Labor, Birth & Postpartum

Epidural During Labor: How It Works, Side Effects and Risks

By the Find Her Doctor editorial team · Updated November 1, 2026 · 6 min read

An epidural is the most common form of labor pain relief in the United States. A thin, flexible tube goes into your lower back so medicine can flow continuously around the nerves that carry pain from your uterus and birth canal. Most people stay awake and alert, feel pressure instead of sharp pain, and can still push when it's time.

What getting an epidural is actually like, step by step

People are often more nervous about the needle than the contractions. Here's what usually happens, so there are no surprises.

1. Prep. You get IV fluids, and your blood pressure and the baby's heart rate are monitored.
2. Positioning. You sit on the edge of the bed and curl forward like a shrimp, or lie on your side with your back rounded. A nurse or your partner helps you stay still, which is the hardest part when a contraction hits. The anesthesiologist will usually pause and wait it out with you.
3. Numbing. Your lower back is cleaned (it's cold) and the skin is numbed with a small injection. That stings for a few seconds, about like a bee sting.
4. Placement. A needle is guided into the epidural space, just outside the sac that holds the spinal fluid. Most people feel pressure here, not sharp pain. A thin catheter is threaded through, and the needle comes out. Some people feel a quick zing down one leg as the catheter goes in; tell the anesthesiologist if you do.
5. Taping and dosing. The catheter is taped to your back, and medicine (usually a local anesthetic mixed with a small dose of an opioid) runs through it for the rest of labor.

Relief usually starts in about 10 to 20 minutes. Many hospitals use a pump with a button you can press for an extra dose within safe limits. The whole placement often takes 10 to 20 minutes, sometimes longer.

The anesthesiologist (or a nurse anesthetist working with one) places it. They'll ask about your health history, any bleeding problems and blood thinners first, so have that ready.

"Is it too late? Is it too early?"

ACOG states that asking for pain relief during labor is reason enough to get it. There's no rule that you have to reach a certain number of centimeters first. That's one of the most common myths.

That said:

• It takes time to place and start working, so if birth is very close there may not be time.
• The anesthesiologist may be with another patient, like an emergency C-section, which can mean a wait.
• Some health problems change the timing or make an epidural unsafe (more below).

If you think you might want one, tell your nurse early so it can be planned. You can always change your mind.

Epidural, spinal or combined?

If you already have a working epidural and need a C-section, the anesthesiologist can usually give a stronger dose through the same catheter, so you can stay awake for the birth.

Why people choose it

• Strong, steady pain relief for most people
• You stay awake and present for the birth
• Rest. In a long labor, many people finally sleep for a few hours, which helps when it's time to push
• Ready for surgery. If a cesarean becomes necessary, the epidural can often be used instead of general anesthesia

What it feels like once it's working

Your legs feel heavy, warm or tingly. You'll still feel your belly tighten during contractions, and many people feel pressure, especially near the end. That pressure is useful; it helps you know when to push.

Common, usually temporary side effects:

• Low blood pressure. Your team watches for it and treats it with fluids, position changes or medicine.
• Itching, usually from the opioid in the mix.
• Shivering or feeling cold.
• Leg numbness or heaviness. You usually can't walk safely while it's running, so you'll stay in bed and your nurse will help you change sides.
• Trouble peeing. A bladder catheter may be placed.
• Fever. Some people develop a low fever during labor with an epidural.
• Uneven numbness. Sometimes one side or a small patch isn't fully numb. Tell your nurse; the catheter can often be adjusted.
• Back soreness at the insertion site for a few days.

Rare but serious risks

• Spinal headache (post-dural puncture headache). If the needle goes slightly too far, spinal fluid can leak and cause a headache that's worse sitting or standing. It's uncommon and treatable, including with an "epidural blood patch."
• Infection or bleeding near the spine is rare.
• Nerve injury is very rare and usually temporary.
• Medicine entering a blood vessel or the spinal fluid by mistake is very rare; anesthesia teams use test doses and monitoring to catch it.

Does it slow labor or lead to a C-section?

Studies reviewed by ACOG show that epidurals may make the pushing stage longer and may raise the chance of a vacuum or forceps birth. They have not been shown to increase the overall chance of a cesarean. Your team may adjust the dose or your pushing position to help.

Who might not be able to get one?

Your anesthesia team reviews your history. An epidural may not be possible, or may need special planning, if you:

• Have a bleeding or clotting disorder, or a very low platelet count
• Take blood thinners (the timing of your last dose matters)
• Have an infection in your lower back or a serious body-wide infection
• Have had certain spine surgeries or have certain spine conditions
• Have very low blood pressure or are bleeding heavily

If any of these apply, ask your OB/GYN about a prenatal consult with the hospital's anesthesia team. Bring your records from any spine surgery. People with high-risk conditions may also see a maternal-fetal medicine specialist.

Other options

An epidural isn't the only choice. IV opioids, nitrous oxide (where offered), and non-drug methods like water immersion, movement and continuous support all help many people. Compare them in our guide to labor pain relief options. Many people also find a doula helps them cope, with or without medication.

Questions to ask before your due date

• Is an anesthesiologist on the labor floor 24 hours a day?
• Do you offer combined spinal-epidurals or a patient-controlled pump?
• Do you offer nitrous oxide?
• Should I meet with anesthesia ahead of time because of my history?

In New York, the Maternity Information Law requires hospitals to give prospective maternity patients a leaflet with their rates of epidural and other anesthesia use. Ask for it during prenatal care.

When to call your provider

After birth, call your provider or the hospital if you have:

• A severe headache that's worse when you sit or stand and better when you lie down
• Fever, redness, swelling or drainage at the epidural site
• New numbness, leg weakness, or trouble controlling your bladder or bowels after the epidural has worn off
• Severe or worsening back pain

Get emergency care right away for sudden leg weakness or loss of bladder or bowel control.

Your next step

Ask your OB/GYN or midwife which hospital you'll deliver at, then ask that hospital the questions above. To find an obstetric provider near you, browse obstetrics in Brooklyn or search the directory.

Frequently asked questions

Sources

• ACOG — Medications for Pain Relief During Labor and Delivery (Patient FAQ)
• ACOG — Obstetric Analgesia and Anesthesia (Practice Bulletin 209)
• American Society of Anesthesiologists — Epidural for labor (Patient information)
• MedlinePlus — Epidural block during pregnancy

This article is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician who knows your history. If you think you have a medical emergency, call 911.