The pros and cons of epidurals

When preparing for birth, many parents want to understand their options for pain relief. One of the most common choices in Canada is the epidural, a type of regional anesthesia that numbs pain in the lower half of the body during labour. While an epidural can be an effective tool, it’s important to weigh both the benefits and potential drawbacks so you can make the decision that feels right for you.

✅ The Pros of an Epidural

1. Effective Pain Relief

Epidurals are often considered the most effective form of pain management in labour. They can provide significant relief and allow you to rest if labour is long or exhausting.

2. Ability to Stay Awake and Alert

Unlike general anesthesia, an epidural allows you to remain awake and aware during your birth experience, which is especially important if a cesarean birth becomes necessary.

3. May Lower Stress Hormones

By reducing pain, epidurals can also lower stress and anxiety levels, helping some parents feel more relaxed and in control.

4. Can Be Adjusted

The level of medication can often be adjusted to provide more or less sensation depending on how your labour is progressing.

⚠️ The Cons of an Epidural

1. Limited Mobility

Because an epidural numbs the lower body, walking or changing positions may not be possible. This can make it harder to use movement and gravity to support labour progress.

2. Possible Side Effects

Some people experience side effects such as low blood pressure, itching, shivering, or difficulty urinating. Rare but serious complications (like a severe headache or nerve injury) can also occur.

3. May Affect Pushing

Numbness can make it more difficult to feel contractions and push effectively, which may lengthen the pushing stage of labour.

4. Increased Use of Interventions

Research suggests that having an epidural may increase the likelihood of interventions such as continuous fetal monitoring, assisted delivery (vacuum or forceps), or pitocin to strengthen contractions.

5. Doesn’t Always Work Perfectly

While usually effective, some epidurals provide uneven relief (working better on one side of the body than the other) or may not work as expected.

🧾 Things to Keep in Mind

• Epidurals are usually placed once you are in active labour.

• They are administered by an anesthesiologist, so availability may depend on hospital staffing.

• Choosing an epidural doesn’t mean you’ve “failed” at birth—it’s one of many options available.

• Knowing both the pros and cons ahead of time can help you make an informed decision in the moment.

Final Thoughts

There’s no one “right” way to cope with labour. For some, an epidural provides needed relief and a more positive experience. For others, the drawbacks outweigh the benefits, and they prefer to use other comfort measures.

As a doula, my role isn’t to tell you what choice to make—it’s to help you understand your options, prepare for the possibilities, and feel supported no matter what decisions you make along the way.