With childbirth approaching, you’re wondering about the different methods of pain relief. Do you know the difference between an epidural and a spinal anesthesia?
Epidural
An epidural is a regional anesthetic designed to create partial motor paralysis (reduced sensitivity) of the lower body in laboring women. This technique is usually performed by an anesthetist. It involves inserting a needle and catheter into the lower back, between two vertebrae, to reach the epidural space in the spinal column. Once the catheter is firmly in place, the needle is withdrawn completely. The medication is then injected continuously or repeatedly. It will take about twenty minutes to complete the insertion, then another twenty minutes or so to feel the greatest relief.
The mother will feel a sensation of heaviness in her legs, sometimes accompanied by trembling. The need to urinate will also be altered. The nurse, at her bedside throughout the labor, will look after her and her baby’s well-being, throughout the procedure and afterwards.
Most women feel well relieved, but the epidural may be less effective and not provide sufficient relief. It doesn’t take the pressure off the baby as it moves down the pelvis towards the vulva. A perfect epidural means feeling a contraction set in without being accompanied by severe pain. It’s this balance that allows the mother to push instinctively and appropriately at the right moment.
Women with no contraindications (e.g. coagulation disorders) can receive epidurals as soon as they are in active labor (with regular contractions of good intensity), the cervix is changing and evolving (thinning and/or dilating) and the doctor authorizes it.
There’s also the patient-controlled Epidural Analgesia (PCEA) (in french only). Widely used today, this method offers laboring women self-administered relief.
Spinal Anesthesia
Spinal anesthesia goes deeper into the spinal cord than an epidural and provides an instant effect. It’s very popular when trying to soothe quickly and effectively. Spinal anesthesia is never continuous; it’s a single dose. It’s anesthesia that will numb the lower body, like an epidural, but it’s more effective for soothing pain. This is why doctors will choose it if they want quick and effective soothing, especially during a caesarian, because it has fewer undesirable effects than with general anesthesia (putting the mother under). The procedure is the same as an epidural, so the anesthetist can do it quickly and easily, and the mother is frozen faster and better while remaining alert and conscious of what is going on around her.
The doctor may choose to combine relief methods for a Caesarean section, i.e. perform a spinal to quickly anesthetize the lower body, and then, by drawing the needle out of the back, install a tube in the epidural space to provide a longer duration of post-surgical relief with an epidural.
Depending on your medical history, you may not have access to these forms of analgesia. Your treating professional can then discuss other options with you.
Updated article : October, 2024.
