It’s no secret that giving birth doesn’t exactly feel great, and that’s why many women opt for a pain relief intervention like an epidural during the process. Apparently Chrissy Teigen, who is pregnant with her second child, plans to be one of them—and she shared a “genius” idea on how she could get the most out of her pain-free time.
“Any doctors here? Am I allowed to get a wax during my epidural? It's genius and there's a ton of time to kill anyhow,” she wrote on Twitter. A doctor and a nurse both chimed in to say that, as long as it's not too late in the process and it doesn't get in the way of any medical procedures, it's probably fine and a genuinely clever use of your time. (Although, of course, if this is something you're personally interested in, it's best to consult your own doctor.)
Regardless of whether or not Teigen is being serious about the plan, her question does bring up an interesting point that many people who haven't gotten an epidural before may be wondering: What is it like to get an epidural, and do you really not feel a thing once it's in?
First, let's cover the basics of getting an epidural.
In most people, the spinal column is made up of 33 stacked vertebrae that house and protect the nerves of the spinal cord and the bundle of nerves that sits below it. But there's a tiny bit of space surrounding the nerves in the lower back, called the epidural space.
What we commonly refer to as an "epidural" is anesthesia medication that's injected directly into this space. There, the medication can directly affect the nerves responsible for sending signals related to pain, thus numbing the lower half of your body to prevent the feeling of pain.
There are actually a few different approaches to pain management during birth, and a standard epidural is only one of them.
Standard epidural: First, you'll get a local numbing agent, so you'll only feel a pinch (if anything) when the needle goes in. "Epidural placement is typically not painful and definitely not as uncomfortable as active labor," Philip Levin, M.D., chief medical officer of Santa Monica-UCLA Medical Center and Orthopaedic Hospital, tells SELF.
Then, both an analgesic (which reduces pain without reducing feeling) and a local anesthetic (which reduces pain and feeling in the area) are delivered to the epidural space in the lower back continuously through a catheter, Erin S. Grawe, M.D., an assistant professor of clinical anesthesiology and director of perioperative services at the University of Cincinnati College of Medicine, tells SELF. The catheter remains in place until after the baby is delivered.
A standard epidural will make you feel numb from the waist down. “This allows women to feel pressure, but that pressure isn’t uncomfortable. They shouldn’t have pain,” David Stahl, M.D., an assistant professor of anesthesiology The Ohio State University Wexner Medical Center, tells SELF. Sometimes your legs might feel heavy too, he says.
Spinal block: Often used in a C-section delivery, a spinal block consists of a single shot of anesthesia into the fluid surrounding the spinal cord. A spinal block provides pain relief more quickly than an epidural, but it only lasts a few hours.
Combined spinal-epidural (sometimes referred to as a "walking epidural"): This combines the single shot of a spinal block with the continuous analgesia of an epidural, allowing for lower doses of both medications. And, because this doesn't include the local anesthesia, you'll still have some movement in the lower limbs. However, you won't be able to do too much actual walking.
But a walking epidural tends to wears off more quickly than a standard epidural, Jack Stecher, M.D., an obstetric anesthesiologist at Baylor University Medical Center, tells SELF. "It's really only used in the early stages of labor when contractions aren't that strong," Dr. Grawe says. "As labor progresses, contractions get much stronger, and usually there is a need for numbing medicine."
Low-dose epidural: Often confused with a walking epidural, this technique is essentially the same as a standard epidural (injected into the epidural space) but uses lower doses of the local anesthesia, meaning you'll have less pain relief and be able to feel more while pushing.
The best option for you depends on your individual circumstances, including the type of birth you're planning to have, how things are progressing, and how far along you are when you get to the hospital.
Epidurals can work differently in different people.
In most cases, epidurals successfully reduce pain during labor. But, in some cases, an epidural can produce some weird effects, like only working on one side of your body or not working much at all.
It all comes down to how the epidural is done and the quirks of your own anatomy, Dr. Stahl says. When you get an epidural, remember that your skin is numbed and an anesthesiologist is using a needle to find the epidural space. When they feel a "loss of resistance," that's the sign that the needle has made it to the right spot within your spinal column. But since they can't see directly inside of you, it's possible that the syringe isn't quite where it's supposed to be, Dr. Stahl says. Or, if you’ve had back surgery or a back injury in the past, that might make it harder to find the right spot for your epidural, Dr. Stahl says.
There might also be issues with the catheter once it is threaded into the needle. “Most of the time it stays in the middle, but sometimes it doesn’t and goes to the left or right,” Dr. Stahl says. If the catheter is off to one side, it might numb that side more than the other or just not help much at all, Dr. Stecher explains. Sometimes it's fixable by increasing the amount of medication or reinserting the catheter.
While this does happen, it doesn’t happen often. There isn't a lot of hard data on the incidence of epidural failure, but Dr. Stecher estimates that maybe three out of every 1,000 epidurals he performs will have this problem.
If you have an epidural and you feel like you’re in more pain than you should be, talk to your doctor. Your anesthesiologist may need to make some adjustments to make you more comfortable.