According to Kevin Chen, M.D.
Chief, NCH Department of Anesthesia and Pain Medicine
- Epidurals for labor have a very good safety record. The severe risks of the procedure, including epidural hematoma, total intrathecal anesthesia and nerve injury, are exceedingly rare. The only “significant” risk is a “spinal headache,” which can result from spinal fluid. Even then, the risk in the U.S. is only 1 percent, and it is not permanent. It’s treatable after the epidural.
- The epidural is safe for the baby. If a woman does not get an epidural and requires intravenous (IV) medication for labor, these drugs may get to and affect the fetus since they are absorbed intravenously. The drugs used for an epidural primarily stay in the epidural space. The amount absorbed by the bloodstream and its effect on the baby is minimal.
- The procedure itself is not painful. An injection of local anesthesia is done before the actual epidural placement, once the back is “numbed.”
- Worries regarding back pain are not warranted. Studies have shown an equal percentage of women complain of back pain after delivery, regardless of epidural or not. The backache most likely results from back strain during the pregnancy and pushing during delivery.
- Epidurals do not prolong labor. Studies have shown epidurals do not prolong labor, especially since the advent of Pitocin, a drug used to maintain active labor progression.
For the above reasons, women on blood thinners and antiplatelet drugs, women with medical conditions that lead to bleeding disorders or platelet dysfunction, as well as those having a complex labor, may not qualify for an epidural during labor.