Side effects /disadvantages
Acts within a few breaths and wears off in minutes
Causes no harm to baby
Nausea & vomiting
Reduces pain intensity
Partial pain relief only
Can be used together with other pain relief
Opioids are painkillers such as pethidine.
Side effects / complications
Can provide some pain relief
Drowsiness, nausea or vomiting
Can be given easily by midwives as an injection into a large muscle
May slow down your breathing
Acts after 30 min and the pain relief may last a few hours
May make your baby drowsy or slow to take their first breath. These effects are worse if the baby is born one to four hours after an injection of pethidine. This may mean that your baby may not suckle well in the first few hours or may need special care post-delivery. If necessary, your baby can be given an injection to lessen this side effect.
Hence, it may not be possible to give you an opioid injection if you are too close to delivering your baby.
Who cannot have an epidural?
Most people can have an epidural, but having certain medical problems, spine abnormalities such as spina bifida, previous back operations or problems with blood clotting, may mean that an epidural is not suitable for you.
The best time to find out about this is before you are in labour. If you have any doubts, you can request to make an appointment with an anaesthesiologist to discuss your pain relief options.
Epidural does not…
It is the most effective labour pain relief.
Common, but minor self-limiting side effects such as reduced blood pressure, weak legs, slight fever, difficult urination, shivering and itchiness can occur while the epidural is working.
There are minimal side effects to your baby.
May prolong second stage (cervix is fully dilated) of labour. There is an increased chance of instrumental (vacuum or forceps) delivery. (17% with epidural, 12% without).
In certain serious medical conditions such as high blood pressure, heart or lung problems or morbid obesity, epidural helps by decreasing the stress of labour on your body.
Inadequate pain relief for labour in 1 in 10 -20 women, which requires troubleshooting and/or reinsertion. Inadequate supply of anaesthesia for emergency procedures in 1 in 8-10 women.
In some obstetric conditions, such as complicated labour or twins, an epidural may help your baby because it enables the obstetrician to delivery your baby quickly if urgent obstetric intervention (e.g. forceps or caesarean section) is needed.
1 - 2% of women could get a severe positional headache that could last for days or weeks if left untreated. If this happens, please inform your anaesthesiologist, who will discuss with you about available treatment options.
Nerve damage may occur, can be short lived (1 in 3000) or long lasting (1 in 80,000 – 320,000).
Other rare risks:
An anaesthesiologist will insert an epidural under sterile conditions. The patient can be sitting or lying on the side. At the end of the epidural procedure, the epidural needle will be removed and the catheter will be taped onto the back. The patient will be free to move after that.