Quick take: An epidural is the most effective pain relief for labor, but it can cause short-term side effects like low blood pressure, itching, and a post-procedure headache. Serious complications are rare, and most side effects resolve within hours to days. If you experience severe headache, fever, or numbness that doesn’t fade, call your provider right away. This article covers every common and rare side effect, how long they last, and what to do about them.
You’re 5 centimeters dilated, contractions are coming every 3 minutes, and the pain is more intense than you imagined. The anesthesiologist walks in, explains the epidural procedure, and you sign the consent form—relieved, but also a little nervous. "What if it doesn’t work? What if I get a headache? What if it hurts the baby?" These questions swirl in your mind as the needle goes in. It’s normal to feel anxious about the unknown, especially when it comes to something as important as pain relief during labor.
Here’s the good news: epidurals are used in over 70% of hospital births in the U.S., and most women tolerate them well. But like any medical procedure, they come with potential side effects—some mild, some more serious. In this guide, we’ll walk you through every possible side effect, how long they last, and what you can do to manage them. We’ll also compare epidurals to other pain relief options, so you can make the choice that’s right for you.
What Are the Common Short-Term Side Effects of an Epidural During Labor?
Most side effects of an epidural are mild and temporary. They happen because the medication numbs the nerves in your lower back, which can affect other parts of your body too. Here’s what you might experience in the hours after the epidural is placed:
- Low blood pressure (hypotension): This is the most common side effect, affecting about 1 in 5 women. The epidural can relax your blood vessels, causing your blood pressure to drop. Your medical team will monitor this closely and may give you fluids or medication to bring it back up.
- Itching: About 1 in 3 women experience itching, especially on the face, neck, or chest. It’s usually mild and goes away on its own, but your provider can give you medication if it’s bothersome.
- Nausea or vomiting: This can happen if your blood pressure drops too low or if the medication affects your stomach. Anti-nausea medication can help.
- Shivering: Some women feel cold or shiver after an epidural. This is usually harmless and goes away on its own.
- Backache: You might feel soreness at the injection site for a day or two. This is normal and not the same as a serious complication.
- Difficulty urinating: The epidural can numb the nerves that control your bladder, so you may need a catheter to empty it during labor.
- Leg weakness or heaviness: The epidural numbs the nerves in your legs, so you may not be able to walk or move them easily. This is temporary and wears off after the medication is stopped.
Many moms describe the feeling of an epidural as a wave of relief—like a warm blanket wrapping around their lower body. One reader shared, "I was so focused on the pain of contractions that I didn’t even notice the epidural going in. When it started working, it was like someone turned down the volume on my pain. I could finally relax and focus on my breathing."
But it’s not always perfect. Another mom told us, "The itching was the worst part for me. It started about 30 minutes after the epidural and lasted for a few hours. My nurse gave me some medication, and it helped, but I was so distracted by it that I almost forgot about the contractions!"
How Long Do Epidural Side Effects Typically Last After Delivery?
- Immediately after delivery (0–2 hours): You may still feel numbness or heaviness in your legs, and your blood pressure might be monitored closely. If you had a catheter, it will be removed once you can feel your bladder again.
- First 24 hours: Itching, nausea, and shivering usually go away within a few hours. Backache at the injection site may last a day or two. If you had a fever during labor (a possible side effect of epidurals), it should resolve within 24 hours.
- 2–3 days: Most women feel back to normal by this point. If you had a post-epidural headache (more on this later), it may take a few days to fully go away.
- 1 week or longer: Serious complications like nerve injury or infection are rare, but if they happen, recovery can take weeks or months. Most women, however, don’t experience these.
One mom described her recovery like this: "I had a little soreness at the injection site for about a day, and my legs felt heavy for a few hours after delivery. But by the next morning, I was up and walking around like normal. The epidural made labor so much more manageable that I didn’t mind the temporary side effects."
It’s important to remember that everyone’s body reacts differently. Some women bounce back within hours, while others take a little longer. If you’re still feeling side effects after a few days, or if they’re getting worse, let your provider know.
Can an Epidural Cause Low Blood Pressure in Pregnant Women?
Yes, low blood pressure (hypotension) is the most common side effect of an epidural, affecting about 14–30% of women. Here’s why it happens and what you can do about it:
Why Does an Epidural Cause Low Blood Pressure?
The epidural medication blocks the nerves that control your blood vessels, causing them to relax and widen. This can lead to a drop in blood pressure, which may make you feel lightheaded, dizzy, or nauseous. In rare cases, it can also affect your baby’s heart rate if your blood pressure drops too low.
