The Unspoken Truth About Epidurals: What Every Birthing Person Deserves to Know
When it comes to pain management during labor, epidurals are one of the most common tools offered—and for good reason. For many, they bring real relief and allow rest in long or exhausting labors. But while epidurals are often portrayed as an easy fix or the “default” option, there’s a side of the story that many birthing people aren’t told until they’re already deep in the experience.
As a doula, I don’t hold bias toward whether a client chooses an epidural or not. Every birth is different, and every choice is valid. My role is to support people through whatever path they choose. But time and time again, I’ve seen clients feel surprised, disoriented, or even panicked by the actual experience of having an epidural—because the truth is, it’s not always as straightforward or easy as it’s made out to be.
This article is here to fill in those gaps.
What Is an Epidural, Really?
An epidural is a form of regional anesthesia that blocks sensation from the waist (or higher) down. It’s administered through a catheter placed into the epidural space near your spine. Once it’s in, you’ll often feel numb or tingly from your bra line down. You can’t walk. You can’t reposition yourself. You may not be able to feel or control your pelvic floor muscles.
And that has real implications for how the rest of labor unfolds.
What You Might Not Hear from Providers
1. “You won’t feel pain—but you also won’t feel control.”
Many clients expect relief from pain—and that’s true. But what they aren’t always told is that losing sensation can feel strange, unsettling, or even frightening. Some people describe feeling disoriented or dissociated from their body. I’ve supported clients who were shocked by the intensity of that numbness, especially when paired with the hormonal intensity of labor. You’re doing one of the most powerful physical acts of your life—and you might not be able to feel any of it.
2. “Labor with an epidural is not necessarily easier—just different.”
Providers often say that laboring with an epidural is “easier because you don’t have to feel the pain.” But in my experience, it’s not easier—it’s just a different kind of challenge. You’ll likely be:
Confined to the bed
Hooked up to continuous fetal monitors
Given IV fluids and possibly Pitocin to keep labor progressing
Unable to eat
Dependent on others to help you move or adjust position
At risk for longer labor or interventions like bladder catheterization or assisted delivery
3. “Pushing can be harder—not easier.”
One of the most overlooked challenges of epidurals is that when it’s time to push, you may not be able to feel your contractions or your own pushing muscles. Many people describe this as deeply frustrating—like trying to push out a baby with no feedback from your body. This can lead to:
More coaching from providers (often directing how and when to push)
Less freedom to use instinctual pushing positions (squatting, side-lying, hands-and-knees)
The use of stirrups, bed breakdowns, or directed breath-holding (“purple pushing”)
Increased risk of assisted deliveries (forceps, vacuum) or even cesarean
If providers want you to push more effectively, they may suggest turning down the epidural, which means you begin to feel everything again—often suddenly and without preparation or the freedom to move.
The Psychological Side: When Numbness Feels Like Powerlessness
Epidurals don’t just block pain—they disconnect you from the sensations of labor. While that can be helpful in some circumstances, it can also leave you feeling like a passenger in your own birth. I’ve witnessed clients say:
“I don’t know if I’m doing anything.”
“I feel like I’m not in control of my body.”
“This feels really strange—I didn’t think it would be like this.”
This loss of sensation can be psychologically jarring—especially in such a powerful and vulnerable moment. And unfortunately, it’s not something most people are prepared for ahead of time.
When Epidurals Can Be a Lifeline
To be clear: epidurals have their place. They can be incredibly useful in specific scenarios, like:
If someone is utterly exhausted after days of labor
If contractions are overwhelming and no coping tools are working
If labor has stalled and the body needs rest to reset
If medical complications require a calm, controlled delivery
In those cases, an epidural can allow rest, reset the nervous system, and reduce tension that may be slowing labor down. This is when they can be not just helpful—but transformative.
“I’m planning to labor unmedicated—but I’ll get an epidural if I need it.”
This is one of the most common things I hear from clients. And while it sounds like a balanced approach, in practice, most people who plan to “try unmedicated but get the epidural if it’s too hard” do end up getting it.
Why? Because labor is intense. Without preparation, education, and a strong support team, it’s easy to reach for the epidural the moment it gets hard—especially in a hospital environment where it’s readily available and frequently encouraged.
People who do have unmedicated births usually go in with:
A strong mindset and intention
Practical coping tools
A supportive team (including partners and doulas)
Confidence in their body’s ability to move and labor freely
The Real Takeaway: Make an Informed Choice
This article isn’t about saying epidurals are bad. They’re a powerful medical tool. But no one should walk into birth thinking an epidural will be like flipping a pain-free switch without consequences. It’s not an easy button—it’s a tradeoff.
You deserve to know the full picture:
The loss of movement
The strangeness of numbness
The potential loss of control or connection
The increased need for monitoring, coaching, and intervention
The impact on pushing and recovery
You also deserve support—no matter which path you choose.
Final Words
Whether you plan to go unmedicated or are certain you want an epidural, the most important thing is that you walk into birth informed and empowered. Not surprised. Not misled. Not unsure about what’s happening to your body in one of the most transformative experiences of your life.
I’m here to help you prepare for every possibility—because you deserve a birth that you can feel proud of, no matter how it unfolds.
References
Anim-Somuah, M., Smyth, R. M., Cyna, A. M., & Cuthbert, A. (2018). Epidural versus non-epidural or no analgesia in labour. Cochrane Database of Systematic Reviews, (5). https://doi.org/10.1002/14651858.CD000331.pub4
Gizzo, S., Noventa, M., Fagherazzi, S., Lamparelli, L., Ancona, E., & Di Gangi, S. (2014). Update on best available evidence on epidural analgesia during labor: a literature review. Archives of Gynecology and Obstetrics, 290(3), 543–557.
American College of Obstetricians and Gynecologists (ACOG). (2019). Practice Bulletin No. 209: Obstetric Analgesia and Anesthesia. https://www.acog.org
Lieberman, E., & O’Donoghue, C. (2002). Unintended effects of epidural analgesia during labor: A systematic review. American Journal of Obstetrics and Gynecology, 186(5), S31–S68.
Simkin, P., & Bolding, A. (2004). Update on nonpharmacologic approaches to relieve labor pain and prevent suffering. Journal of Midwifery & Women’s Health, 49(6), 489–504.
Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN). Position Statement: Pain Relief during Labor.https://www.awhonn.org
