Epidural analgesia is a safe and effective way of reducing the pain of labour and delivery.  An epidural involves a needle in your back, through this needle we put a fine plastic catheter in a space next to your spinal cord and then give you a mixture of pain killer and anaesthetic to provide the pain relief.  The needle is removed, but the fine plastic catheter remains throughout your labour, although it is so fine you probably wont notice that it is there.

The procedure can be performed with you laying on your side or sitting up, we are happy for you to be in either position, which ever is the most comfortable for you. Your partner and other support people can remain with you throughout the procedure.  The procedure takes about 10 minutes to perform and it then takes another 10 to 15 minutes before you will notice the full effect of the epidural.  It is important you stay still during some parts of the procedure, don't worry we will tell you when this is.  It is also important you tell us when you are starting to get a contraction.

If you requie a forceps delivery or a caesarean section and you already have an epiddural in place we will probably use the epidural for the delivery.  Occasionally we wil perform a spinal anaesthetic for these procedures even though you have an epidural in place.

There are a number of possible complications of the procedure.  Between 10 and 15% of epidurals require some sort of adjustment before they work adequately.  Occasionally the injection may have to be repeated  it is common for you to sometimes feel some pins and needles or short sharp pains during the procedure.  This happens if the needle or catheter brushes against a nerve.  In 1% of epidurals the needle inadvertantly goes in one layer too deep into the sac of fluid your spinal cord floats in.  We would do this deliberately for a spinal anaesthetic, but we would use a different size and shape needle.  The epidural needle make a large hole in this membrane and this can give you a severe headache.  If this happens it is sometimes nessecary to do another epidural injection and put some of your own blood in to seal the hole (this is called a "blood patch").

About 1 in every 500 epidurals can leave you with a small area that feels funny, numb, or tingly after the epidural has worn off.  This is due to the nerves being slightly bruised by the needle or catheter.  This usually resolves, but can take anything from 6 days to 6 months to do so.  Very occasionally (about I in 5,000) this small area never recovers completely.  Serious permanent nerve damage, including paralysis, is possible but is extremely rare.  This occurs about 1 in every 180, 000 epidurals, usually when there is bleeding or infection around the catheter.  If you have any concerns after your baby is born that you think might be due to your epidural you should have the staff looking after you contact us straight away.  

Epidurals do not cause any significant extra problems in people with pre existing back problems.  It is more common that back problems after pregnancy are due to the pregnancy and labour itself.  You may however have some slight discomfort in the skin of your back for a day or so where the nedle has been.