Epidural Analgesia



What is epidural analgesia?

How can having an epidural affect my pelvic floor?

What are alternative ways of coping with labor pain?




What is epidural analgesia?

Epidural analgesia involves injecting one or more medications into the space that surrounds the spinal cord in order to relieve labor pain. The Epidural and Spinal page in the Labor Pain Pergnancy Topic discusses this technique in detail.

How can having an epidural affect my pelvic floor?

Epidural analgesia can lead to pelvic floor harm by increasing the likelihood of episiotomy (cutting the vaginal opening straight back to enlarge it for birth) and vacuum extraction or forceps delivery (assisted vaginal birth). These procedures, especially with use of midline episiotomy (cutting straight toward the anus to enlarge the vaginal opening at the time of birth), greatly increase the chance of a tear into or through the anal muscle. Anal muscle tears can lead to bowel incontinence (leaking gas — and more rarely, feces — or a sense of urgency about elimination) as well as increased likelihood of pain during sexual intercourse. Epidurals may have this effect because they numb women from the belly down. This makes it more difficult both to push effectively and to get into upright positions that can help move the baby out.

What are alternative ways of coping with labor pain?

The many alternatives to epidurals include:

  • continuous labor support from a trained or experienced woman
  • comfort measures such as positioning pillows, massage, applying ice, deep tub baths, showers and more
  • mental strategies such as breathing techniques, visualizations, music, or hypnosis
  • sterile water injections under the skin of the lower back, which can relieve back pain in labor
  • breathing nitrous oxide ("laughing gas"), and
  • injection of narcotics (opioids)

You can use many of these, in combination or in sequence.

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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 2/21/2006