Epidurals are usually safe, but as with all medical treatments, side effects and complications can sometimes occur.
For more on side effects of epidurals in labour, read about pain relief in labour.
Low blood pressure
It's normal for blood pressure to fall a little when you have an epidural. Sometimes this can make you feel sick.
Your blood pressure will be closely monitored. If necessary, fluids and medication can be passed through a drip to keep your blood pressure normal.
Loss of bladder control
After having an epidural, you may not be able to feel when your bladder is full because the epidural affects the surrounding nerves.
A catheter may be inserted into your bladder to allow urine to drain away. Your bladder control will return to normal as soon as the epidural wears off.
This can be a side effect of the pain relief drugs that may be used in your epidural.
Medication can be given to help the itching, or the drug in the epidural can be changed.
Feeling sick is less common with an epidural than with other pain relief methods like morphine and other opiates.
It can be treated with anti-sickness medicines, or by raising your blood pressure if it's low.
Inadequate pain relief
The epidural may not block all your pain. You may be offered an additional or alternative pain relief method.
A severe headache can be caused if the bag of fluid that surrounds the spine is accidentally punctured. You may need specific treatment for the headache.
A procedure known as a blood patch may be used to seal up the puncture. It involves taking a small sample of your blood and injecting it into the puncture.
When the blood thickens (clots), the hole will be sealed and your headache will stop.
Not all headaches require a blood patch. Your anaesthetist will discuss your options with you.
Occasionally, some drugs used in the epidural can cause slow breathing or drowsiness.
You will be monitored closely to spot this and it can be treated easily.
Temporary nerve damage
The needle or epidural tube can damage nerves, but this is uncommon. This can cause loss of feeling or movement in parts of the lower body.
The most common symptom is a small numb area with normal movement and strength. This usually gets better after a few days or weeks, but can sometimes take months.
An infection can occasionally develop around the skin next to the epidural tube.
It's rare for the infection to spread. Antibiotics may be necessary or, rarely, emergency surgery.
Permanent nerve damage
In rare cases, an epidural can lead to permanent loss of feeling or movement in, for example, one or both legs.
The causes are:
- direct damage from the epidural needle or catheter
- infection deep in the epidural area or near the spinal cord
- bleeding in the epidural area, causing pressure on the spinal cord
- accidentally injecting the wrong drugs down the epidural catheter
These are rare events, and anaesthetists undergo extensive training to reduce the chances of these complications.
Nerve damage can also happen for other reasons during surgery unrelated to the epidural.
Other very rare complications of an epidural include:
- fits (convulsions)
- severe breathing difficulties
Before deciding to have an epidural, you should discuss the procedure with your anaesthetist.
They can provide further information and advice on the risks of developing complications.