When Should I Get an Epidural?
By Kristen Barak-Park, CNM, MS | NĀMU Birth Services
Deciding when to get an epidural is one of the most common questions I hear as a midwife. Whether you’re aiming for a fully medicated birth or just want to keep your options open, understanding the right time to ask for an epidural can help you feel more in control of your birth experience.
Let’s talk about the timing, the tradeoffs, and what you can do before you’re ready for one.
What Is an Epidural and How Does It Work?
An epidural is a type of regional anesthesia that blocks pain in the lower part of your body. It’s administered by an anesthesiologist through a catheter placed in your lower back and can provide significant relief during labor and birth.
But with that relief come a few important considerations—especially around mobility, diet, and monitoring.
What Happens After You Get an Epidural?
1. You Won’t Be Able to Walk Freely
Once the epidural kicks in, you’ll be confined to bed. Some people retain slight leg movement, but walking or using the bathroom on your own is no longer possible.
2. You’ll Switch to Clear Liquids Only
Most hospitals move you to a clear liquid diet after an epidural. That means broth, Jell-O, popsicles, and water—but no solids. This is done in case anesthesia is needed for an emergency cesarean, but it can feel restrictive.
3. You’ll Need a Bladder Catheter
Because the epidural reduces sensation, you won’t be able to feel when your bladder is full. A urinary catheter is usually placed to help empty your bladder during labor.
So, When Should You Get an Epidural?
When you are ready to accept staying in bed, drinking clear liquids only, and having a catheter to go pee. Waiting for a specific number of centimeters dilation may not be very helpful because pain is subjective and different people feel intensity at pretty different dilations.
I have seen some people get an epidural at 2-3 centimeters, I have seen others make it all the way to 8 centimeters without
What Can I Do Before I’m Ready for an Epidural?
If you’re not quite ready for the epidural—or you want to delay it as long as possible—there are several alternative pain management techniques that can offer real relief:
1. IV Pain Medications
Medications like fentanyl or Nubain can take the edge off contractions. They’re typically given in early to mid-labor and wear off after a few hours.
2. Warm Bath or Shower
Hydrotherapy is a simple but powerful tool. Warm water can relax your muscles, ease back pain, and give you a break mentally and physically.
3. TENS Unit
A TENS (transcutaneous electrical nerve stimulation) unit uses mild electrical pulses to reduce pain signals. It works best in early labor, especially for back labor.
4. Nitrous Oxide (“Laughing Gas”)
This inhaled option gives you more control—you breathe it in during contractions and stop when the contraction ends. It doesn’t numb pain, but it can help you feel calmer and more in control.
5. Sterile Water Papules
This lesser-known technique involves injecting small amounts of sterile water just under the skin on your lower back. It sounds intense, but it can significantly relieve back labor for 30–90 minutes.
Every Birth Is Different—And So Is Your Pain Management Plan
The truth is, there’s no perfect time to get an epidural—it’s about your needs, your labor, and your preferences.
At NĀMU Birth Services, I offer personalized childbirth education that walks you through exactly what to expect—from natural coping strategies to medical pain relief options like epidurals, IV meds, and more. You'll leave each session with the clarity and confidence to make the right choices in the moment.
Want to feel prepared no matter how your labor unfolds?
Explore my custom childbirth education packages and schedule a free consultation today.