How Is It Managed?
Your medical team will monitor your blood pressure closely before, during, and after the epidural is placed. If it drops, they may:
- Give you IV fluids to increase your blood volume.
- Adjust your position (lying on your side can help).
- Give you medication to raise your blood pressure (like ephedrine or phenylephrine).
What Does It Feel Like?
Some women don’t notice anything, while others feel dizzy, sweaty, or nauseous. One mom described it like this: "I felt like I was going to faint. My vision got blurry, and I had to lie down. The nurse gave me more fluids, and within a few minutes, I felt better."
Is It Dangerous?
Most cases of low blood pressure are mild and easily managed. However, if your blood pressure drops too low, it can reduce blood flow to the placenta, which may affect your baby’s heart rate. This is why your medical team will monitor you and your baby closely.
Can You Get an Epidural If You Already Have Low Blood Pressure?
Yes, but your provider will take extra precautions. They may give you IV fluids before the epidural to help stabilize your blood pressure. If you have a history of low blood pressure or other medical conditions, let your provider know ahead of time so they can plan accordingly.
What Are the Signs of a Serious Epidural Complication That Need Emergency Care?
Serious complications from an epidural are rare, but they can happen. Knowing the warning signs can help you get prompt treatment if needed. Here’s what to watch for:
1. Severe Headache (Post-Dural Puncture Headache)
What it is: This happens if the epidural needle accidentally punctures the dura (the membrane around your spinal cord), causing spinal fluid to leak. It affects about 1 in 100 women who get an epidural.
Symptoms: A severe headache that gets worse when you sit or stand up and improves when you lie down. It may be accompanied by neck stiffness, nausea, or sensitivity to light.
When to seek help: If you have a severe headache that doesn’t go away with pain medication or gets worse over time, call your provider. This usually starts within 48 hours after delivery.
2. Nerve Injury
What it is: This is very rare (about 1 in 1,000 to 1 in 10,000 cases) and usually temporary. It can happen if the epidural needle or catheter irritates or damages a nerve.
Symptoms: Numbness, tingling, or weakness in your legs that doesn’t go away after the epidural wears off. In rare cases, you may have trouble walking or controlling your bladder or bowels.
When to seek help: If you have persistent numbness, weakness, or trouble moving your legs after the epidural wears off, let your provider know right away.
3. Infection (Epidural Abscess or Meningitis)
What it is: This is extremely rare (less than 1 in 100,000 cases) but serious. It can happen if bacteria enter the epidural space during the procedure.
Symptoms: Fever, severe back pain, headache, neck stiffness, or confusion. Symptoms usually start within a few days after delivery.
When to seek help: If you develop a fever, severe back pain, or any of the other symptoms listed above, seek medical attention immediately.
4. High Block or Total Spinal
What it is: This happens if the epidural medication spreads too high in your spine, affecting your breathing or heart rate. It’s very rare (about 1 in 10,000 cases).
Symptoms: Difficulty breathing, numbness or weakness in your arms, or a sudden drop in blood pressure. You may also feel lightheaded or faint.
When to seek help: This is a medical emergency. If you experience any of these symptoms, tell your provider immediately.
5. Allergic Reaction
What it is: Some women are allergic to the medications used in an epidural. This is rare but can be serious.
Symptoms: Rash, itching, swelling, difficulty breathing, or dizziness.
When to seek help: If you develop any signs of an allergic reaction, tell your provider right away.
One mom shared her experience with a post-dural puncture headache: "I thought I was just tired after delivery, but the headache got worse and worse. By the second day, I couldn’t even sit up to hold my baby. My provider diagnosed me with a spinal headache and gave me a blood patch, which helped right away. I wish I had called sooner!"
Remember, serious complications are rare, but it’s important to know the signs. If something doesn’t feel right, trust your instincts and call your provider.
Does an Epidural Increase the Risk of Fever During Labor?
Yes, studies show that women who get an epidural are more likely to develop a fever during labor. Here’s what you need to know:
How Common Is It?
About 1 in 5 women who get an epidural develop a fever (temperature above 100.4°F or 38°C) during labor, compared to about 1 in 20 women who don’t get an epidural. The risk increases the longer you have the epidural in place.
Why Does It Happen?
Researchers aren’t entirely sure, but there are a few theories:
- Inflammation: The epidural may cause a mild inflammatory response in your body, which can raise your temperature.
- Reduced sweating: The epidural can affect the nerves that control sweating, making it harder for your body to cool down.
