Should You Get An Epidural During Childbirth? The Honest Truth

When you picture giving birth, what comes to mind? For many moms-to-be, one of the biggest decisions surrounding labor is whether or not to get an epidural during childbirth. It’s one of the most common pain relief options, but is it the right choice for you?

You’ve probably heard mixed opinions. Some say epidurals are a game-changer, allowing them to experience labor with minimal discomfort. Others worry about the potential downsides, like longer labor or increased interventions. With so much information out there, making a decision can feel overwhelming.

Here’s the truth: There is no right or wrong answer. The choice to get an epidural in labor is highly personal, and what works for one mom might not be the best option for another. That’s why I’m breaking down everything you need to know—the pros, the cons, the myths, and, most importantly, the ultimate decision-making factor that will help you determine if an epidural is right for you in the moment.

By the end of this post, you’ll have clarity and confidence about whether an epidural aligns with your birth plan. Let’s dive in!

Wondering who I am and why I'm giving advice? I'm a mom of three and a labor and delivery nurse. I've assisted in thousands of births and helped countless women on their journey to an empowered motherhood journey. I want to bring my knowledge and genuine mom advice to you. I'm so glad you're here. If you're looking for someone to talk to or lean on in this new mom life, I'm your girl.

Please note: The views on this website are personal opinions only and do not represent the opinions or policies of any provider or institution that I am affiliated with. I am not giving medical advice. Information on this website is not intended to diagnose, or treat any form of any disease. This article is for informational and entertainment purposes only. I am only telling you what my experiences are. Please refer to my Disclaimer Page for more information.

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What is an Epidural?

If you're considering an epidural during childbirth, it's important to understand exactly what it is and how it works. An epidural is a type of regional anesthesia that blocks pain in a specific area of the body—in this case, the lower half. It is the most commonly used pain relief method in labor and is considered generally safe and effective when administered correctly.

How Does an Epidural Work?

An epidural involves delivering medication directly into the epidural space of your spine, which numbs the nerves responsible for pain. Here’s a simple breakdown of what happens during the procedure:

Positioning: You’ll either sit up or lie on your side while an anesthesiologist prepares your lower back.
Numbing Injection: A small needle is used to inject local anesthesia into your lower back to numb the area before the epidural is placed.
Epidural Placement: A thin catheter is inserted into the epidural space using a larger epidural needle. The needle is removed once the catheter is threaded through into the correct place. The catheter is the only thing that stays in place to deliver medication as needed.
Pain Relief Begins: The medication starts working within 10-20 minutes, gradually numbing the lower half of your body. You may still feel pressure but significantly less pain than you would without an epidural.
Ongoing Pain Management: The dosage can be adjusted throughout labor to keep you comfortable.
The epidural doesn't run out: The epidural placement stays in place until your labor and delivery nurse or anesthesia provider takes it out of your back. The medication is continuously dripped into the epidural space until the medication is stopped. This medication never runs out and you can theoretically have your epidural working for days.

What Medications Are Used in an Epidural?

An epidural typically contains a combination of local anesthetics (such as bupivacaine or lidocaine) and opioids (such as fentanyl). This mix allows for effective pain relief while keeping you alert and able to push when the time comes.

When Can You Get an Epidural?

Many moms wonder if there’s a perfect time to get an epidural in labor. The truth is, it depends on your labor progression and hospital policies. Some hospitals have restrictions, while others allow epidurals to be administered at almost any point. However, most providers recommend getting one when labor is well established (typically at least 4-5 cm dilated).

If you wait until too late in labor (e.g., 9-10 cm dilated), your provider may advise against it, as it takes time for the epidural to take effect, and you may be close to pushing.

Epidural Pros and Cons

Deciding whether to get an epidural during childbirth is a personal choice, and like any medical intervention, it comes with both benefits and drawbacks. To help you make an informed decision, let’s break down the epidural pros and cons so you can weigh them against your birth preferences and comfort level.

Pros of Getting an Epidural

An epidural is the most commonly used form of pain relief in labor for a reason—it provides significant pain relief while allowing moms to stay alert and engaged in their birth experience. Here’s why many women choose an epidural in labor:

✅ Highly Effective Pain Relief

Epidurals are considered the gold standard for pain management in labor, significantly reducing or even eliminating contraction pain.
Unlike IV pain medications, an epidural allows you to remain fully conscious and aware while experiencing near-total relief.

