1. What are the side effects of epidurals?

Although side effects are not common, complications or side effects can occur.

• Having a drop in blood pressure (hypotension), which can lower your baby's heart rate. This is why you receive fluids through an intravenous line beforehand and are encouraged to lie on your side, to improve blood flow.
• Shivering can be commonly seen.
• Infection
• Bleeding
• Seizure: The veins in the epidural space can become swollen during pregnancy. Due to this, there is a risk from accidental injection of medication into an epidural vessel. This may also happen from migration of catheter into a vein.
• Severe headache after delivery. This occurs in about 3% of women receiving an epidural. This is due to a dural puncture. Treatment is bed rest, fluids, analgesics and epidural blood patch.

Combined Spinal-epidural carries the same types of risks as an epidural alone. Rarely it can cause a slowing of the fetal heart rate.

2. How long does it take for the epidural medication to take effect?]

It usually takes 10 to 20 minutes after injection of the anesthetic drug epidurally. This is because the medication needs to be absorbed into several nerves. The onset maybe faster with a combined spinal epidural.

3. What will I feel after the epidural block takes effect?

You will have significant pain relief. However, you will still feel your contractions as a pressure sensation. You may notice some temporary numbness and heaviness in your legs. You might also feel the examinations of your obstetrician.

4. Will the block wear off?

No. With the use of a continuous epidural infusion, the duration of analgesia can usually be extended for as long as you need it.

5. Are there any contraindications to having an epidural?

Yes. Some are relative. You will be at greater risk if you:

• Have localized infection in the area where the epidural would be placed.
• Have a bleeding disorder or a low platelet count. Also if you are taking blood thinners. This would make bleeding into the epidural space more likely.
• Have a spinal deformity that would make it difficult to place the epidural.
• Fever or Sepsis.
• If there is an abnormal fetal monitoring pattern.
• Previous back surgery.
• Allergies to local anesthetics. This is rare.

6. Will I be able to push after the epidural block?

Yes. The epidural analgesia can decrease your pain, while enabling you to push when needed.

7. Are there any benefits to epidural anesthesia besides pain relief?

Yes. If you were to develop a need for a cesarean delivery, the epidural could be topped off quickly to numb the area for surgery. Also in certain conditions such as Pregnancy induced hypertension, the epidural infusion may help with blood pressure control.

8. Will I have back pain after an epidural

Back pain: Some women fear that an epidural causes chronic back pain—studies have not shown a connection between new back pain and epidural use. Some temporary soreness - lasting a few days - can occur.