Yes, you can often get an epidural at 10cm (fully dilated), but it depends on the hospital's policy, anesthesiologist availability, and how quickly you're progressing, as there might not be enough time for it to fully work before delivery, though some providers can place it even as you're ready to push. While it's generally too late if the baby is crowning or about to be born immediately, it's not always too late at 10cm if you can remain still for the procedure.
In many hospitals, epidurals are typically placed once labor is active, which is around four to six centimeters of cervical dilation, when contractions are stronger and more consistent. However, every labor is different, and if your labor is moving slowly, there's usually plenty of time to request an epidural later.
Do I have to wait until I'm at least 4 cm dilated before I can ask for an epidural? No. It's almost never too early or too late to start an epidural during childbirth. You can request an epidural at any point, from the very beginning of labor right up until the baby is crowning.
You can get an epidural any time you want. However, you shouldn't wait too close to delivery because you need to make sure the anesthesiologist is available and have at least 30 minutes for it to be administered and take effect.
A woman can get an epidural at almost any time in labor if she can remain relatively still; however, an epidural is generally not given if the baby is close to being delivered. Some women have heard they need to be dilated (meaning the cervix opens in preparation for birth) a certain amount before an epidural is given.
In general, you can have an epidural when your cervix has dilated anywhere from 3cm to 9cm. But research suggests 6cm is the optimal dilation for getting an epidural [4]. Bear in mind that extra staff are needed to give you an epidural, so the more notice you can give that you'd like an epidural, the better.
The primary challenge of a natural birth is managing the intensity of pain during labor. For many women, this pain can feel overwhelming, especially during the pushing stage. While breathing techniques and support from your birth team can help, the pain may be more intense than expected.
It is almost never too late to get an epidural unless the head of the baby is visible (crowning). Even if you initially attempted natural childbirth and never saw an anesthesiologist, you may change your mind later on if you find labor to be extremely painful.
Not everyone is a candidate
Women who have bleeding disorders should not have epidurals, due to the risk of hematoma. This includes clotting, platelet or other blood-related issues. Some blood thinning medications may also interfere, depending on when the last dose was taken.
With her second baby, the epidural seemed more effective, and pushing was easier and faster. “They let me feel her head as she was crowning and it gave me the motivation to push her out, and it felt more natural and easier,” she says. Without an epidural, pushing can feel more intense.
Epidurals can be sited at any stage of labour, although it is better to have one sited during the first stage of labour. It takes around 20-25 minutes, longer in some cases, for an epidural to be sited and start working effectively.
Staying mobile during your labor encourages your body and baby to work with gravity and movement, helping your baby descend and encouraging your labor to progress. Usually, your nurse is in charge of helping you rotate/flip/change positions every 30-60 minutes after you have an epidural placed.
Midwives are affected by the setting where they work, and research highlights that an epidural might lead to a focus on medical procedures instead of the normality of labour.
Hospitals and doctors have their own individual policies for epidurals. In most cases, however, an epidural will not be given until the mother is at least 3-4 centimeters dilated. Once the mother is fully dilated most doctors and hospitals will consider it too late for an epidural to be given.
About 73% of U.S. women who give birth use an epidural for pain relief. However, natural birth – choosing vaginal delivery without pain medications or other routine interventions – is becoming more common.
If you don't think you want an epidural, there are other options available that can reduce your pain. Medicated options like a pudendal nerve block or acetaminophen may be helpful if you don't like the idea of an epidural. Or you can look into medication-free methods, like a birthing class.
A new analysis contradicts previous findings that giving an epidural too early can prolong labor and up C-section rates. Let each patient decide when to have an epidural during childbirth. That's the advice of the Cochrane Pregnancy and Childbirth Group based on a recent meta-analysis.
Women who have epidurals are encouraged to move around in bed to get comfortable. The tube is carefully taped in place but you must be careful not to slide on your lower back because this could pull out the tube carrying the medicine. Some women with epidurals can walk to the bathroom or around their room.
While childbirth is famously painful, conditions like Cluster Headaches, severe Kidney Stones, Endometriosis, Trigeminal Neuralgia, and even intense dental procedures like root canals are often described by sufferers as worse, with cluster headaches frequently topping pain scales due to their intensity and lack of breaks, unlike labor. Pain perception is subjective, but these conditions involve excruciating, sharp, or prolonged agony that some individuals rate higher than childbirth.
Everyone's birth experience is different, so there isn't a clear answer. If you had an epidural or other pain relievers during delivery, you'll likely have no clue if or how much you tore until your provider tells you. However, even if you deliver with no pain medication, you may not feel a vaginal tear.
Many women feel a bit down, tearful or anxious in the first week after giving birth. This is often called the "baby blues" and is so common that it's considered normal. The "baby blues" do not last for more than 2 weeks after giving birth.
Many people choose to get an epidural during the first stage of labor once their cervix has dilated to around 4-5 centimeters – this is right before active labor typically begins. If you're eight or more centimeters dilated, it's likely that your care team won't have enough time to place the epidural.
This exhibit shows the coronal view of the cervix during delivery undergoing dilation measurements using a medical professional's fingers. 1 finger is equivalent to 1-2cm dilated, 3 fingers are equivalent to 5-6cms dilated, and 4 fingers are equivalent to 7-10cms dilated.
An epidural can cause fetal distress, generally by triggering a series of events that include slowing down labor, extending the second stage of labor, and lowering the mother's blood pressure.
Take away: One study shows that epidurals increase the risk of tearing. Another says that the reason more tearing occurs with epidurals is that more first time moms choose epidurals and first vaginal deliveries are already associated with a higher risk of tearing.