- Infection: While rare, an infection at the epidural site could cause a fever. However, most fevers during labor are not due to infection.
Does It Affect the Baby?
If you develop a fever during labor, your baby may also have a slightly higher temperature at birth. In some cases, this can lead to:
- An increased heart rate (fetal tachycardia).
- A higher chance of needing antibiotics after birth (if the fever is thought to be due to infection).
- A slightly higher risk of breathing problems or low Apgar scores (though most babies are fine).
One mom told us, "I had a fever during labor, and my baby’s heart rate went up. The nurses gave me antibiotics just in case, and my baby was fine. It was scary at the time, but everything turned out okay."
How Is It Managed?
If you develop a fever during labor, your provider will:
- Monitor your temperature and your baby’s heart rate closely.
- Give you fluids and medication to lower your fever (like acetaminophen).
- Consider giving you antibiotics if they suspect an infection.
- May recommend delivering sooner if the fever is high or your baby shows signs of distress.
Can You Prevent It?
There’s no guaranteed way to prevent an epidural-related fever, but staying hydrated and keeping your room cool may help. If you’re concerned, talk to your provider about the risks and benefits.
How to Treat a Post-Epidural Headache After Childbirth
A post-epidural headache (also called a post-dural puncture headache) is one of the most common—and most uncomfortable—side effects of an epidural. Here’s what you need to know about treating it:
What Causes It?
This type of headache happens when the epidural needle accidentally punctures the dura (the membrane around your spinal cord), causing spinal fluid to leak. The leak reduces the pressure around your brain, which can cause a severe headache. It affects about 1 in 100 women who get an epidural.
What Does It Feel Like?
The headache is usually:
- Severe and throbbing.
- Worse when you sit or stand up and better when you lie down.
- Often accompanied by neck stiffness, nausea, or sensitivity to light.
One mom described it like this: "It felt like someone was hammering on my head from the inside. I couldn’t even sit up to feed my baby. The only thing that helped was lying flat in a dark room."
How Is It Treated?
Most post-epidural headaches go away on their own within a few days, but there are treatments that can help:
1. Conservative Treatments (First Line)
- Bed rest: Lying flat can help reduce the pressure on your brain.
- Hydration: Drinking plenty of fluids can help your body replace the lost spinal fluid.
- Caffeine: Coffee, tea, or caffeine pills can help constrict the blood vessels in your brain and relieve the headache.
- Pain medication: Over-the-counter pain relievers like acetaminophen or ibuprofen can help with mild headaches.
2. Blood Patch (For Severe Headaches)
If your headache is severe and doesn’t improve with conservative treatments, your provider may recommend a blood patch. This is a procedure where a small amount of your own blood is injected into the epidural space to "patch" the leak. It’s about 90% effective and usually provides relief within hours.
One mom who had a blood patch said, "I was in so much pain that I could barely function. The blood patch worked like magic—within an hour, the headache was gone. I wish I had done it sooner!"
How Long Does It Last?
Most post-epidural headaches start within 48 hours after delivery and last for a few days to a week. With treatment, they usually go away faster. If your headache lasts longer than a week or gets worse, let your provider know.
Can You Prevent It?
There’s no guaranteed way to prevent a post-epidural headache, but using a smaller epidural needle may reduce the risk. If you’re concerned, talk to your anesthesiologist about their technique.
Are There Long-Term Neurological Risks Associated With Epidural Anesthesia?
For most women, the side effects of an epidural are short-term and resolve completely. But what about long-term risks? Here’s what the research says:
1. Nerve Damage
Risk: Temporary nerve damage (like numbness or tingling) happens in about 1 in 1,000 to 1 in 10,000 cases. Permanent nerve damage is extremely rare (less than 1 in 200,000 cases).
What it looks like: Most cases of nerve damage are mild and go away on their own within a few weeks or months. In rare cases, you may have persistent numbness, weakness, or pain in your legs or back.
Why it happens: It can be caused by the epidural needle or catheter irritating a nerve, or by pressure on a nerve during labor (which can happen even without an epidural).
2. Back Pain
Risk: Many women worry that an epidural will cause long-term back pain, but studies show that it doesn’t. In fact, women who get an epidural are no more likely to have back pain 6 months after delivery than women who don’t.
What it looks like: Some women have soreness at the injection site for a few days or weeks, but this is not the same as chronic back pain.
Why it happens: Pregnancy itself puts a lot of strain on your back, and labor can cause muscle soreness. These factors are more likely to cause back pain than the epidural.
