Epidural myths and facts: what is often misunderstood

Everyone has an opinion on the epidural: some call it a lifesaver, others say never to have one. This article goes through the most common myths one by one. For the options themselves, see the Guide article on epidural and pain management; the aim here is to correct misinformation and help you and your team decide.

Myth 1: “An epidural causes permanent back pain”

Fact: Back pain is very common in pregnancy and after birth, including in people who did not have an epidural. Studies have not shown a cause-and-effect link between epidurals and long-term back pain. Mild tenderness at the needle site for a few days can happen.

Myth 2: “It harms the baby”

Fact: With an epidural the medicine is given close to the spinal cord, and the amount reaching the baby is generally very small. Most babies born with an epidural are not expected to have long-term problems. The team monitors the baby’s heartbeat throughout.

Myth 3: “It prevents breastfeeding”

Fact: An epidural does not take away your ability to breastfeed. Most people breastfeed successfully after an epidural. Skin-to-skin contact and early feeding support in the first hours can help. If you struggle, a midwife or lactation consultant can assist.

Myth 4: “It always lengthens labour or leads to a caesarean”

Fact: In some people an epidural can slightly lengthen the second stage of labour; it does not always. Studies show that epidurals do not clearly raise the caesarean rate. A longer labour or the need for a caesarean mostly comes from other factors, such as the baby’s position and how labour is progressing.

Myth 5: “It will not work if done too early or too late”

Fact: When to start an epidural is now mostly based on your level of pain and your need, not on a fixed stage of labour. If it is left very late, it may not be possible; so if you want one, it helps to tell the team early. The final decision rests with the anaesthetist and the midwife or doctor.

Myth 6: “It causes paralysis”

Fact: This is the scariest myth, but the reality is very different. Permanent nerve damage is an extremely rare complication. Temporary numbness, a heavy feeling in the legs or a drop in blood pressure are more common, and the team is prepared for them. You can talk about these rare risks with the anaesthetist at an antenatal appointment; asking your questions builds confidence.

Who might not be suitable for an epidural?

An epidural may not be suitable with a clotting problem, certain spinal conditions or an infection at the site. This is an individual decision, so ask your doctor.

Questions to ask the anaesthetist

1. Is an epidural available 24/7 at our hospital?
2. Do I have any personal risk factors?
3. What will I feel during and after the procedure?
4. What happens if it does not work or works on one side only?
5. Can I move around with an epidural?

When to contact your doctor

• If you have a severe, persistent headache, neck stiffness or fever in the days after an epidural
• If numbness or weakness in the legs lasts longer than expected or you have trouble passing urine
• If there is redness, swelling or discharge at the needle site
• For sudden breathlessness, chest pain or confusion, call 112 (in Turkey) or your local emergency number

Frequently asked questions

If I want an epidural, am I “less brave”? No. Pain relief is a personal choice, and every path deserves respect.

If I have an epidural, can I not give birth vaginally? Vaginal birth is possible with an epidural too.

What if I do not want an epidural? Other methods exist, such as breathing, movement, warm water and a support person. Have a look at the options.

This article is for information only; for the decision, the advice of your anaesthetist and obstetrician comes first.