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Where Does An Epidural Go? Understanding Epidurals Part 1

Where Does An Epidural Go?

The epidural is the most popular method of pain relief used in many countries. It is a regional anaesthesia which blocks pain in particular parts of the body. Epidurals block the nerve impulses from the lower spine, resulting in numbness in the lower half of the body. In most high-income countries, epidurals are requested by around 50% of women giving birth in hospital settings. So it’s common for women to wonder, where does an epidural go?

If you decide to have an epidural, it will be administered to you by a specialist called an anaesthetist. If your hospital has an anaesthetist on call 24 hours a day, you will probably not have a long wait before your epidural can be placed.

You will be asked either to lie on your left side or sit up and curl over a pillow. Either position will encourage you to arch your back so the anaesthetist can find the correct place to insert the epidural.

You will need to stay as still as possible during the procedure, to assist the anaesthetist in placing the epidural correctly, and to avoid any problems. If you have any contractions during this time (and it’s likely to happen), let the anaesthetist know.

An antiseptic cleaning solution is used to wipe your back; this helps prevent infection. A local anaesthetic is injected into your skin to numb the area. You will feel some pressure as the epidural needle is then inserted into this numb area. It can take a few minutes for the anaesthetist to find the epidural space.

So, Where Does An Epidural Go?

A small tube (catheter) is threaded through the epidural needle into the epidural space around the spinal cord. You should feel no pain, or perhaps a split second jolt down one leg, similar to how it feels when you hit your elbow.

If you have a regular epidural, the needle is carefully removed once the catheter is in place. The catheter is then taped to your back to prevent it from slipping out, and medication is inserted into the epidural space. Depending on the type of anaesthesia you are having, the medication is inserted either continuously or intermittently. Regular epidural anaesthetic takes about 20 minutes to work.

If you opt for a combined spinal-epidural (CSE), otherwise known as a ‘walking epidural’ the anaesthetist will inject an initial dose of anaesthetic beneath the outermost membrane which covers the spinal cord (intrathecal area). The needle is then pulled back into the epidural space and the catheter inserted. The spinal injection provides pain relief within five minutes and the epidural anaesthetic will provide pain relief long-term.

If you wish to avoid having an epidural during labour, the best way is to choose care providers and a birth setting that encourage and support natural birth. Be informed about how labour works. Hire a doula to help you achieve an active labour, and find out what natural pain relief methods are available to you.

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