This 2nd article in my Epidural series — this one talks about how long you can expect the epidural to last, how long it takes to wear off and when to get it so it lasts your whole labor.
How Long Will My Epidural Last?
What is an Epidural?
Now, epidurals come in all shapes and sizes. There is an epidural injection that doctors can use to help back or neck pain.
Epidurals are regional anesthesia (meaning it only numbs a portion of your body instead of putting you to sleep, or local anesthetic that only does a small area). Medicine is pushed in the epidural space (hence, the name) of your spinal column.
It is aimed to numb spinal nerves while help control pain (including labor, surgical pain, and chronic pain). Most often it is given sitting up, and your medical team will help position you for it.
Epidurals are most often given by a nurse anesthetist or an anesthesiologist — your pain management specialist.
Each of those will last for a different period of time, and are for pain management — but today we’re talking labor epidurals — how they work to numb the pain of contractions.
How long does an epidural last during labor?
Initially, they do a needle insertion (using an epidural needle), into your epidural space.
After that, they will feed in an epidural catheter (a tube — it’s just about the side of spaghetti noodle, and is flexible) that will hang-out in your back until you’ve had the baby — and that replaces the needle.
That little tube (called an epidural catheter) will carry the medicine into your epidural space (which is not the same space your spinal cord is in) until we stop it or it gets pulled out. It’s sort of like an IV in your back.
Some doctors do a combined spinal-epidural (CSE) that helps if you’re in a lot of pain when the epidural is placed — although that is usually doctor preference.
The doctor then gives you a large amount of epidural medication into that space — we call that a “bolus”.
The medicine is pushed in via a small tube in your back through a pump — very similar to how your IV goes into your arm. This makes it a very reliable method of pain control. The actual pain medication given in the epidural space does NOT last a long time, but we pump in new medication until we turn it off.
The amount of medication (and type), and how much pain relief you get is up to the doctor, for the most part.
Most people have it take full effect by about 20-40 minutes after the complete placement (there is a good amount of set-up time after the provider enters the room).
In general, the plan is for an epidural to last until we stop it, making for a positive birth experience.
That can go awry with things like the tube coming out of the right spot, or it gets kinked, but in most situations, it lasts until we stop it.
Can an Epidural “Wear Off”?
“Back in the day”, doctors used to just come in and give a giant amount of medicine every few hours (that’s how it worked when I had my first baby in 2000). It didn’t drip into your back — but I would guess that all hospitals have it going in via a pump while you’re in labor.
Can I get extra medicine if I need it?
Most pumps have a button that you can push for an extra amount of medication. The pump is set to only allow you a certain amount of medication each hour.
If you are in a lot of pain, it is important you let your nurse/provider know so they can assess if you’re progressing or what is up.
Your anesthesiologist can also come in and give more/different medication if the medicine going in via the pump isn’t enough. He can also turn the rate that the medicine goes into your back either up or down depending on if you’re feeling too much or too little.
**Sometimes we will turn off, or lower the rate for your epidural once it’s time to push so that you’re able to feel more. However, we can titrate it to make sure you still don’t feel a lot of pain when baby is coming out.
Are there side effects to the epidural medicine?
Common side effects of the epidural anesthesia can be itching, a mild increase in temperature and clearly — numbness/inability to move their lower extremities.
Kind in mind that the MOST common side effect is your blood pressure dropping (which is why we give you a lot of fluids in advance), and that does NOT last long (as your body becomes used to the epidural medications.
You can also get a severe headache if the epidural block goes a bit far into the spinal fluid. This type of headache is very apparent and your provider can fix it with a blood patch. There are a few other rare complications and some serious complications your provider should go over with you before getting it.
If you’re on blood thinners there can be an increased risk.
Keep in mind that the epidural is done in a separate spot than the actual nerves. So the risk of nerve damage is VERY small. Many women complain of lower back pain after having a baby (but it’s hard to separate that from the pain you might have from all your new tasks, the car seat, feeding etc.
** Your doctor should do informed consent explaining the risks and benefits to the procedure before placing the epidural.
Btw, if you’d like you thank your nurse, I have a whole post on gifts for labor and delivery nurses.
How long can you have an epidural?
In general, you could have an epidural for quite a long time. It can infuse for days (I’ve never gotten to the point that we had to replace it), but it is best not to….
In general, we don’t want people in hard labor (hard enough to get an epidural) for more than a day…. Although it does happen.
How long does it take for an epidural to wear off?
Once we turn the epidural off, it slowly wears off. Usually taking 1-2 hours of recovery time to wear off. Most often we turn it off after the doctor has the placenta out and is done with any repair needed.
Make sure you hold onto your nurse and take her help the first time you get up. Your legs will likely feel a bit weird.
How long does an epidural last after a C-section
Most planned C-sections have a spinal, although if you have an in-dwelling epidural they may put in a lot of medicine to get that to work the same way.
Those epidurals will wear off slowly — and last about 2 hours. BUT, your abdomen will have the epidural last the longest, so that’s a total perk of spinal or epidural anesthesia vs general anesthesia. We usually leave the catheter in for 12 hours after the surgery and we often will sit you on the side of the bed when that comes out.
I also have a post on what to take to the hospital for your C-section.
Which is better — epidural or natural birth?
Every woman and every labor is so different. Never has this advice been more pertinent — you do you. Do what works for you. You can’t compare your labor or your pain with anyone else’s. After almost 20 years in L&D I can guarantee you that.
BUT, let’s answer a few more questions:
When should I get my epidural so that it doesn’t wear off before I have my baby?
Hopefully, you understand that it should last through labor if done properly, and nothing messes it up. I do have the answer to when I think you should get it right here:
Most often we recommend you not get it until you’re well into active labor (I go over the phases of labor in this post)
So, that’s that — in general, you don’t need to worry about the epidural wearing off before you have your baby — but remember — an epidural isn’t meant to take away ALL labor pain << read that post to find out why.
AND if you’re interested in more info on pain management during delivery be sure to check out my Online Prenatal Class for Couples hosted day and night on the internet, with your’s truly. Hundreds of couples love this class. It’s:
- Accurate — you’ll get the RIGHT info. Since I still deliver I really know what I’m talking about
- Engaging — there are videos and questions to help you take it at your own pace and stay involved
- Available — no more having to fight traffic, and find the right classroom. It’s here just waiting for you.