Epidural anesthesia is considered the most effective technique for pain control during labor. It can be used to partially or fully numb the lower body, either allowing you enough feeling to push with your contractions or blocking all feeling for a cesarean delivery if that becomes necessary.

Epidural pain medication is given through a very thin tube (epidural catheter) into the area surrounding the spinal cord, called epidural space. From the epidural space, medication goes through the membrane directly to the spinal nerves that cause feeling in the lower body. You remain more alert as very little medication travels through your blood and to your brain. Also because the epidural pain medication doesn't go directly into your bloodstream, your baby is unlikely to be affected (research data aren't yet clear enough to say that there are no effects). By comparison, when medication is given through a vein (intravenous, or IV) or by injection into a muscle (intramuscular), it travels to your baby across the placenta after an hour or so. If your baby is born before the medication wears off, he or she may suffer side effects such as breathing difficulty and grogginess (which are reversed at birth with another medication).

A combination spinal-epidural anesthesia (CSE) is gaining more use for labor and delivery. Before the epidural line is installed, medication is injected into the spinal fluid around the spinal cord. This spinal injection acts more quickly than the epidural. Then the epidural catheter is placed and used for ongoing anesthesia.