — so I’m a good one to answer this question for you today.
Can I Get an Epidural at 7 Centimeters?
In general, yes. If you can get an epidural, you can likely get one at 7 cm. If it’s your first baby you still have more time to decide, but if it’s your second+ baby than you probably need to make a choice soon as you don’t have much longer before baby is born.
But, it’s a important question, and it can get a bit complicated — so let’s keep talking about it.
If you prefer to watch your content, I also have a video on when it might be too late to get your epidural:
What’s in This Article (click on an area to jump ahead)
What is an Epidural?
{not interested in this bit, skip to the next section by clicking here}
Modern medicine uses analgesia, often saved for the operating room (OR) to help women have a better childbirth experience, and is used very frequently in the United States in vaginal births. It is given by an anesthesiologist, not your regular health care provider (midwife or OB).
It is when medication is injected by an epidural needle into the epidural space. They also insert a small tube (called an epidural catheter) into that space It is called epidural anesthesia.
Before doing all of that they will put on some local anesthetics into your lower back so you only feel the pressure of the needle (similar to when they numb you at the dentist or for stitches).
Pro Tip: Worried about getting your epidural? In here I have a video that shows me putting in an epidural with a stuffed animal and some common household items that you might find helpful.
A lot of women worry that this will paralyze them as it is very close to the spinal cord, but the epidural needle is not in the spinal canal space and that risk is very minimal (but they should go through all the risks when the anesthesiologist places your epidural block).
The epidural analgesia that they inject (and then it flows through that tube they place in your back) will help numb your spinal nerves, so you don’t feel as much pain during labor.
This should last a long time and it very safe.
However, there is the largest risk of the epidural placement in pregnant women is a small amount of spinal fluid leaking, which can cause a severe headache (called a spinal headache). This can be fixed by anesthesia (and it is different from a regular headache). This happens in only very rare cases (and makes it so your positioning is important during the placement).
You might also be at an increased risk for low blood pressure as you relax from all the pain relief (which is why we will monitor your blood pressure frequently during labor). If this happens, the baby’s heart rate can drop as well (but again, we are monitoring it and we have a medications that can reverse this) and may require medical intervention. We also give a LOT of IV fluids prior to your epidural to try to make sure this doesn’t happen.
This can also be a perk for women experiencing high blood pressure during their third trimester (and that relaxation can be good for anyone with preeclampsia as well).
Other common side effects include drowsiness, and itching.
The epidural injection is mean to take away about 80% of the labor pain in your lower body (from about your rib cage down). The lower part of your body will also likely be difficult for you to move (and you can’t get out of bed).
Alternatives to the epidural would be IV pain medication, nitrous oxide (not in use at all US hospitals yet), local anesthetics or natural pain management.
The epidural is most often used for vaginal births, and spinal anesthesia is used for cesarean deliveries (I have a whole post on cesarean anesthesia). BUT the epidural can be used during an emergent cesarean to help provide adequate pain relief as well.
If you’re interested in more information on the epidural procedure << I have a whole post on that on my sister site.
If all this pain management talk is making you more nervous, grab my positive affirmations:
Why can’t you get an epidural late in labor?
There are a couple of reasons — You have to sit still for the epidural placement, and many women find that too difficult during transition, and also you won’t have time for the epidural to take effect before the baby comes out. But, let’s talk about both of those.
Sitting still for the epidural placement:
For much of the epidural process you can still move a bit, but during the time when the anesthesiologist is placing the needle between the coverings of your spinal column (called the dura) it is important that you not move as it is a very small spot that they’re working in to get it to work right. And, if you do move there is the possibility that they go into the spinal space which could lead to a spinal headache.
It is also REALLY hard to sit (at all) if the baby is actually coming (and yes, I’ve had this happen many times).
Giving the Epidural Time to Work
The epidural medicine (usually fentanyl and bupivacaine, but every doctor has their own mix) takes a bit to work on the nerves and numb those pain signals coming from your body. Unlike IV pain medicine, the epidural does not take effect immediately. Normally, this takes 10-20 minutes to set-up.
Also, if during this time your baby is coming down quickly into the birth canal, the epidural has a hard time “catching up” to all that pain. While you may feel a bit better with the epidural, you are still going to feel a lot of pressure. It’s always a bummer when this happens.
