Does Labor Still Hurt With an Epidural?

How much labor pain should you expect during labor when you have an epidural? Should you expect to be pain-free?

Before we get started — hi, I’m Hilary — The Pregnancy Nurse. I’ve been a nurse since 1997 and have worked in many fields including labor and delivery where I worked for 20 years. Today, I’m going to share some of the information I’ve learned in the thousands of epidurals I have taken care of!

Epidural Pain Relief

The epidural is a method of pain relief that goes into the epidural space of your back. It works from about your bra line to your knees.

Most often a tube is left in that can infuse the medication to allow for continuous pain management.

How does the epidural work?

Basically, an anesthesiologist puts medication in that numbs the nerves and takes away the pain.

If you want more info about it — the epidural medication is injected through the epidural needle into the lower back into a specific spot. called the dural sac that surrounds the spinal nerves. The medication numbs those nerves and makes it so that you don’t feel as much pain.

How much pain does the epidural take away?

The epidural CAN take away all of your pain. However, most anesthesiologists only aim to take about 80% of the pain.

That may sound unfair, but by allowing you to feel just 20%, it allows;

• Your body to have some feedback about the pain (which I think helps allow labor to progress)
• You to be able to move, or help the nurses move you — movement after an epidural is way important!
• Help you to feel when you’re supposed to push (and again have feedback for that situation as well)

As I said before, an epidural can be dosed up more for a cesarean section. But, for a good labor epidural — it should take away 80% of your pain.

If you’re interested in more information on pain management in labor, I recommend The Online Prenatal Class for Couples. It has a whole chapter on pain management where it discusses in detail all your options. It also has a bonus video on natural pain management if you’d prefer to try that. You’ll end up feeling confident about making the choices for pain in your labor!

What to do if you are uncomfortable during labor with an epidural?

Some epidurals have a “button” that can be pushed to allow for a “bolus” of epidural pain medication (that means it temporarily gives you a large dose). This does have a lock-out and maximum feature so you aren’t given too much.

If that isn’t available or isn’t working. Be sure to let your nurse know. You are paying a LOT of money for that epidural, and you deserve to have it attended to and pain relief given.

However, if medication doesn’t help there are only a few things the doctor can do:

1. Pull back the small tube (called an epidural catheter), in case there is a kink beneath the skin
2. Replace the epidural — they can slip out of the right spot

I actually have a whole post on what to do if your epidural isn’t working.

What you will feel during labor with the epidural

Most often the epidural takes away your labor pains in your belly/back area.

Often women feel a lot of pressure as the baby descends. The epidural can’t help all of that as pain receptors are different than pressure receptors. This is a good time to use some breathing to help your body relax into that pressure.

Are the Epidural risks or side effects?

As all medical procedures there are risks to an epidural:

• Spinal headache is the most frequent risk
• Back pain/bruising
• Other more severe, but VERY RARE complications your anesthesiologist will go over with you

Pro Tip: Remember they’re required to give ALL the risks, which often ends with “death” — but remember every time we turned on our oven or got in our car — that is one of the risks we take (we just know it is very small)

Common side effects of the epidural are:

• A decrease in blood pressure (we have medications we can give to fix this)
• Itching

Is the epidural my only option?

Keep in mind there ARE other pain management options in labor — I have a whole podcast on your pain management options.

But essentially you do have 3-4 options in labor:

1. IV pain medicine — this will take the edge off the pain
2. “natural” pain management — breathing, etc.
3. Epidural placement
4. Some hospitals have nitrous oxide which similarly takes the edge off the pain like the IV.

As I said above — in my Online Prenatal Class I talk about all of this more in depth. I also give other resources for you to learn more about specific topics, as well as couples questions to get your partner ready to be a team member (rather than just a cheerleader). Oh, and it starts at just $35!

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.