EBAMG anesthesiologists are the exclusive obstetric anesthesia service providers at Alta Bates Summit Medical Center - Alta Bates Campus in Berkeley, CA.

We are always happy to discuss pain control options with laboring patients and will work to make your labor experience as comfortable and safe as possible. We have multiple anesthesiologists available on the floor 24 hours a day to help ensure prompt delivery of pain therapies and emergency care.

Frequently Asked Labor Anesthesia Questions

What are my options for pain control during my labor?

The gold standard for pain control during childbirth is the epidural, however, it is not the only option. Intravenous pain control medications (e.g. fentanyl) can also be given, but these medications can have significant side effects and pain control tends to be shorter in duration. Nitrous oxide inhaled during contraction is also a pain control option, but may or may not be available at any given time. Non-pharmacologic techniques (breathing exercises, water, massage, meditation, etc) can also be helpful for certain patients. Please don’t hesitate to ask your labor and delivery nurse to call the anesthesiologist if you’d like more information about pain control options.

What should I expect with an an epidural?

Common side effects that patients experience from an epidural include skin itching, low blood pressure, decreased strength in hips and legs, and decreased bladder control. To address the possible low blood pressure, we will give you extra fluids before we start the procedure and will take your blood pressure more frequently immediately after the epidural is placed. For skin itching, medications will be available to treat the symptoms.  Side effects usually resolve shortly after the epidural medication is stopped. 

Once you have your epidural, we will have you stay in bed because your legs will be weak. A Foley catheter will be placed so that you do not need to get out of bed to empty your bladder. You will also limit what you eat to clear liquids. 

Sometimes as labor progresses the pain with contractions can worsen requiring adjustments to the epidural. If the pain persists sometimes the epidural will need to be replaced. 

What are the main risks of labor epidurals?

Epidurals have been used in labor for decades and are very safe procedures, but as with everything we do in medicine there are risks involved. Whenever we break the skin, there is risk of infection and bleeding. We do these procedures under sterile technique so infections are very rare. In patients without bleeding disorders or on anticoagulation, significant bleeding is also very rare. In any procedure, the possibility of damage to nearby structures is possible. With epidurals damage to the nerves is such a rare complication that the incidence of most neurologic complications has not been determined. We take precautions to perform epidural, combined spinal-epidural (CSE), and spinal procedures below the level of the spinal cord to limit our proximity to critical structures. 

A rare, but serious side effect of epidural anesthesia is the development of a severe headache 24-48 hours after the procedure. If this occurs it is important that you ask your nurse to notify an anesthesiologist as there are a number of treatment options.  If left untreated the headache usually resolves on its own within two to three weeks.

There are many myths about epidurals. Complications of epidurals such as prolonged labor, increased risk of Cesarean section, development of chronic back pain (some soreness a few days after the procedure is normal), and harm to the baby in any way have never been found consistently in research studies. Your anesthesiologist will be happy to discuss any specific concerns you have about the risks of epidurals during your labor.

How do labor epidurals work for pain control?

Every year millions of women receive epidurals to relieve pain associated with childbirth. In the United States, about seventy percent of women in labor get epidurals or other spinal anesthesia. During the procedure, an anesthesiologist will use a needle to insert a small tube (a “catheter”) under the skin into the low part of your back near the nerves of your spinal cord. Usually the most painful part of the procedure is the numbing of the skin of your low back as the procedure begins. Once placed, the tube will then be connected to a pump which delivers local anesthetic medication continuously until you have your baby. After placement of the catheter, most women will receive significant pain relief in about 15 minutes. The goal of an epidural is to provide pain control while still allowing you to feel the pressure of contractions. Sometimes as labor progresses the epidural pain control can require adjustments. Your anesthesiologist will be available throughout your labor to help ensure your comfort.

What are the benefits of labor epidurals?

Epidurals are the best therapy available for pain control during labor and have been used safely for decades. Because the anesthesia medication is given through the catheter close to the spinal nerves, very low dosages can be used. Lower dosages of medications results in a lower amount of medication transferred through the placenta to your baby compared to intravenous pain medications. Epidurals allow the mother to be both fully awake and comfortable for delivery while minimizing the amount of medication to which the fetus is exposed. If it is decided while in labor with an epidural that a Cesarean section (C-section) is preferred method for delivery, the epidural can be used to quickly provide surgical anesthesia. In a situation where a Cesarean section is urgently needed, giving stronger medication through the epidural catheter is the fastest option for obtaining surgical anesthesia.

What kind of anesthesia will I get for a Cesarean section?

Spinal anesthesia, epidural anesthesia, and general anesthesia are all possible options for a c-section. The type of anesthesia you get depends on the health of you and your baby and why you’re having a c-section. In a scenario where a c-section is elective, the preferred method is typically a spinal block. If you already have an epidural catheter in place during labor, your physician anesthesiologist will be able to inject a stronger medication through it to provide surgical anesthesia. In cases of emergency or significant bleeding, general anesthesia may be necessary, which would involve placing a breathing tube.

Click below for an educational video about pain management during labor.