We do really want to have the epidural help you not feel the baby coming out.
Plus, the epidural does come with risks along with great pain management — so, making sure it’s WORTH the risk (especially if it will only be “in” for a few minutes) is something to discuss with your team.
Understanding how labor progresses will help you decide when to get your epidural. The Online Prenatal Class for Couples has a bonus videos on the stages of labor that your body will go through as your progress towards delivery. It also has information on natural pain management to help you cope prior to the epidural (or if you get it too late).
**Please keep in mind that some women with a previous back injury or are on blood thinners may NOT be able to get an epidural at all — so check with your healthcare provider about your specific circumstances.
Risks of Getting an Epidural Too Late
The main risk is that it just won’t have time to take effect as you’re being overwhelmed by giant waves of pain. This is why the stage of labour you’re in can be really important to know before you place the epidural to help you with the pain of contractions.
The other risk would be moving during the placement (as you are in so much pain) and that can have more serious consequences.
Those risks are enough that if the baby is too low or you can’t sit still, some anesthesiologists will refuse to give an epidural too late in your labor (but they should at least try).
So, is 7 cm too late to get an epidural?
I don’t think so, but there is something else to keep in mind — and that’s what # baby you’re on, plus how high the baby is in the birth canal. BTW, still not sure what all this talk of centimeters dilation and how high the baby is — check out my post on vaginal exams on my sister site.
But, let’s break it down into your first vaginal delivery baby (many moms may have had a cesarean for their first baby, so this would apply just to the first baby coming out their birth canal), and into subsequent vaginal deliveries
Epidural Window for your First Vaginal Delivery
First vaginal deliveries — 7 cm still gives you quite a lot of time to enjoy the benefits of the epidural. In general, you have another hour or two of dilating, plus 2’ish hours of pushing (on average).
So, not only will you get the relief while you’re letting baby move down into your pelvis, you’ll also have it during pushing.
One of the big benefits is that if you were to need an emergency c-section (more likely on your first time) they can dose-up the epidural for that procedure and keep you very comfortable (instead of taking the time to put in a spinal).
Epidural Window for your Second (or more) Vaginal Births
If it’s your 2nd (or more) baby you may not get a lot of pain relief from it, but there’s a good chance you’ll get quite a bit. 7-10 cm (when you can push) usually takes 1-2 hours, so you probably do have time — keeping in mind that’s the textbook case, your case could be different.
If your labor is going super fast (like, you went from 4 cm to 7 cm in less than an hour) — then, you may not have time.
But, either way at 7 cm that is sort of the time to “fish or cut bait” or to make up your mind if you want it or not.
Will your nurse help you get an epidural at 7 cm?
I would hope so, and they should. Honestly, at whatever point my patient requests an epidural, I try to make it happen. It does take about 30 minutes from when the patient requests it til’ anesthesia is in the room set up to put it in.
But even if you’re 9 cm and really asking for it, I try to make it happen. I think most nurses do.
If your nurses is being hesitant about it ask them why. But you should be able to get what you want, and I would encourage you to be insistent about it even if they are hesitant.
Even 10 centimeters, if you really want it and it is your first baby, they should make it happen. You’ll still have that pushing time to enjoy the pain relief with it.
How many cm dilated before you can’t get an epidural?
It is a good question — when is it too late to get an epidural?
Let me remind you that while centimeters matter, it really depends on:
- If you’ve previously had a baby come down your birth canal before
- How fast your labor is going
- How high/low the baby is in your pelvis (called “station”)
- If anesthesia is readily available
But, let’s talk about the rest of the centimeters, and if they affect if you can get an epidural:
Epidural Availability by Centimeter:
Keep in mind your epidural is available with doctor’s orders. SO, if your doctor says you can get it at any time, you CAN get it at any time!
The American College of Obstetricians & Gynecology (ACOG) says that they say a woman who asks for an epidural during labor should not be deprived of it (which makes me think it should be made available as soon as the patient is in labor — although, this isn’t always the best choice — as I’ll talk about below).
Also keep in mind that availability of an epidural can depend on the availability of an anesthesiologist. Sometimes there is a “line” of epidurals needing put in, or they are in the OR with surgery. So, if an epidural is on your mind be sure to talk with your labor nurse so they can figure out what’s up with anesthesia and can inform you if your window might close if they’re going into surgery.