3. Chronic Headaches
Risk: Post-epidural headaches usually go away within a week, but in rare cases, they can last longer. Chronic headaches after an epidural are very rare.
What it looks like: If you have a persistent headache that doesn’t go away with treatment, your provider may recommend further evaluation.
4. Other Neurological Risks
Other long-term neurological risks, like paralysis or brain damage, are extremely rare. The risk of these complications is much lower than the risk of complications from general anesthesia (which is rarely used for childbirth).
What Does the Research Say?
A large study published in the New England Journal of Medicine followed over 1,000 women for 6 months after delivery and found no difference in long-term back pain or neurological problems between women who got an epidural and those who didn’t. The American College of Obstetricians and Gynecologists (ACOG) states that epidurals are safe and effective for pain relief during labor, with a very low risk of long-term complications.
One mom shared her experience: "I was so worried about long-term side effects that I almost didn’t get an epidural. But after 18 hours of labor, I was exhausted and in so much pain. The epidural was a lifesaver, and I haven’t had any issues since. My back feels fine, and I’m so glad I made the choice that was right for me."
Who Is at Higher Risk?
While long-term risks are rare, some women may be at higher risk for complications, including:
- Women with bleeding disorders or who take blood thinners.
- Women with infections or skin conditions at the injection site.
- Women with certain neurological conditions (like multiple sclerosis).
- Women who have had previous back surgery.
If you have any of these risk factors, talk to your provider about whether an epidural is right for you.
Epidural vs. Spinal Anesthesia Side Effects for Childbirth
Epidurals and spinals are both types of regional anesthesia used for pain relief during childbirth, but they work differently and have different side effects. Here’s how they compare:
| Feature | Epidural | Spinal |
|---|---|---|
| How it works | A catheter is placed in the epidural space (outside the dura), and medication is delivered continuously or in doses. | A single injection is placed in the spinal fluid (inside the dura), and the medication works immediately. |
| Onset of pain relief | 10–20 minutes | 2–5 minutes |
| Duration | Can be used for the entire labor and delivery (catheter stays in place). | Lasts 1–2 hours (no catheter, so it can’t be topped up). |
| Common side effects | Low blood pressure, itching, nausea, backache, difficulty urinating, leg weakness. | Low blood pressure, itching, nausea, headache (higher risk of post-dural puncture headache), leg weakness. |
| Risk of post-procedure headache | About 1 in 100 | About 1 in 100 to 1 in 200 (higher because the needle goes into the spinal fluid). |
| Use for labor vs. C-section | Used for both labor and C-sections (can be topped up for surgery). | Usually used for planned C-sections (works quickly but doesn’t last long). |
| Ability to move | Some women can walk with an epidural (called a "walking epidural"), but most have limited mobility. | Most women can’t move their legs at all during a spinal. |
| Effect on pushing | May make it harder to feel contractions, so you might need coaching to push effectively. | Not typically used for labor (only for C-sections), so this isn’t a concern. |
Which One Is Right for You?
The choice between an epidural and a spinal depends on your situation:
- Epidural: Best for labor pain relief because it can be used continuously. It’s also used for C-sections if you already have an epidural in place.
- Spinal: Best for planned C-sections because it works quickly and provides complete numbness. It’s not typically used for labor because it doesn’t last long enough.
One mom who had both shared her experience: "I got an epidural for labor, and it was amazing. I could still feel pressure, but the pain was gone. When I needed a C-section, they topped up my epidural, and I didn’t feel a thing. I’m so glad I didn’t have to go under general anesthesia!"
Combined Spinal-Epidural (CSE)
Some women get a combined spinal-epidural (CSE), which gives the quick pain relief of a spinal with the ability to top up the epidural for longer labor. The side effects are similar to an epidural, but the risk of post-dural puncture headache is slightly higher because the spinal needle is used.
Epidural Side Effects and Breastfeeding Safety
If you’re planning to breastfeed, you might be wondering whether an epidural will affect your baby or your milk supply. Here’s what you need to know:
Does an Epidural Affect Breastfeeding?
Most research shows that epidurals do not have a long-term impact on breastfeeding. A large study published in the Journal of Human Lactation found no difference in breastfeeding success between women who got an epidural and those who didn’t. However, there are a few short-term considerations:
1. Medication Transfer to Baby
The medications used in an epidural (usually a combination of a local anesthetic like bupivacaine and a narcotic like fentanyl) do cross the placenta, but the amounts are very small. Your baby may be a little sleepy at birth, but this usually wears off within a few hours. One study found that babies born to mothers who had an epidural were just as likely to breastfeed successfully as babies born without an epidural.
