An epidural should be considered when you, or your obstetrician or midwife feel that the pain is more than you can cope with. You are more likely to need epidural pain relief if your baby is in the posterior position, and intensive contractions result in little progress. You might have an epidural if you need a Caesarean delivery, or with a forceps or ventouse delivery. An epidural may also be necessary with a multiple birth or if your baby is in the breech position. Your doctor or midwife will tell you if they think you need an epidural, but the final decision will be yours .
An epidural should act as a total pain block, numbing all sensation in your abdomen. However, it can also affect the nerves that control the movement in your legs and bladder, which means that your legs may feel quite heavy and difficult to move, and you may not be able to feel when you need to pass urine. When an epidural is inserted , you will be encouraged to lie down, and a small plastic tube (catheter) will usually be passed into your bladder to prevent it from becoming too full; an overly full bladder could impede the progress of your baby or cause bladder problems.
An epidural anaesthetic works by numbing the nerves in your spine that lead to your abdomen. A small amount of local anaesthetic is injected into the lower part of your back to numb the area before the main anaesthetic is injected. This procedure usually takes around 20 to 40 minutes, and the effect should last for several hours. The anaesthetic can then be topped up every few hours through the end of the catheter where a filter valve is attached in order to prevent bacteria from entering your body.