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The truth about epidurals

Monica Beyer is a mom of four and has been writing professionally since 2000, when her first book, Baby Talk, was published. Her main area of interest is attachment parenting and all that goes with it, including breastfeeding, co-sleepin...

What are the real risks?

Epidurals are often hailed as the golden standard of childbirth pain relief, and generally go off without a hitch, but there are real risks involved. How likely is it that you will experience a side effect?
What are the real risks?

Epidural anesthesia is the most common childbirth pain relief requested in the United States — it is estimated that more than 50 percent of mothers laboring in hospitals have one administered. The anesthesiologist will go through the risks of the procedure and you will need to sign a release form (as long as you haven’t already received some narcotic pain relief), but do most moms really understand the risks involved?

Likelihood of risks

We asked Jaime Arruda, MD, assistant professor of Obstetrics & Gynecology at the University of Colorado about how likely it would be for a mother-to-be to experience a negative side effect from epidural administration — and her answer was very reassuring. “Very unlikely,” Dr. Arruda shared. “Most epidurals give excellent pain relief with few side effects. There is a small risk of a ‘spinal headache’ following epidural. Occasionally a mom's blood pressure may lower right after the epidural which could require some medications or IV fluids to correct.”

That said, there are several things that can go wrong, although permanent disability and death are extremely infrequent, it is still a very remote possibility. Here is a rundown of the most common side effects.

Blood pressure drop

Sometimes Mom’s blood pressure can plummet shortly after the epidural is administered, which is dealt with by increasing your fluids (this is one of the reasons you will have an IV already in place), administering medication or providing oxygen. Even though it's usually easily taken care of, the experience can be uncomfortable and sometimes scary.

Spinal headache

One mom we spoke with described the spinal headache that she experienced after her fourth child was born as “a special kind of hell that the name ‘spinal headache’ cannot possibly convey.” A spinal headache occurs when there is leakage of spinal fluid into the epidural space, and it creates a headache like no other, and one that is made worse by bright light and sitting upright.

A depressing way to start your baby’s life, most spinal headaches heal on their own but some moms have to go back to the hospital to have a blood patch administered to provide relief. Spinal headaches occur less than 1 percent of the time, but when they do happen, it can be really miserable.

Labor slowdown

Most practitioners will wait until your labor is well into the active stage and some hospitals even have a minimum dilation needed before an epidural is administered. Even when these thresholds are met, however, labor can sometimes slow down or even completely stop, which can lead to additional interventions such as augmentation with Pitocin or even a C-section.

Even with these potential risks, most moms who get an epidural feel that the benefits outweigh any potential problems. And as long as you know the risks beforehand, it can make any issues that arise easier to deal with if you know what to expect.

More on childbirth pain relief

Childbirth classes: Should you take one?
Pain relief in labor
How to manage labor pain naturally

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