Many expectant mothers feel uneasy after seeing online “scary stories” about the epidural: a very long, very thick needle, a painful insertion, a sore back afterwards, even paralysis. As the due date approaches, the worry only grows — after all, contractions already hurt, and now a needle has to go into the lower back. Will I be able to handle it? In reality, those pictures exaggerate the visual impact of the instruments and needlessly amplify a mother’s fear of labor analgesia.

What people commonly call “painless delivery” is usually one of the standard forms of labor analgesia: epidural analgesia. It is a type of regional anaesthesia. The anaesthesiologist uses a puncture cannula to place a thin catheter into the epidural space, then continuously infuses a low-concentration analgesic through that catheter into the spinal canal, blocking the transmission of labor pain.

As the most effective and most widely used method of pain relief, epidural analgesia eases the pain of childbirth while the mother stays fully conscious and retains her ability to move. Once regular contractions begin and the cervix is dilated to 2 cm or more, a mother may ask for analgesia based on her situation. The anaesthesiologist first gives a manual test dose and observes how each mother responds to the medication. Generally, within 10 to 20 minutes of the dose, the pain of labor begins to ease.

Depending on the mother’s condition, the anaesthesiologist connects a pump with preset parameters to the catheter. Throughout the rest of labor, the pump keeps delivering medication to reduce pain across the whole process.

A reminder: do not wait until the pain is unbearable before calling the anaesthesiologist. On one hand, leave enough time for the procedure; on the other, performing the puncture during strong, frequent contractions raises both the difficulty and the risk.

Why is labor analgesia promoted?

Labor analgesia does far more than relieve the intense pain of childbirth. It lowers the rate of non-medically-indicated caesarean sections driven by fear of pain, protecting the safety of both mother and baby. It also improves the comfort of delivery and the quality of care, and supports a more supportive fertility policy system.

In June 2025, China’s National Health Commission, together with the National Administration of Traditional Chinese Medicine and the National Disease Control and Prevention Administration, jointly issued a notice on comprehensively advancing labor analgesia. It sets clear targets: by the end of 2025, all tertiary hospitals that provide obstetric services must be able to offer labor analgesia; by 2027, all secondary and higher-level hospitals providing obstetric services must do the same.

For mothers, the benefits of labor analgesia are concrete —

Stable labor — it avoids the sympathetic over-activation, failure to dilate, and stalled labor caused by severe pain.
Conserved energy — the first stage of labor is well rested, leaving more strength to push effectively in the second stage.
Less injury — once pain eases, the mother is emotionally steady, reducing the chance of precipitous labor and forceful pushing that lead to tearing and episiotomy.
Protected mental wellbeing — it greatly lowers the risk of postnatal fear, anxiety, and postpartum depression.
Lower risk — a stable maternal state avoids fetal tachycardia, abnormal fetal movement, and intrauterine stress caused by severe pain, as well as the emergency caesarean risk from pain shock or exhaustion.

What does getting an epidural feel like?

Before the puncture, the anaesthesiologist first numbs the skin locally. That local anaesthetic needle is very fine — a brief pinch, a bit like a blood draw or a routine injection. Once the local anaesthetic takes effect, the puncture itself is not noticeably painful; what you feel more is soreness and pressure. After the analgesia works, the periodic severe pain disappears, leaving only a tightening of the abdomen and mild soreness. There is no numbness or stiffness, the legs can still move, and you remain fully conscious — so you can rest and eat normally and save your strength for delivery.

When can labor analgesia actually begin?

Under modern obstetric guidelines, once labor has started, regular contractions have begun, the pain is hard to tolerate, and the obstetrician and anaesthesiologist assess that there are no contraindications, labor analgesia can be given — there is no need to wait until the cervix is dilated to 3 cm. Starting analgesia early is not passively enduring pain; it is a scientific way to manage labor. Early analgesia helps avoid the exhaustion, fast heart rate, and over-breathing caused by severe contraction pain, and reduces the risk of stalled labor and of switching to a caesarean because the pain cannot be tolerated.

Will an epidural cause back pain after delivery?

The epidural puncture causes only short-term, mild, dull pain at the puncture site, which usually eases on its own within a few days and generally does not leave long-term back pain. Postpartum back pain is quite common, and its main cause is the physiological changes of pregnancy: weight gain and a forward-tilting abdomen shift the load on the lumbar spine, and the back and pelvic muscles are strained over a long period; add to that the delivery process, breastfeeding posture, and carrying the baby. Together these factors cause the discomfort — not the long-term after-effects of epidural analgesia. If back pain persists after delivery, seek prompt evaluation to rule out issues with the pelvis, lumbar spine, and muscles.

Does an epidural delay an emergency C-section?

A properly placed epidural catheter can serve as the anaesthesia pathway for an emergency caesarean. If an indication for conversion arises during labor, there is no need to re-puncture — the doctor only adjusts the dosing and increases the anaesthetic concentration to quickly meet the needs of surgery, so it does not delay the emergency. Only in a few situations — such as the catheter shifting, coming out, or poor analgesia — is a change of anaesthesia method needed; the anaesthesiologist evaluates and plans throughout to keep mother and baby safe.

This article is for health education only and does not replace medical advice. Please consult your obstetrician about your individual situation.

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