What is spinal and epidural anesthesia for childbirth?

Spinal and epidural pain relief options are used during childbirth. They can block pain from an entire area of the body. Both are given by an anesthesia specialist.

For a spinal, usually a single shot of medicine is given near the spinal cord. It's often used for an assisted birth (such as a cesarean section or a delivery with forceps). Or it can be used when a delivery is happening fast.

For an epidural, medicine is usually given through a small tube (catheter). This is placed into the area near the spinal cord. The tube can be left in place so that more medicine can be given as needed.

Sometimes both types are used. Spinal offers quick pain relief. Then the epidural can offer relief for longer.

Spinal and epidural pain relief methods are used to block pain from an entire region of the body. They use numbing medicine given near the spinal cord. They can be used for either a vaginal birth or a cesarean delivery (C-section). They partly or fully numb your belly and lower body.

If you had an epidural, the catheter may be removed right after delivery. The numbness and muscle weakness in your legs will probably wear off within 2 hours after the medicine is stopped. If you had a spinal, the medicine takes a couple of hours to wear off. You may find that it's hard to urinate until all the medicine has worn off. Your back may be sore.

You may have a small bruise at the catheter or injection site. This usually gets better in 1 or 2 days. In rare cases, you may get a headache that gets worse when you sit or stand. Tell your doctor or nurse if this happens. It can be treated.

You may need to sit up and curl your body forward to round your lower back. Or you'll lie on your side and curl your knees up to your chest. First you'll get a shot to numb the skin on your back. Then the doctor or nurse will put a needle into the numbed area.

For a spinal, you'll probably get a shot of numbing medicine near your spinal cord. For an epidural, usually a thin tube (catheter) is placed through a needle into the space next to the spinal cord. Then the needle is removed. The tube stays in your back to supply the numbing medicine. Sometimes a spinal and an epidural are combined.

An epidural catheter may be placed but not used unless it is needed. This is done in case you need one right away. An example of this is if you need a cesarean (C-section). Or it may be used if you decide you want it for pain relief. It's safer to place the catheter early in labor.

The medicine will fully or partly numb your belly and lower body. The amount and type of medicine you get will affect how numb you are. For labor and vaginal birth, a lower dose is often used to ease pain. But it usually will allow enough feeling and muscle strength so that you can push during contractions. For a C-section, a higher dose and stronger medicine is used to block your pain. You will still feel pressure.

You may need to stay in bed during labor. You will also have an I.V. placed in a vein. Plus, you will have a fetal monitor.

The specialist sets the amount of medicine you will get through an epidural tube. Sometimes you will be able to push a button for more medicine when you need it. This is called patient-controlled epidural analgesia (PCEA).