Transcript: About half of all women who give birth in a hospital receive an epidural for pain relief.  The goal of an epidural is to provide analgesia, or pain relief, rather than complete anesthesia, which is total lack of feeling.  Epidurals work by blocking nerve impulses from your lower spine, in turn causing decreased sensation in the bottom portion of the body. Because a standard epidural seeks to provide pain relief,  it’s often combined with a narcotic medication, like morphine or fentanyl. An epidural can also contain MORE narcotics and LESS anesthetic, a procedure known as a combined-spinal epidural, or walking epidural. Although the pain may sometimes be greater with walking epidurals, some women prefer them because they may allow more personal control over pushing. Many physicians recommend that you enter the active phase of labor with the cervix dilated at least three centimeters before you get an epidural  AND you must usually receive about a quart of intravenous fluid to prepare for the procedure. At that point the epidural catheter, a small tube, can be inserted into your epidural space. Epidurals provide pain reduction and may make labor easier for you, and the advantages with respect to pain management are quite clear.— If your labor is particularly long, an epidural may also let you get some much-needed rest. Also, you’ll be fully present at your baby’s birth since the medication does not sedate you. In terms of the disadvantages, epidurals  MAY temporarily make pushing more difficult for you. In addition, about 1 to 3 of every 100 women who has an epidural can develop a severe headache in the days after the procedure, which usually gets better and can be treated. In about 10% of cases, an epidural may ALSO cause your blood pressure to drop suddenly, which may temporarily reduce blood flow to your baby. In addition, the epidural may cause temporary side effects that can include shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinatingSome mothers may wish to consider the potential effect of epidural anesthesia on newborns.  Most medical research indicates that there is little or no medically significant effect of epidurals on newborns, while some studies suggest limited and temporary changes in newborn temperature and breastfeeding behaviors. For most women, the option of epidural anesthesia can provide pain relief during a difficult and stressful labor, with fairly limited risks. Despite the risks, many women weigh their options and decide that a pain-free labor and delivery is the way to go-and most doctors approve. As with all important decisions in pregnancy, discuss this with your obstetrician- preferably BEFORE you go into labor.