2. Delayed Lactogenesis II
Some studies suggest that epidurals may slightly delay the onset of "milk coming in" (lactogenesis II), but this doesn’t seem to affect long-term breastfeeding success. Staying hydrated and nursing frequently can help encourage milk production.
3. Maternal Fatigue
Labor is exhausting, and an epidural can help you conserve energy by reducing pain. This may make it easier for you to breastfeed in the early hours after birth. One mom told us, "I was so tired after labor that I don’t know if I could have breastfed without the epidural. It helped me stay calm and focused on my baby."
Tips for Breastfeeding After an Epidural
If you’re planning to breastfeed, here are a few tips to help things go smoothly:
- Nurse as soon as possible after birth: Skin-to-skin contact and early breastfeeding can help your baby latch and stimulate milk production.
- Stay hydrated: Drink plenty of fluids to help your milk come in.
- Ask for help: If you’re having trouble with latching or positioning, ask a lactation consultant or nurse for assistance.
- Be patient: It can take a few days for your milk to come in fully. In the meantime, your baby is getting colostrum, which is packed with nutrients and antibodies.
What About Spinals or CSEs?
The medications used in spinals and combined spinal-epidurals (CSEs) are similar to those used in epidurals, so the breastfeeding considerations are the same. If you’re having a C-section, you may need extra support with breastfeeding positioning (like using a football hold) because of your incision.
Epidural Side Effects After a Cesarean Section
If you have a C-section, you’ll likely get either an epidural or a spinal for pain relief. Here’s what to expect in terms of side effects after the procedure:
Common Side Effects
The side effects of an epidural or spinal after a C-section are similar to those during labor, but there are a few additional considerations:
- Numbness: You may still feel numbness or heaviness in your legs for a few hours after the procedure. This is normal and will wear off as the medication wears off.
- Itching: This is common, especially if you received a narcotic like fentanyl. It usually goes away on its own, but your provider can give you medication if it’s bothersome.
- Nausea: This can happen if your blood pressure drops or if you received narcotics. Anti-nausea medication can help.
- Backache: You may have soreness at the injection site for a day or two.
- Headache: The risk of a post-dural puncture headache is slightly higher with a spinal than with an epidural, but it’s still rare (about 1 in 100 to 1 in 200 cases).
- Difficulty urinating: You may need a catheter for a few hours after the procedure until the numbness wears off.
Pain Management After a C-Section
After a C-section, you’ll likely receive:
- Oral pain medication: Like acetaminophen or ibuprofen.
- IV pain medication: If you had an epidural, your provider may give you additional medication through the catheter for the first day or two.
- Narcotics: Like oxycodone or hydrocodone, if needed for severe pain. These are safe to take while breastfeeding in small doses, but let your provider know if you’re nursing.
One mom who had a C-section shared, "I was worried about the pain after surgery, but the epidural helped so much. I could still feel pressure, but I didn’t have sharp pain. The nurses gave me oral medication, and I was up and walking the next day."
Recovery Timeline
- First 24 hours: You’ll likely stay in bed for the first few hours while the numbness wears off. You may need help getting up to use the bathroom or hold your baby.
- First 2–3 days: You’ll start walking around more, and your provider will encourage you to move to help with recovery. You may still need pain medication, but the doses will decrease.
- 1 week or longer: Most women feel much better by this point, though you may still have some soreness or fatigue. Avoid heavy lifting or strenuous activity until your provider gives you the okay.
When to Call Your Provider
While most side effects are mild, call your provider if you experience:
- Severe pain that doesn’t improve with medication.
- A fever over 100.4°F (38°C).
- Redness, swelling, or drainage at the incision site.
- Heavy bleeding or foul-smelling vaginal discharge.
- Signs of a blood clot, like leg pain, swelling, or redness.
Epidural Side Effects on Baby’s Heart Rate
One of the biggest concerns moms have about epidurals is whether they’ll affect their baby’s heart rate. Here’s what you need to know:
How an Epidural Can Affect Baby’s Heart Rate
The most common way an epidural can affect your baby is by causing a temporary drop in your blood pressure. If your blood pressure drops too low, it can reduce blood flow to the placenta, which may cause your baby’s heart rate to slow down (a condition called fetal bradycardia). This happens in about 1 in 5 women who get an epidural, but it’s usually mild and easily managed.