Remember: Cervical dilation is where they measure how wide the opening of your cervix is, that is the end of your uterus as baby progresses into your vagina. Most often your nurse will want to check your cervix before administering an epidural.
Epidural in Early Labor
Can I get an epidural at 1 cm?
Most often this is too early to get an epidural. It would be better if you had your full movement to help your cervix open, but sometimes it is appropriate.
Although, this depends on many factors. However, if you’re being induced things are a bit different. I have a whole post on if you can get your epidural before your induction.
Can I get an epidural at 2 cm?
Similar to 1 cm, it is often too early to get it. Keep using movement/changes in your positioning to your benefit.
Remember you can’t get an epidural until you are in active labor (or are being induced). Most often that isn’t true until you’re a bit further into your dilation….
Can I get an epidural at 3 cm?
This is a bit more likely… Most doctors will order it at 3 cm (although many are OK with the patient getting it whenever they want as long as they’re in active labor).
Can I get an epidural at 4 cm?
Most often
Epidural During Active Labor
Can I get an epidural at 5 cm?
Yes, this is a great time to get it.
Can you get an epidural at 6 cm dilated?
Yes, most often — although if you’ve had a few babies, this is the part where your labor starts to speed up — so I’d get it soon.
Can I get an epidural at 8 cm?
If it’s your first baby, yes. If it’s your 2nd baby it is time to have a frank discussion with your healthcare team.
Can I get an epidural at 9 cm?
If its your first baby, you likely can — depending more on how low the baby is.
If it’s your second baby, you need to consider if it will be in long enough to make it worth it. Also, if you’re really going to be able to sit still for the placement.
Can I get an epidural at 10 cm?
If it’s your first baby, and baby isn’t low. Most often, yes.
If it’s your second baby — just push and you’ll have pain relief much faster that way.
This all being said — your body, your choice. Beyond your medical doctor’s orders, you can ask for what you want.
The other good news is that most people feel much better once they’re able to push against the pain. If you’ve already had a baby pushing time will hopefully not be long and you’ll be done with it!
When to get an Epidural FAQ’s
There are actually quite a lot of epidurals, but yes — those words are used synonymously.
It is probably better to wait to get an epidural until the baby has descended into the birth canal…
Yes, they most often numb the top skin layers of your back where they will put the epidural needle
This study shows there isn’t an increased risk of a cesarean section (although previous studies have shown there is). Most studies and doctors think that when you want an epidural (and if you’re in labor with your cervix dilating) you can get an epidural.
You need to be in labor to get an epidural, so in order to be sure that you are in labor we do need to see cervical change (or be initiating cervical change through induction or augmentation). People not in active labor may be better suited at home, and no one wants to send someone home who has gotten an epidural (although I have seen it, rarely).
The textbook case is an hour/centimeter (so, 3 hours) but most people do dilated that amount in less than two hours, but it really depends on your labor and how quickly the baby is moving into the birth canal.
Ok, now that we’ve gone over all this — NOW is the time to get in a prenatal class so I can explain all the things you really need to prepare for your birth. This birth class…
- Can be done in just a few hours
- Is priced to be budget-friendly
- Is taught by an experienced RN that you can trust.
Listen to what Makayla had to say about the class:
“This course was above and beyond. I have been around babies since I was young and have a good understanding but this course taught me so much more!”
Read more Online Prenatal Class for Couples reviews here.
And, if you’re not quite sure you’re ready for that whole thing, check out my free prenatal class. It’s your first step toward getting in the driver’s seat of your birth.
- About the Author
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A nurse since 1997, she has worked in various fields including pediatrics, geriatrics & hospice.
She has 20 years of labor and delivery experience in the San Jose, CA and Phoenix, AZ areas.
She is also the curly head behind the website Pulling Curls and is the creator of The Online Prenatal Class for Couples — the #1 hospital-based prenatal class on the internet.
Are Childbirth Classes Covered by Health Insurance? 
[…] ** FYI, most often pain relief isn’t offered during the pushign stage because IV pain medication might make the baby tired. You can sometimes still get an epidural at this point though. […]