Epidural in Labor: What You Need to Know About Benefits, Risks, and Options

When it comes to pain relief in labor, the epidural is one of the most common choices. But it also comes with a lot of questions, myths, and sometimes pressure to “just get one.”

As a birth doula in the Michiana area (Southwest Michigan, Northern Indiana, and Virtually), I’ve supported families who chose an epidural, families who went unmedicated, and families who shifted plans mid-labor.

No matter what, my role is always the same: to make sure you feel informed, supported, and confident in your choices.

So, let’s talk about epidurals in labor—what they are, how they work, the risks and benefits, and what to expect if you decide this is the right choice for your birth.

What Is an Epidural?

An epidural is a type of regional anesthesia commonly used during labor to provide pain relief. A provider (usually an anesthesiologist or nurse anesthetist) inserts a small catheter into the lower back, delivering medication that numbs pain from the waist down while you remain awake and alert.

The Epidural Process: What to Expect

If you choose an epidural in labor, here’s how the process typically unfolds:

1. IV Line Placement – You’ll need an IV for fluids before the epidural can be administered.

2. Positioning – You’ll sit curled forward or lie on your side while the provider inserts the needle and catheter.

3. Placement – A numbing shot is given first, followed by the epidural catheter placed into the epidural space.

4. Testing & Adjustment – Medication is tested and adjusted to ensure even coverage.

5. Ongoing Monitoring – You’ll usually stay connected to continuous fetal monitoring, and the epidural can be adjusted as labor progresses. Your blood pressure will also be closely monitored for the first thirty minutes as a drop in blood pressure is one of the most common side-effects of an epidural.

   
   

Benefits of an Epidural

For many families, epidurals can be an empowering choice. Benefits include:

• Effective pain relief for most people.

• Allows rest during long or exhausting labors.

• Can reduce stress hormones, which may help with blood pressure issues.

• Keeps you alert and present, unlike general anesthesia.

• For some people an epidural can help them relax enough to rest and kick labor into gear.

  
  

Risks and Considerations

Like any medical intervention, epidurals have potential risks. Evidence shows:

• Drop in blood pressure, which can affect baby’s heart rate

• Limited mobility once the epidural is in place.

• Possible slowing of labor, which may increase interventions like Pitocin.

• Increased chance of assisted delivery (vacuum or forceps), though not necessarily cesarean.

• Temporary side effects such as itching, shivering, or difficulty urinating.

• Rare complications like spinal headaches or nerve injury.

• Whenever you get an intervention, it opens the door for more interventions. Nothing is a solo package when it comes to birth interventions.

  
  

Positioning and Labor with an Epidural in Labor

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A common misconception is that once you get an epidural, you’re “stuck flat on your back.” That doesn’t have to be the case. With support and the help of your birth doula, you can still use:

• Side-lying positions with a peanut ball to open the pelvis.

• Hands-and-knees or throne positions if the epidural isn’t too dense.

• Upright sitting or semi-reclined to use gravity effectively.

Movement may be limited, but with creativity and advocacy, you can still help your baby descend and rotate.

FAQs About Epidurals in Labor

Does an epidural hurt?

Most people describe the placement as pressure and a pinch, but not unbearable.

Can I still push with an epidural?

Yes! You’ll usually still feel pressure, even if pain is numbed. Your doula and provider can guide you in pushing effectively. You can also taper or turn off the epidural when it is closer to pushing to aid in more effective pushing.

Can I get an epidural at any time?

Usually yes, as long as anesthesia is available, but some providers may recommend waiting until active labor.

What if the epidural doesn’t work?

Sometimes it only works on one side or needs to be adjusted. In rare cases, it may not provide full relief. Regardless, epidurals do not mean you will not still have to cope with labor.

Advocacy and Epidurals

Here’s the truth: epidurals can be a powerful tool—and you are still in charge of your birth.

It’s not about whether an epidural is “good” or “bad.” It’s about whether it’s right for you, in your body, in your birth. You deserve providers who explain your options clearly and respect your decisions.

That’s why I created my Birth Advocacy Toolkit—a $10 guide that gives you scripts, tools, and confidence for navigating conversations about interventions like epidurals, induction, or continuous monitoring.

Whether you’re leaning toward an epidural, planning an unmedicated birth, or simply keeping your options open—remember this: you get to decide.

Your pain relief choices don’t define your strength or your worth as a birthing person. What matters is that you feel informed, supported, and respected every step of the way.

Ready to Feel Empowered in Your Birth?

If you’re pregnant in Cass, Michigan, South Bend, Mishawaka, or the greater Michiana area, let’s talk about how I can support you.

✨ Download your free Birth Advocacy Toolkit for more evidence-based information on epidurals, GBS, and other common interventions.

💬 Then book a consult with me today to learn more about my birth doula packages and pregnancy coaching support. Together, we’ll make sure you feel confident and fully in charge of your birth experience.