On epidurals & the birth of my daughter
On Christmas Day 2024, I gave birth to my first child, a little girl weighing 2.8kg. During labour, I had an epidural for pain relief. An epidural is a type of local anaesthetic, delivered through a small flexible tube that is placed into the lower back. There are no side effects for the baby.
Not everyone’s epidural ends up working in exactly the same way, but I was able to feel my legs and to feel pressure. It meant that I lightly dozed through what are considered to be some of the most painful parts of labour, occasionally having a snack and a cup of tea. I dozed not because the epidural made me sleepy, but because I was so relaxed.
In the minutes right before my daughter was born, I paused to tell my husband that I wasn’t in pain and that the noises I was making were simply from the effort of pushing. He describes this moment as “surreal”. It was surreal for me too – I had expected more pain.
I did experience one unpleasant side effect from the epidural – 20 minutes or so of intense shivering. Epidurals can also make labour last longer, and there’s debate over whether or not having one raises the chance of an unplanned caesarian section.
Epidurals in the UK
Astonished at just how effective my epidural was, I was surprised to learn that I’m in the minority of mothers by choosing to have one.
Take-up is low
Take-up of epidurals in the UK is low. In 2020, a report found they are used in England for just under a third of births (31%). And a 2024 study looking at Scottish data from 567,216 women who gave birth between 2007 and 2019 found that only 22% of mothers received an epidural. By contrast, 83% of French women receive epidurals.
Poorer women are less likely to have an epidural
Research into the aforementioned Scottish data shows that socio-economic deprivation is associated with lower take-up of epidurals. In fact, Scottish women living in the most deprived areas who have a medical condition that means an epidural is advisable for their safety are still less likely to receive one than women from the most advantaged decile with no such medical condition.
Increasing take-up of epidurals
It is a fact that not everyone wants an epidural and that very many women have excellent birth experiences without one. However, I suspect that take-up in the UK would be higher if pregnant women received more information about epidurals from their midwife teams.
Though midwives were extremely supportive of my decision to get one, I found information from the hospital about epidurals sparse as my due date approached. In one information session I attended, epidurals were described as “for those who require further pain relief”. I believe that framing like this means that women are more likely to assume that an epidural simply isn’t for them, and perhaps do not realise that it can literally remove the pain of childbirth.
Anecdotally, I’ve also found that many women worry about the risk of paralysis when considering an epidural. But the Royal College of Anaesthetists puts this risk at somewhere between 1 in 54,500 and 1 in 141,500, or between 0.000707% and 0.001834%.
Things that are more dangerous than having an epidural include hip replacement surgery, liposuction, and having your appendix out.
With this in mind, I believe it is important to better communicate two things to women:
How effective at removing labour pains epidurals are;
How safe they are.
Conclusion
When we think about how we can help more people have the children that they want to have, it’s also important to think about how those children come into the world and how we can make that experience better for parents, especially mothers.
For me, an epidural was part of giving me a good birth experience. And because giving birth – and recovering from it – is going to be physically and emotionally demanding for almost all of us, it is important that women are aware of all the tools available to them. With epidural use at under a third in the UK, I believe we could do a much better job at informing women that this method of pain relief is here for them, if they want it.
Phoebe