The Actual Steps to Getting an Epidural: What You Can Expect

When it comes to giving birth, there’s no “right” way—only what feels right for you. For many people an epidural can offer rest, relief, and relaxation. If you are considering a hospital birth with the option of an epidural, here's a factual, step-by-step look at what really happens, from an ex-labour and delivery nurse who worked in an obstetrical unit.

🧠 First, What Is an Epidural?

An epidural is a type of anesthesia that blocks sensation in the lower part of your body. It doesn’t put you to sleep—you’ll remain awake and aware, but with significantly reduced sensation and mobility in the lower part of your body.

The procedure is done by an anesthesiologist and involves:

• A needle about 3.5 inches (8–9 cm) long placed into your lower back

• A small catheter that stays in the place where the needle was inserted

• Medications such as local anesthetics and opioids that are delivered through the catheter into your body

  
  

💊 Which Medications Are Used?

Most common epidural medications include:

• Bupivacaine – a local anesthetics that blocks nerve signals

• Fentanyl – an opioid for pain relief

🩺 Step-by-Step: What Happens When You Get an Epidural

Here’s a walk-through of what typically happens in the hospital:

1. You Request the Epidural

Once you’ve decided you'd like an epidural, the nurse notifies the anesthesiologist. This can take time depending on hospital workflow.

2. Initial Preparation

Before the epidural is administered:

• An intravenous catheter (IV) is set up to give you fluid hydration into your bloodstream if you do not already have one

• You are helped into the correct position—usually sitting upright and hunching forward to round your back for the placement

• The anesthesiologist cleans your lower back with antiseptic and uses a small needle to inject a local anesthetic (lidocaine) just under the skin where the epidural will be placed. This part may sting or burn slightly for a few seconds.

3. Epidural Placement

Once the area is numbed:

• A hollow needle (around 8–9 cm) is inserted into the epidural space of your lower spine, this is the fluid-filled area that surrounds the spinal cord.

• A flexible catheter is threaded through the needle and taped in place on your back

• The needle is removed from your back, and medications begin to flow through the catheter, blocking pain signals from reaching your brain.

🕒 This step usually takes 5–15 minutes, and relief begins within 10–20 minutes.

💡 Immediate Effects of the Epidural

Most people report:

• A warming, numbing, or “melting” sensation in the lower belly, hips, and legs

• Relief from contraction pain but ongoing pressure or tightening during contractions

• Heaviness, weakness, or numbness in the legs

  
  

🧪 Medical Monitoring After the Epidural

Once the epidural is in place, additional steps include:

🔄 Continuous fetal monitoring

• Two belts (one for the baby’s heart rate, and one for contractions) are placed on your belly for monitoring throughout the rest of labor.

💧 Urinary catheter placement

• Because the epidural affects your ability to feel the urge to pee, a urinary catheter is placed up your urethra into your bladder to drain your urine.

💓 Blood pressure monitoring

• Your BP will be checked every hour after the procedure by a nurse.

🛏️ Remaining in bed

• You will not be able to move independently so you will be repositioned from one side to the other every hour by a nurse, until baby is born.

  
  

If you're preparing for birth and want to explore your options—natural or medicated—I offer personalized, nonjudgmental support to help you navigate each step with clarity and care.

📞 Book a free consultation