✅ Allows You to Rest and Conserve Energy

Labor can be exhausting, especially if it’s long. An epidural can help you relax and even sleep, giving your body the chance to rest before pushing.
For those experiencing a long or drawn-out labor, an epidural can be a game-changer in preventing fatigue and burnout.

✅ Can Help Lower Stress and Blood Pressure

The pain of labor can sometimes cause stress and anxiety, leading to higher blood pressure and increased adrenaline.
An epidural can help keep your body calm and relaxed, potentially reducing stress-related labor complications.

Cons of Getting an Epidural

While epidurals offer excellent pain relief, they do come with potential downsides. Here are some of the most common concerns:

⚠️ May Slow Down Labor

Some studies suggest that an epidural can lengthen the second stage of labor (the pushing phase), though this varies for each person.
Because an epidural numbs the lower body, it can reduce the urge to push, which might require additional guidance from your provider.

⚠️ Temporary Loss of Movement and Sensation

Once an epidural is in place, you’ll need to stay in bed since you won’t be able to walk. Even simple position changes in bed can be difficult or sometimes impossible with an epidural.

⚠️ Potential Side Effects

While most women tolerate epidurals well, there are a few potential side effects to be aware of:

Low blood pressure – Epidurals can sometimes cause a drop in blood pressure, leading to dizziness or nausea, fetal intolerance of labor, or fetal bradycardia that can lead to an emergent C-Section.
Spinal headache – A rare but intense headache can occur if the epidural needle accidentally punctures the spinal fluid sac. This headache can be debilitating, making it difficult or impossible for you to care for your new baby until it's treated with something called a “blood patch”.
Shivering or fever – Some women experience shivering or a slight fever after receiving an epidural.

⚠️ Increased Chance of Additional Interventions

Not only does an epidural lead to automatic interventions that are required when you agree to receive an epidural – such as IV fluids, a Foley Catheter, and a restricted diet; it may also increase the likelihood of needing Pitocin (to strengthen contractions), AROM to reverse a stalled labor or an assisted delivery (vacuum or forceps).

⚠️ It’s Not Guaranteed Pain Relief

An epidural takes 10-20 minutes to take effect after placement. If you wait until you’re too far along in labor, there might not be enough time to get one.
Sometimes an epidural does not work the way it's expected to. Many women still feel immense pressure that is interpreted as pain, significant back pain if the epidural doesn't cover back labor, the ring of fire if the epidural isn't covering the pain of transition and pushing, or even one-sided relief where you feel all of your labor pain on one side of your body while the other side is numb.

Myths and Misconceptions About Epidurals

There are many misconceptions surrounding epidurals, and you’ve probably heard mixed advice from friends, family, or even social media. Let’s separate fact from fiction so you can make an informed choice about an epidural during childbirth.

Myth #1: Epidurals Always Slow Labor

🛑 Fact: While some studies suggest that an epidural may slightly prolong labor, modern epidurals are designed to provide pain relief without completely numbing your ability to push. Many women still have smooth and efficient labors with an epidural.

In fact, for some moms, pain-induced stress and tension can actually slow labor down—so getting an epidural might help their body relax and progress more efficiently if they're feeling very tense and unable to let go.

Myth #2: You Can’t Get an Epidural if You’re Too Dilated

🛑 Fact: While some hospitals recommend getting an epidural before you’re too far along, there isn’t a universal cutoff. Some women receive an epidural as late as 9 cm dilated and still experience relief before pushing.

However, if you’re fully dilated (10 cm) and ready to push, an epidural will not be recommended since it takes 10-20 minutes to take effect and you'll probably need to sit up in a still position to get it (which is extremely hard to do when 10 cms dilated).

Myth #3: Epidurals Completely Eliminate Pain

🛑 Fact: Epidurals are usually effective, but they don’t always make you 100% pain-free. Many women still feel pressure and pain sensations, especially during intense contractions and pushing. The goal is to reduce pain, not erase all feeling—which actually helps with effective pushing.

Some women may also experience a “window” of pain relief, where certain areas don’t get relief.

Myth #4: If You Get an Epidural, You'll be able to relax through your entire labor

🛑 Fact: Epidurals are designed to numb pain. They don't actually do anything for your labor. Even if the epidural works as it should by taking away most of your pain, there is so much more to labor than just contraction pain. You will still have to participate in your birth by making tough decisions, dealing with the discomfort of being stuck in bed for long periods of time, not being able to move your own body, the possibility of your labor stalling, you becoming exhausted, overwhelmed and defeated, the fear of whether or not baby is ok, etc.

