The epidural is a common method of pain management during labor, delivering medication continuously into the epidural space of the spine. It blocks pain signals from the lower body while allowing the patient to remain awake and aware. Understanding the sensory experience helps reduce anxiety, as the procedure is typically quick compared to the length of labor. The process involves distinct sensations, from preparation to the final feeling of pain relief.
Setting the Stage: Positioning and Preparation
The process begins with the physical setup, which can feel awkward during contractions. To allow the anesthesiologist access, the patient is asked to sit or lie on their side, rounding the back like a cat or hugging a pillow. Maintaining absolute stillness is required during the procedure, which can be challenging during a contraction. The lower back is cleaned with an antiseptic solution, which often feels cold and wet. A nurse will help support the position and remind the patient to stay motionless.
The First Sensation: Local Anesthetic
The first injection is a local anesthetic, like Lidocaine, used to numb the skin and underlying tissue. This small injection is generally reported as the sharpest part of the entire procedure. Patients describe the feeling as a strong, brief sting, similar to a bee sting or a deep pinch, which quickly subsides. This initial injection anesthetizes the area so the subsequent insertion of the larger epidural needle is felt minimally. Once the numbing agent takes effect, the skin becomes desensitized.
The Feeling of Epidural Placement
Needle Insertion
Once the numbing agent has created a localized block, the anesthesiologist inserts the epidural needle to locate the epidural space. This part of the procedure is most often felt as intense, deep pressure in the back, rather than sharp pain. The pressure sensation occurs as the needle is advanced through the ligamentous tissue.
Catheter Placement
The needle guides a thin, flexible tube called a catheter into the epidural space. As the catheter is threaded, some people report a momentary cold sensation or an electrical tingling that may briefly shoot down one leg. Any sudden, sharp pain should be communicated immediately. The needle is then removed, leaving the soft catheter secured to the back with tape and a dressing.
The Sensation of Relief Taking Effect
After the catheter is secured, the medication begins to flow, and the sensory experience shifts from the back to the lower body. Pain relief is gradual, typically starting within five to ten minutes, with the full effect felt after 15 to 20 minutes. Many describe the initial signs of relief as a spreading warmth or a growing heaviness throughout the hips and legs. The epidural medication works to interrupt pain signals from the uterus and birth canal. While the intense pain of contractions disappears, a person may still feel the sensation of pressure, which is beneficial for knowing when to push.