Research Summary - Epidurals

Epidurals

An epidural is a local anaesthetic which is injected into the spine. It numbs the nerves which carry pain from the lower part of the body to the brain. This procedure is carried out by an anaesthetist.

Epidurals can give very effective pain relief, although a few women find they do not work very well.

This effective pain relief needs to be balanced against a number of disadvantages of having an epidural:

• It can make labour longer, and make it more likely that labour will be speeded up using drugs.
• It is more likely that a woman will need an assisted delivery such as forceps or ventouse.
• It reduces sensation in a woman's legs and she will usually need to stay on the bed.
• It can make women sick or dizzy.
• A catheter may be needed to empty their bladder.
• About 8 in every 1000 women experience a "dural tap" headache. In 6 of these women it will be a severe headache and may last for 10 days or longer.
• About 1 in 4000 women has a serious complication as a result of the epidural.
• There may be an effect on the baby from the drugs used in the epidural, although more research needs to be done on this.

Recently, a new type of "low-dose" epidural has been invented which uses a different mixture of drugs. This can allow the woman some use of her legs, although she may not be able to walk about. This new type of epidural is not always available in all hospitals. There is no evidence yet that this reduces the number of women who need an assisted delivery.

Most women who have an epidural during labour are very satisfied with it, and would request another one in a subsequent labour.

For women who wish to avoid an epidural, the following can help:

• using self-help techniques for pain relief, such as water, massage, aromatherapy, distraction techniques, TENS machine
• staying upright and mobile throughout labour
• having your baby's heart beat monitored intermittently rather than continuously
• already knowing the midwife who is with you during labour
• having the continuous support of a female experienced in childbirth

Epidurals are usually not available in a midwifery-led unit or a GP unit.

[This research summary includes information from the following leaflet produced by MIDIRS:

Informed Choice for Women No.6 - Epidurals for pain relief in labour

For details on how to purchase the Informed Choice leaflets go to the Informed Choice website.]

For more detailed research evidence, click here

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