Many of those things can come up in any labor regardless of what pain management methods you choose. They are not necessarily unique to epidural users. But the point here is that getting an epidural takes away a piece of the hard parts of labor. It doesn't take away labor.

What to Expect If You Choose an Epidural

If you decide to get an epidural during childbirth, it helps to know exactly what to expect so there are no surprises. While every labor is different, here’s a step-by-step guide to the process.

Before Getting an Epidural

Your healthcare provider will assess your labor progress and discuss any medical considerations before proceeding.
You’ll likely receive IV fluids beforehand, as epidurals can sometimes lower blood pressure.
The anesthesiologist will explain the procedure and possibly have you sign a consent form.

The Epidural Procedure: Step by Step

1️⃣ Positioning: You’ll sit on the edge of the bed or lie on your side while curling forward. This helps expose your spine for precise placement.

2️⃣ Numbing Injection: A small amount of local anesthetic is injected into your lower back to numb the area before the epidural catheter is placed.

3️⃣ Catheter Placement: A thin, flexible catheter is inserted into the epidural space (outside the spinal cord). The catheter stays in place while the needle is removed.

4️⃣ Medication Administration: Pain relief medication flows through the catheter, and you’ll start feeling relief within 10-20 minutes. The dosage can be adjusted throughout labor as needed.

5️⃣ Pain Relief Begins: Your lower body will start feeling warm, heavy, or numb, but you should still be able to move your legs slightly and feel pressure.

What Happens After the Epidural Is In?

✅ You’ll stay in bed since your legs may feel weak or numb.

✅ You still might feel pressure during contractions, which helps with pushing.

✅ A nurse will monitor your blood pressure frequently, as epidurals can cause a temporary drop.

✅ Your baby’s heart rate will also be closely monitored to ensure they are handling labor and your vital sign changes well.

✅ The epidural catheter will remain in place until after birth and will be removed once you no longer need pain relief.

How Long Does an Epidural Last?

The effects of an epidural in labor typically last as long as medication continues to be administered through the catheter. Once it’s stopped, the numbing effect wears off within 1-2 hours.

What If the Epidural Doesn’t Work?

Some women experience patchy pain relief or a “hot spot” where one area is not fully numb. If this happens:

Your anesthesiologist may adjust the dosage, reposition the catheter, or start over and try to place it again.
If nothing is working to get your epidural to relieve your pain, the anesthesia provider may be able to give you “top-offs” occasionally to bring your pain down again once it creeps up. In this case, your pain relief will come in waves rather than consistent numbness.
In the case where nothing is working for your pain, you may be left to manage pain with other methods other than an epidural such as your natural pain coping strategies that you learned prior to labor starting.

Alternatives to an Epidural in Labor

If you’re on the fence about getting an epidural during childbirth or simply want to explore all your pain management options, there are several alternatives to consider. Whether you prefer a medication-free birth or want pain relief without an epidural, here are some effective ways to manage labor pain.

Non-Medicated Pain Relief Options

🔹 Breathing Techniques & Relaxation

Deep breathing (such as the “slow breathing” technique in Lamaze) can help you manage contractions by keeping your body relaxed and oxygenated.
Guided meditation or hypnobirthing techniques can shift your focus away from pain and toward calmness and control.

🔹 Movement & Positioning

Walking, swaying, or using a birthing ball can ease contraction discomfort and encourage your baby to descend.
Side-lying, hands-and-knees, and upright positions can help reduce pain and make labor more efficient.

🔹 Hydrotherapy (Laboring in Water)

Many women find warm water immersion (in a birth pool or tub) soothing, as it relaxes muscles and reduces pressure.
Even a warm shower on the lower back can provide relief.

🔹 Counterpressure & Massage

Applying firm pressure to the lower back (especially helpful for back labor) can ease pain.
A support person, doula, or nurse can use massage techniques to release tension between contractions.

🔹 TENS Machine (Transcutaneous Electrical Nerve Stimulation)

A TENS unit sends mild electrical pulses through adhesive pads on your back, helping to interrupt pain signals and reduce discomfort.
It’s drug-free and can be used throughout labor, but availability varies by hospital or birth setting.

If you're interested in an unmedicated birth, I encourage you to download the Enjoy Your Birth Ebook for free and consider investing in the Unmedicated Birth Playbook to truly prepare for the birth that you want.

