“How much is this going to hurt?” “Will an epidural make it hurt less?”

Most moms think about these questions.

Many contemplate having an epidural—the low-dose anesthetic that some moms talk about like it's a saving grace.

For some women, maybe it is.

What Exactly is an Epidural?

It's a drug that reduces pain during labor. There are two types or epidurals (pdf), according to the American Congress of Obstetrics and Gynecology.

1) Analgesia: This type of epidural focuses on blocking pain, but you can still feel other sensations in the area and you can still move.

2) Anesthesia: This type of epidural numbs you from the waist down. You lose all feeling, including pain, but remain conscious.

More than half of women who give birth in hospitals use epidurals, according to the American Pregnancy Association.

How do Epidurals Stop Labor Pain?

Epidurals block the nerve impulses from the lower spine, so you feel less pain in the lower half of the body.

To get an epidural, a needle will be inserted into the area surrounding your spinal cord in your lower back (after the area is numbed). Then, a small tube or catheter will be inserted and left in place.

Sometimes, epidural injections include other opioids or narcotics.

Should I Have an Epidural?

There are medical reasons and philosophical reasons both to have an epidural and to skip it.

One reason to have an epidural is obvious: You're pretty sure that giving birth hurts so badly that you'll kick someone if you have to scream through one more contraction.

But, philosophical reasons tend to steer women toward avoiding too much medication during childbirth.

Some advocates for natural childbirth believe epidurals, and other pain-relieving drugs, over-medicate women. Others believe that epidurals make it harder for women to push when it comes to delivery time.

If you feel strongly that you don't want drugs during labor, let your medical team know. You also may want to look into other pain management techniques prior to going into labor.

If you know you plan to have an epidural, let your doctor know that, too, but be ready to adjust if there's a medical reason that you can't have one.

Epidurals aren't an option for some women. You may not be a candidate if you take blood thinners, you're bleeding too much, or labor is moving too fast

Are There Alternatives to Epidurals?

Yes, it's called exercise. While most women think of pregnancy as a time to rest, it's actually not, says the American College of Obstetricians and Gynecologists (pdf).

Exercising during pregnancy can:

  • help reduce backache, constipation, bloating and swelling
  • give you energy and lift your mood
  • help you develop mental discipline to control labor pain
  • tone your lower body to handle the demands of labor and birth

Talk to your doctor about what kind of exercise is best for you based on your fitness level before pregnancy and your personal health history.