Intrathecal vs Epidural for Labor and Delivery

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Pain Medications

There are many kinds of medications that can be used during pregnancy and delivery to help lessen the pain. Epidural and intrathecal pain control are just two of the types used. Before you deliver your baby, you need to know the benefits and disadvantages of intrathecal vs. epidural for labor and delivery.

Intrathecal Pain Control

Intrathecal analgesia is a valuable procedure normally used during the first stage of labor for pain control. It is a simple, effective technique and has a low complication rate which makes it very useful for obstetricians when continuous epidural anesthesia is not obtainable. Intrathecal analgesia is provided by injection of opiates in small doses into the dural space. By using such small doses of narcotics, the mother avoids critical side effects that could happen if given she were given larger doses of narcotics. Additionally, there are no side effects to the newborn. This pain control is useful in rural or community hospitals where intravenous narcotics or relaxation methods are the only means of pain control.

There are very few complications with this method but there are some disadvantages. In the second stage of labor, the pain comes from the passage and descent of the baby through the birth canal. Since intrathecal pain control does not modify the feeling in the perineum and the vagina, this pain medicine does not work for this stage of the delivery. A local anesthetic or block on the perineum may be utilized for added relief of pain in the lower genital tract. All of these concerns need to be considered when understanding intrathecal vs. epidural for labor and delivery.

Epidural Pain Control

Epidural anesthesia is the most widely used form of pain control during labor and delivery. An epidural block is utilized during active labor or right before a C-section is performed and is a local anesthetic or analgesic. The medicine is injected just outside the bag of fluid surrounding the spinal cord into the lower back. The epidural is not actually used as a form of anesthesia but more accurately as pain control. The epidural is utilized to block the nerve impulses from the lower spinal section which produces a lessened feeling in the lower part of the body in order to ease the pain during delivery.

By having an epidural, the mother, who is aware and awake, has less pain in the lower part of the body but it does not notably slow labor down. Additionally, it can be utilized throughout the entire labor. Another kind of epidural is called a walking epidural which is a combination of a spinal injection and an epidural. This epidural gives the mother enough strength to be able to walk around during labor. Like the intrathecal analgesia, there is no harm or effect on the newborn by using the epidural.

There are a few disadvantages to having an epidural. It might only work on one side of the body more than the other side. An epidural can also slow the baby’s heart rate and decrease the mother’s blood pressure. Some women experience a severe headache in the days following the delivery. Additionally, since the epidural might cut off the capability of emptying the bladder, the mother may need a catheter.


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Mayo Clinic Staff. (2009, July 22). Labor and delivery: Pain medications. Retrieved December 22, 2010, from

Wildman, K. M. (1997). Intrathecal Analgesia for Labor. Journal of Family Practice .