Medication-Based Pain Relief Options

💉 Nitrous Oxide (“Laughing Gas”)

A safe, inhaled gas that helps take the edge off pain and promote relaxation.
You control when to breathe it in during contractions.
Doesn’t eliminate pain completely but can make it more manageable.

💉 IV Pain Medications (Opioids like Fentanyl or Stadol)

Intravenous (IV) pain medications can provide temporary relief but may cause drowsiness or nausea.
Unlike an epidural, they do not numb pain but instead help you tolerate contractions better.
Can cross the placenta and may affect the baby’s alertness at birth.

💉 Local Anesthesia (Pudendal Block)

If you choose to labor without an epidural but still want some pain relief during delivery, a pudendal block can numb the vaginal area before pushing.
It’s injected into the birth canal region and does not relieve contraction pain, but it can help with the burning sensation of crowning.

How Do These Compare to an Epidural?

Pain Relief Option	Effectiveness	Mobility	Side Effects
Epidural	Numbs lower body	No movement	Potential drop in BP, longer labor
Nitrous Oxide	Mild relief, helps with anxiety	Full mobility	Can cause dizziness or nausea
IV Pain Meds	Moderate pain relief, temporary	Full mobility	May cause drowsiness, affects baby
Hydrotherapy	Natural relief, soothing	Full mobility	No medical risks
Counterpressure/Massage	Reduces pain naturally	Full mobility	No medical risks
TENS Machine	Helps block pain signals	Full mobility	Needs to be removed before delivery

The Ultimate Decision-Maker: My #1 Tip for Choosing an Epidural

After weighing the epidural pros and cons, learning about alternatives, and considering all the information, you might still be wondering:

How do I know if an epidural is the right choice for me?

Here’s my #1 tip for making that decision in the moment:

Pain Does Not Equal Suffering

Labor is intense, and yes, it can be painful—but pain and suffering are not the same thing. You can experience pain without suffering – like when you choose an unmedicated birth, plan for it, and have a labor toolbelt full of tools and strategies that you can use to keep you relaxed and confident. But if you feel like you're truly suffering, an epidural may be the right choice for you.

How Do You Know If You're Suffering in Labor?

Ask yourself these questions during labor:

✅ Am I able to cope with the pain, or do I feel completely overwhelmed and hopeless?

✅ Am I still in control, or do I feel panicked and helpless?

✅ Is my pain manageable, or am I exhausted, discouraged, and emotionally drained?

✅ Do I feel safe and supported, or am I struggling to keep going?

✅ Do I dread each next contraction before it comes, or am I relaxed and confident between contractions?

If you feel in control, focused, and empowered, you may don't need an epidural. However, if you feel like you are drowning in pain, unable to rest, or mentally breaking down, an epidural might be the best way to regain your strength and feel safe in your birth experience.

There’s No Right or Wrong Choice

Some women plan to birth without an epidural and find that their pain is manageable and empowering. Others plan for an unmedicated birth but find that labor is longer, harder, or more exhausting than expected.

💡 The most important thing? Your birth should feel like a positive experience, not one of suffering.

If an epidural allows you to feel present, calm, and in control, it’s a great choice. If you feel confident riding the waves of labor without one, that’s great too!

When deciding whether to get an epidural during childbirth, don’t focus on pain alone—focus on whether you feel like you’re suffering. If you’re in pain but still coping well, you may not need an epidural. But if you’re feeling overwhelmed, exhausted, or unable to manage, an epidural could be the best way to help you through labor. Your comfort and well-being matter.

Final Thoughts: Should You Get an Epidural?

At the end of the day, the best birth experience is one where you feel supported, informed, and in control. There’s no universal right or wrong choice when it comes to an epidural during childbirth—only the choice that feels right for you.

The key is knowing that you have options and making a decision based on what feels best for your body, your birth, and your unique experience in the moment.

Want More Support in Preparing for Birth?

Understanding your options is the best way to step into labor with confidence instead of fear. That’s why I created the “Enjoy Your Birth” eBook, a free guide designed to help you:

✅ Learn how to mentally and physically prepare for labor

✅ Explore pain management techniques (with and without an epidural!)

✅ Build a birth plan that aligns with your goals

✅ Feel empowered and in control of your birth experience

What Do You Think?

Are you planning to get an epidural in labor, or are you considering going unmedicated? Let me know your thoughts and experiences in the comments—I’d love to hear from you! 💬👇