In Part One of this episode, we explained how an epidural works and the pros and cons when considering using this form of pain relief during labour.

We also looked at the side effects and risks associated with an epidural.

Now we’re going to get really specific with how an epidural procedure is carried out so you know exactly what to expect.

So, how is an epidural carried out?

When opting for an epidural, your midwife or doctor will explain the procedure to you and you should have the chance to ask the anaesthetist any questions about it.

Preparing for an epidural

Before the epidural, a plastic tube will be inserted into a vein in your arm or the back of your hand and will be connected to a drip containing fluids. These fluids prevent your blood pressure from dropping during the procedure. Your midwife will then adjust you into the right position to receive the epidural. This will either be with your legs over the side of the bed leaning forwards, or laying on your side with your knees up by the edge of the bed. Once in position, your lower back will then be cleaned with antiseptic and you’ll be given an injection of local anaesthetic to numb the skin ready for the epidural needle to be inserted. You may temporarily feel a scratching sensation, which subsides relatively quickly.

The procedure

The anaesthetist will insert the epidural in between contractions to avoid any movement. They will then locate the epidural space with a small hollow needle, at which point you will feel a pushing sensation in your back. Once the space has been located, a fine plastic tube called an epidural catheter is fed through the hollow needle. The hollow needle is then removed leaving the catheter in the epidural space. The catheter is secured onto your back with sticky tape and remains in place until your baby has been delivered. As the tube is soft and pliable, it is safe to move around and lie on it as much as you need.

Managing the epidural

Once the epidural catheter is in place, the anaesthetist will give you your first dose of medication through the tube using a syringe. Top-ups or subsequent doses will then be given by your midwife. As soon as the first dose is given, your blood pressure will be carefully monitored for the next half an hour or so and then again after each top-up. Each dose takes about 20 minutes to take effect and can last anywhere between one to two hours. The epidural can be topped up as often as is required, usually every three to four hours. There should be an anaesthetist on standby 24 hours a day in case any problems arise.

What is an epidural and how does it work (Part Two)?

For Unii’s Giving Birth Journey, we explore all things epidural.