When it comes to pain control and birth, most of us are familiar with epidurals. Epidurals, when working properly, remove any and all sensations of pain you might feel during labor. But it comes with the downside of being completely bedridden, and well, not feeling anything at all.
Insert: The walking epidural.
Walking epidurals are very similar to a traditional epidural, but they allow for greater feeling and movement in the lower half of the body.
This makes them very appealing to mamas that want a sort of “hybrid” birth experience. One where the edge is taken off the pain, but not so much that they can’t move or feel the sensations of labor and delivery.
Read on to learn more about what a walking epidural is, how it works, its pros and cons, and so much more!
Follow @mommy.labornurse on Instagram to join our community of over 650k for education, tips, and solidarity on all things pregnancy, birth, and postpartum!
What is a walking epidural?
On the most basic level, a walking epidural is a form of pharmaceutical pain relief that can be administered during labor. It’s quite similar to a traditional epidural, but it allows for greater feeling and movement in the lower half of the body.
Most of the time, walking epidurals use the same medication as a traditional epidural – just given at a lesser dose, but in other cases, a slightly different medication might be used.
What’s interesting is that even the medication used in traditional epidurals can vary from hospital to hospital, so this isn’t that surprising!
Additionally, walking epidurals are administered in a slightly different spot in your spinal column to promote more mobility and sensation. In short, a walking epidural is a great alternative to the complete numbness offered by a traditional epidural.
How does a walking epidural work?
You’re probably starting to gather that a walking epidural is essentially just a less potent epidural. So, not surprisingly, a walking epidural works in the same way too! It is a medication that is administered by an anesthesia team member into your spinal column.
For the placement of your walking epidural, you will need to sit still with your back curved like a shrimp, while an anesthesia team member injects a needle into the spinal space of your spinal column. This differs from a traditional epidural which goes in the epidural space of your spinal column.
Once the needle is in the correct space, a thin, flexible catheter is fed through the needle. This catheter stays in your back and the needle is removed. The catheter gets taped to your back and medication continuously flows into that epidural space.
Because of the placement of the medication, you will get almost instant pain relief, but keep in mind that with a walking epidural the medication is given in lower doses. This is what allows the birthing mama to have more flexibility when moving from one position to another.
Related Reading: How Does an Epidural Work?
Can I get a walking epidural?
The answer to this question isn’t so black and white. In theory, anyone who is eligible for a traditional epidural should be able to get a walking epidural.
So, what are the contraindications for an epidural?
- You and/or your baby are unstable
- You can’t sit still
- You have a low platelet count
- You have a local infection
- Your baby is actively coming out of you
The factor of whether you can or cannot get a walking epidural has more to do with their availability!
How common are walking epidurals?
You see, across the board, they are gaining more popularity, but they are still not commonly offered to women during labor at most birthplaces. Many of the hospitals where I live and practice at the bedside do not offer walking epidurals.
I don’t know exactly why they aren’t offered, but I suspect it’s because most women opting for an epidural are looking for total pain relief! The pain relief from a walking epidural really kind of pales in comparison, and from what I’ve heard, most women end up converting their walking epidural to a full epidural anyway.
However! I’m not saying this to discourage you from asking about it and trying it out. I’m simply stating what I’ve heard in the world of labor and delivery. If you are really interested in getting one, definitely discuss it with your provider at one of the prenatal appointments leading up to your due date!
Walking epidurals vs. standard epidurals
Alright, so as we’ve been learning about walking epidurals, I’ve been mentioning some of the similarities and differences between walking epidurals vs. standard epidurals.
But let’s go ahead and break it down into a list format:
- The process of receiving a traditional and walking epidural is the same for the birthing mama
- Traditional epidurals go in the epidural space. The epidural space is just outside of the space that contains spinal fluid and the spinal cord – pain relief will take 20-30 minutes to take full effect
- Walking epidurals go in the spinal space. This means that a small amount of medication is injected directly into your spinal fluid – providing instant pain relief
- The same type of medication is often used, but the amount of medication is less in a walking epidural
- A walking epidural allows mama to labor in a variety of positions, and in some cases even walk around her labor room or the labor and delivery unit
- In both a traditional and walking epidural, the needle is removed, and a small catheter (tube) remains in place to continuously administer medication throughout labor
The pros, cons, risks, and benefits
The pros of a walking epidural
- Quick onset
- Greater ability to move more freely throughout labor
- Increased variety of positions you can labor in
- Frequent position changes in labor can help baby get into a more favorable birthing position
- Labor may be shorter due to the ability to move around more easily
- May decrease the need for other interventions, like forceps and vacuum use
- More make pushing more effective during the second stage of labor because you can feel the contractions
Potential drawbacks of a walking epidural
- The medication administered isn’t as strong, so you will continue to feel some pain with contractions as your labor progresses
- The same risks that apply to traditional epidurals apply to walking epidurals (see below)
- Because the walking epidural needle is placed into the spinal space, there is a greater chance of experiencing a spinal headache after delivery
- Even though it is called a ‘walking’ epidural, most women are not able to walk around after it is administered. And even if you can, many hospitals prohibit women with walking epidurals to walk around due to safety reasons
Are their risks associated with walking epidurals?
Really there are no extra risks that come with a walking epidural. The risks that apply for traditional epidurals apply for walking epidurals as well though.
These include:
- Decrease in blood pressure
- The epidural not working or being “one-sided”
- Itching and shivering
- Epidural fever
- Back pain
- Nausea
As a reminder, epidurals are considered to be a completely safe form of pain relief for childbirth, and the likelihood of any serious risk is very minimal.
Related Reading: 12 Important Epidural Side Effects and Facts You May Not Know
What are the benefits of walking epidurals compared to traditional epidurals?
The main benefit is that walking epidurals allow you to be more dialed into what’s going on with your body, while still providing some pain relief.
Additionally, they:
- Have a fast onset
- Give you the ability to move more freely throughout labor
- Allow you to labor in an increased variety of positions, which can help baby get into a more favorable birthing position
- Labor may be shorter due to the ability to move around more easily
- May decrease the need for other interventions, like forceps and vacuum use
- May allow you to experience more effective pushing during the second stage of labor because you can feel the contractions
Related Reading: How to Push During Labor
Wrapping up
Now that you know the ins and outs of walking epidurals, what are you thinking? Interested in this for your birth?
Remember, the biggest thing to be aware of is that as of now walking epidurals are not commonly offered to women throughout labor – but their use is growing every year!
I recommend talking to your provider during prenatal appointments to discuss what options are available to you for pain relief in general, in addition to walking epidurals.
Not all hospitals provide the same pain relief interventions, so it’s important to know what your options are so you can make an informed decision before you give birth.
