Forget about eye-crossing contractions that take your breath away — or the fact that you somehow have to deliver your darling baby from the depths of your womb out into the world. Nope, what makes many moms-to-be anxious is that epidural needle that you might ask for during active labor. But if you’re nervous about it, this is why your epidural needle won’t hurt — for real.
Throughout your pregnancy, you’ve been poked, pinched, pricked, and prodded during routine medical exams and check-ups. So you would think that yet another needle would be nothing to even think twice about. Chalk it up to the location of the injection (it’s a needle going into your back, after all), and the circumstances in which it’s delivered (you’re more than likely to be in plenty of pain if you’re asking for it), and it’s understandable why the epidural can sometimes get a bad rap. But if you opt to get an epidural, you’re far from being alone. It’s estimated that more than 60% of women get an epidural, spinal, (or a spinal-epidural anesthesia) for labor, the American Society of Anesthesiologists reported. And here’s the reason why: it works. “An epidural is a pain management option, and the numbing takes away the sensation of pain during labor,” OB/GYN Dr. Kiarra King, MD, FACOG, explains to Romper in a phone interview.
So if you’re still worried about it, your epidural needle won’t hurt… and here’s why.
Here’s How An Epidural Works
“Prior to an epidural, you’ll speak with the anesthesiologist and they’ll go over the risks and benefits,” says Dr. King. “You’ll also talk about alternatives that you might have for pain control during labor.” An epidural block (or just “an epidural”) is the most common type of pain relief used for childbirth in the U.S., according to the American College of Obstetricians & Gynecologists (ACOG). In an epidural block, a combination of analgesic and anesthetic medications is given through a tube placed in the lower back. There’ll be some loss of feeling in the lower body, but you’ll remain alert and awake throughout the birth.
Can You Feel The Epidural?
Yes…and no. Although the epidural provides pain management, it’s not a completely painless procedure. Before the real-deal needle goes in, there’s a smaller one that is used to numb the area, Dr. King explains. “The anesthesiologist will place numbing medication before they insert the epidural or spinal needle,” she says. “You can feel it, but it’s not super painful.” (Dr. King likens it to the pinch you’d feel prior to a dental procedure.) And of course, there’s the pressure of when the epidural is actually inserted. “Because the anesthesiologist is pressing on your back, you will feel pressure; it’s not like the epidural takes away the feeling of touch or pressure — it just numbs you and takes away the sensation of pain.”
"The worst part is an injection of lidocaine in the back, which numbs the area, which will burn for 10 to 15 seconds, then go away," Dr. James Lozada, an anesthesiologist at the Northwestern University Feinberg School of Medicine, told SheKnows.
This Is How Long The Epidural Procedure Takes
Overall, the epidural procedure shouldn’t take too long. In fact, the whole process should only take about 20 to 30 minutes, and can apparently be given at any point during labor, though many hospitals traditionally wait to administer an epidural until a woman is at least four centimeters dilated for fear of stalling labor. Depending on when it's administered, Lozada said, an epidural can actually shorten labor (though it can also add an average of 20 minutes, too).
Generally, the process goes like this: You're told to either lie down on your left side or sit up with your back arched, and you're instructed to remain very, very still. Your lower back is swabbed with antiseptic, and a small area is numbed with local anesthetic. A needle is inserted into the anesthetized area, then a small catheter is threaded through the needle into the epidural space, after which the needle is removed and the catheter is left in its place. Then the catheter is taped to your back, where it remains until you don't need the meds anymore.
Once your epidural begins working, you’ll know it. You might see contractions come and go on the electronic fetal monitor — and you may not feel anything at all. Good stuff, right? “Once they place the epidural, the anesthesiologist may ask you if you are feeling pressure on your left or your right,” advises Dr. Vonne Jones, MD, FACOG, an OB/GYN. “You'll still feel pressure, but you shouldn't feel any pain from the epidural.”
Your Partner Might Be Asked To Leave The Room During The Epidural
Sure, they might be feeding you ice chips and holding your hand, but when the time comes to get the epidural, your partner will probably need to leave for a while, says Dr. Jones. “The anesthesiologist will usually ask the patient’s partner to leave the room during the procedure for general risk of infection and different things like that,” explains Dr. Jones. “Because of this, a lot of women get concerned because they think they’re going to be in a room by themselves with the anesthesiologist. That's actually not the case most of the time, since generally patients may have two nurses in the room with them, especially if they have a lot of anxiety. And as long as you know what's going on and what to anticipate, then you can be part of everything and ask questions.”
So… Just How Long Is That Epidural Needle, Anyway?
If you’re up in the middle of the night obsessing over the epidural, you might start searching to see how long the needle is. Don’t. Just don’t. “If you get fixated on how long it is, then it'll freak you out,” says Dr. Jones. “I get this question all the time and patients say, ‘I'm not getting an epidural, because that needle going in is going to hurt!’ So I remind them that the needle itself is not something that you're going to feel going in; it's just actually the numbing.”
That’s all fine and good, but really, how long is that needle? Says Dr. Jones: “The needle is long enough to do the job, but short enough to know that it's not going to penetrate the spine.” So you can start doing some calculating — or just be thankful that the epidural is another alternative to pain management if you choose to use it.
Remember, Your Epidural Is Optional… And Safe
The idea of a long needle going into your back is scary for sure. But just remember that it’s just one of the many alternatives in your pain management arsenal. “I tell patients to keep their minds open, (as well as their options), so that they can make an informed decision,” says Dr. King. During the epidural, you’ll be asked to stay super still while the needle is inserted. This freaks out some laboring women, for fear that they might accidentally move and become paralyzed during the procedure. But according to the study “Safety and efficacy of epidural analgesia,” the chance of having permanent neurological damage rarely occurs. Remember, the entire medical team is there to help you get the pain relief you need, and will help you during the anesthetic procedure to ensure your safety and that of your baby. “And typically, patients are in a position when getting the epidural, so a nurse is there holding your hand, keeping you in that correct position and walking you through things,” says Dr. Jones. They’ll guide you through the process, monitoring your contractions to ensure that you can stay steady, still, and most importantly, calm.
Basically, if you're worried about the pain involved in getting an epidural, don't be. Even if you did feel the needle, the discomfort would still pale in comparison with full-blown labor. And much like those crazy awful contractions, once your beautiful and healthy baby is born, you probably won’t even remember what getting the epidural felt like in the first place.
Bos, E., Hollmann, M, Lirk, P. “Safety and efficacy of epidural analgesia” 2017.
Dr. Kiarra King, MD, FACOG, an OB/GYN
Dr. Vonne Jones, MD, FACOG, an OB/GYN
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