When Can I Get an Epidural?

Have you been wondering, when can you get an epidural during labor?  Lose the fear, get the facts here.

The answer is that a woman in active labor can request epidural anesthesia at anytime. Your cervix does not have to dilate  a certain amount of centimeters to ask for an epidural.

In fact, the American Congress of Obstetricians and Gynecologists (ACOG) and the American Society of Anesthesiologists (ASA) have both made official statements and recommendations regarding analgesia during labor. Both groups reiterate the point above, that maternal request is the only needed indication for initiation of pain relief during labor, specifically epidural anesthesia.

The official statement from the ACOG Committee Opinion Number 339, June 2006, reaffirmed in 2010:

“Therefore, ACOG reaffirms the opinion it published jointly with the American Society of Anesthesiologists, in which the following statement was articulated: “Labor causes severe pain for many women. There is no other circumstance where it is considered acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under a physician’s care. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor”  

In the past, the thought was that epidural anesthesia during labor increased the rate of cesarean sections.  Multiple recent studies, though, have disputed these older studies leading the ACOG to make an official statement that epidural anesthesia does not increase the rate of cesarean section.  Once again, the ACOG Committee Opinion Number 339:

“The American College of Obstetricians and Gynecologists previously recommended that practitioners delay initiating epidural analgesia in nulliparous women until the cervical dilatation reached 4–5 cm. However, more recent studies have shown that epidural analgesia does not increase the risks of cesarean delivery. The choice of analgesic technique, agent, and dosage is based on many factors, including patient preference, medical status, and contraindications. The fear of unnecessary cesarean delivery should not influence the method of pain relief that women can choose during labor.”

Please don’t be afraid of the anesthesia myths that you may have heard.  Whether you choose to tackle the sensation of labor without medicines, opt for an epidural, or choose to use IV medicines, the good news is that you can ask for the relief at any point in your labor.  And remember that anesthesiologists are your advocates for a safe labor and delivery, regardless of whether or not you choose to have an epidural.

If you have questions about pain relief during labor or questions about a labor epidural, please ask to speak with the anesthesiologist.  He or she will be happy to discuss options with you.

Let us know more about your birth experience by visiting the forum or feel free to leave a comment below if you have any feedback.  Thanks for stopping by!