You’ve finally made it to the moment when you’re in labor, and you can’t wait to meet your baby. But there’s one more hurdle before the big arrival: actually delivering your newborn. Giving birth is bound to hurt, and that’s why you might be considering an epidural—but you may have heard that those aren’t exactly pain-free either. Still, the thought of eye-crossing contractions can make an epidural sound like a lifesaver, but you might be wondering, “Will my epidural hurt?” Not as much as you might think.
What is an epidural?
More than 60% of women in labor use an epidural for pain relief, according to the American Society of Anesthesiologists. If you’re thinking about having a medicated birth, an epidural is about to become your best friend. Essentially, an epidural is an anesthetic medication that is administered during labor via injection into your lower back. This area (often referred to as the epidural space) is located between the spinal cord and the vertebrae of the spine.
Although most often associated with labor, epidurals are also used for chronic back pain or before and after surgery, the Cleveland Clinic notes.
How is an epidural done?
An anesthesiologist or nurse anesthetist will first talk you through the procedure. This is the time to ask any questions about the epidural, so you know what to expect. They’ll clean the site to reduce infection risk, then guide you into position—usually lying on your side or seated, chin to chest, hands on your thighs to keep your back stable.
A needle and epidural catheter make up the main components. The catheter delivers a steady supply of anesthesia, and a dressing is applied to your back. IV fluids are typically given beforehand to prevent low blood pressure. Sometimes a combination of fentanyl or hydromorphone is used to help with pain management.
Depending on hospital policy, your partner may or may not be allowed to stay during the procedure to reduce the general risk of infection. The idea of a long-ass needle being inserted into your spine and your partner not being there can cause anyone to feel panic, but Jones assures that you won’t be alone. “A lot of women get concerned because they think they’re going to be in a room by themselves with the anesthesiologist,” says Dr. Vonne Jones, MD, FACOG, a board-certified OB/GYN. That typically isn’t the case, though, since you’ll have at least one or more nurses with you to help you hold your position—and your hand.
How long is the needle?
This is the part that causes most people to panic. The epidural needle itself is about 3.5 inches, though some can be up to six inches for larger patients. Epidural needles may be 17- or 18-gauge, with the Tuohy needle being the most commonly used, according to a PubMed study. But Jones advises against worrying about the length of the needle and focusing instead on the relief it will bring. “The needle is long enough to do the job but short enough that it’s not going to penetrate the spine,” she says.
Will my epidural hurt?
With a needle that long, it’s natural to worry about pain. But the needle itself usually isn’t the painful part—it’s the numbing injection that can sting a bit, according to Jones. “Once the epidural is in place, you may feel pressure, but you shouldn’t feel pain from the procedure,” she explains.
Jones advises focusing on the relief an epidural brings, rather than the needle. “Patients often say, ‘I’m not getting an epidural because that needle is going to hurt!’ If you fixate on it, it’ll freak you out.”
Ultimately, getting an epidural is your choice. Don’t let potential discomfort stop you from considering it. “If an epidural is what you want and your contractions are so intense that you feel you can’t continue, you have options for pain medication,” says Jones. While it won’t guarantee a pain-free delivery, it can help you focus less on the contractions and more on the moment when your newborn is safely in your arms.