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What actually is an epidural and how does it work?

An epidural injection is a very effective pain relief method that allows you to stay awake during childbirth while stopping the pain signals travelling from the spine to the brain. At least, that's the short (ish) answer. But let's dive a bit deeper.

The epidural is actually the space in your spine between the vertebral wall (inside surface of bone) and the dura mater (outermost layer of tissue). The epidural surrounds the spinal cord and is filled with fat, small blood vessels, and fluid. But usually when we talk about epidural we mean the injection that is primarily used for pain relief in childbirth but also in some surgeries.

So how does it work? First and foremost, a small cannula will be placed into your arm so that you can be given fluids or drugs while you’re having the epidural.

You’ll be asked to sit down and lean forwards. During labour, an epidural is inserted into the lumbar area, which is the lower part of the spine. You’ll be given an injection of local anaesthetic to numb the skin where the epidural will be inserted.

Because a single injection usually doesn’t last long enough for a birth, a fine plastic tube called an epidural catheter is inserted instead. A needle is used to insert the catheter into your spine near the nerves that carry pain messages to your brain.

The needle is then removed, leaving just the catheter in your spine. Pain relief medicines are then given through the catheter. They usually take 20 to 30 minutes to take full effect.

While the catheter remains in your back, it can be used to top up your pain relief medicines.

When the epidural is stopped, the numbness usually lasts for a few hours before its effects begin to wear off. You might feel a tingling sensation in your skin, but that should soon wear off too.