Epidural During Labour: Pros, Cons and What to Expect

Somewhere around your third trimester, someone will ask whether you are getting the epidural, in the tone of a yes-or-no question with a right answer. It is neither of those things, and you don’t have to decide today.

What does help is walking in with a clear picture of what one actually does. An epidural is the most effective pain relief available in labor, it keeps you in bed, and it comes with a handful of trade-offs that are much easier to weigh now than in the middle of a contraction. Everything below is that detail, laid out so you can pick your own side of it.

What an epidural actually is

An anesthesiologist places a thin tube into the space just outside your spinal cord in your lower back, then sends in numbing medicine through it. That tube stays in place, so they can top up the relief as your labor goes on.

You’ll usually feel a cold wipe, a sting from the local anesthetic, and some pressure. It takes about 10 to 20 minutes to set up and another 15 or so to fully kick in. Once it’s working, the contractions that were taking your breath away tend to fade into a pressure you can actually breathe through.

The pros

• It works, really well. Nothing else in labor relieves pain as reliably.
• You stay awake. Unlike general anesthesia, you’re present for the whole thing.
• It can be topped up. If labor is long, the relief keeps coming.
• It lets you rest. A long labor is exhausting, and being able to nap or just stop bracing can give you energy back for pushing.
• It’s ready if plans change. If you end up needing a forceps delivery or a cesarean, an existing epidural can often be topped up instead of starting from scratch.

The cons and the caveats

• Your legs go heavy or numb, so you’ll mostly stay in bed and won’t be able to walk around.
• It can lower your blood pressure, which is why you’ll get a drip and regular monitoring.
• Pushing can take a bit longer, and you may need a little coaching since you can’t feel the urge as strongly.
• You’ll likely need a catheter for your bladder, since you won’t feel the need to pee.
• A small chance of a headache afterward, and very rarely the relief is patchy and needs adjusting.

Epidural vs the other options, at a glance

An epidural is one tool on the menu. Here’s how it sits next to the common alternatives so you can picture the trade-offs.

Option	How strong	Stay mobile?	Good to know
Epidural	Most effective	No, you stay in bed	Awake and alert, takes time to set up
Nitrous oxide (laughing gas)	Mild, takes the edge off	Yes	Wears off fast, you control it yourself
Opioid injection (such as Demerol)	Moderate	Limited, makes you drowsy	Can make baby sleepy if given close to birth
Water, movement, breathing	Varies, no medication	Yes, fully	Great early on, can pair with anything above

None of these four rows is the brave one. They are four ways through the same hours, and plenty of labors use two or three of them in sequence. The bottom row gets a fuller treatment in our guide to coping with contractions.

When you can and can’t have one

You can usually ask for an epidural once you’re in established labor, and there isn’t a strict “too late” cut-off, though if you’re very close to delivery there may not be time to place it. There are a few situations where it isn’t suitable, such as certain bleeding or blood-clotting issues or some back conditions, which is exactly the kind of thing worth raising at a prenatal appointment so there are no surprises on the day. If you want a fuller map of the day itself, our guide to labor and birth walks through it stage by stage.

How to decide (without deciding everything now)

You don’t need a final answer before labor starts. A lot of people go in saying “I’ll see how I feel,” and that’s a perfectly good plan. Talk it through with your midwife or doctor, mention any back issues or past reactions, and let your support person know your leanings so they can speak up for you when you’re deep in a contraction. Then give yourself permission to change course. The plan that survives the day is the one with a flexible middle.

If you have had one, the detail that surprised you is the useful thing to leave in the comments, whichever direction it surprised you in. The lists above cover what is common. What people actually remember afterward is usually something smaller and more specific than any of it.

Medical disclaimer: This article is for general educational purposes only and is not medical advice. It does not replace care from a doctor, midwife, or anesthesiologist. Always discuss pain relief options and your individual risks with a qualified healthcare professional. If you think you may be experiencing a medical emergency, contact your local emergency services right away.

Sources

• American College of Obstetricians and Gynecologists. “Medications for Pain Relief During Labor and Delivery.” 2023.
• National Health Service (NHS). “Epidural.” 2024.
• Cochrane Database of Systematic Reviews. “Epidural versus non-epidural or no analgesia for pain management in labour.” 2023.