Spinal block in labour - how does it relieve labour pain?

So, it’s important to know how they work, how effective they are, and what the possible side effects are before you go into labour – on the off chance you end up needing or wanting one.

In this piece, we’ll cover:

• What a spinal block is and how it works
• Who spinal blocks are suitable for
• When spinal blocks are used during labour
• The differences between spinal blocks and epidurals
• Real mums’ experiences of having a spinal

You can skip ahead by clicking on any of the above links – though we’d suggest giving the whole piece a read, so you’re armed with as much info as poss ✊

What is a spinal block?

A spinal block is an injection of local anaesthetic in the lower back, near your spine – which basically numbs you from pain in the lower half of your body i.e. where your contractions are happening.

It’s similar to an epidural in that regard, but spinal blocks are actually faster to administer, last only a couple of hours and cannot be 'topped up'.

How does a spinal block work?

We imagine that a needle to the back is a pretty scary concept for some – so you’ll be pleased to know that first, local anaesthetic cream will be applied to the area where the needle goes.

This should make the actual administering of the spinal block a little easier, we hope!

Then, a local anesthetic-analgesic mix is injected via one single injection directly into the cerebrospinal fluid in the small of your back.

The needle is typically very fine, so it’s not comically huge or anything like that – though you will need to lie on your side and stay very still for the anaesthetist while they’re placing the needle.

With a spinal block, you won’t need a catheter put in.

After you’ve had your spinal, it’s very likely you’ll lose feeling in your legs or become pretty limited mobility-wise.

This is because the spinal is numbing the lower half of your body, crucially the nerves that transmit pain from the uterus and cervix.

How long does a spinal block last for?

Typically, the pain relief from a spinal block will last between 1 – 3 hours.

Unfortunately, unlike an epidural, you can’t top up a spinal block. It’s a one shot deal!

Who can have a spinal block?

Spinals are usually available for women giving birth in hospital – though each hospital will have its own policy on who can have them, and when they’re administered.

We’d definitely recommend telling your midwife you want a spinal block if you do, so he or she can double check they’re possible at your hospital and to make sure an anaesthetist will be on hand for your birth.

Many spinals seem to be an emergency pain relief thing, so if you’re in hospital and you need it ASAP for an emergency birth, you’ll get it as priority.

If you’re having a home birth, you can’t have a spinal block – as they’re only given by qualified anaesthetists.

When can I use a spinal block?

Typically, spinals are used during the pushing stage of labour – especially when there’s no time for an epidural.

Spinals are also often used in emergency situations where intervention such as a ventouse or forceps birth is necessary. Some hospitals routinely do spinals along with C-sections.

It’s best to check with your midwife to see what your local hospital’s policy is.

Spinal block or epidural – which is better?

Loads of you want to know: is there a better option between a spinal block and an epidural?

Truth be told, both have their pros and cons, and we can’t say for sure which will be right for YOU on the day.

We’d suggest reading our full guide to epidurals and then weighing up the advantages, disadvantages and possible side effects for a spinal block…

Advantages of spinal blocks

• A highly effective form of pain relief, most women experience complete relief from pain
• Faster-acting than epidurals
• Requires only a single injection and doesn't require a catheter in your back
• The anaesthetic does not affect your state of mind
• An spinal for a C-section allows you to be conscious for the delivery of your baby
• Can be used to give you a break during labour and allow you to regain strength for delivery
• In the case of intervention being necessary, a spinal is far safer for both mother and baby than a general anaesthetic

Disadvantages of spinal blocks

• Lasts only 2-4 hours and cannot be topped up as an epidural can
• Numbs the feeling in your legs and so limits mobility
• You might experience side-effects of itching, shivering, nausea and difficulties urinating
• A low-pressure headache is more likely to occur than with an epidural

What’s it really like to have a spinal block?

The above’s all well and good, but what does a spinal block really feel like when you’re in the throes of pushing out your little one or delivering via caesarean?

Lots of our forum mums have had spinal blocks and epidurals, and have been more than happy to share their varied experiences…

“I had a spinal block topped up with an epidural,” says Nicole, a member of our MadeForMums community. “The spinal block took effect instantly, whereas I think an epidural can take up to 20 mins to kick in.

“I think a spinal is given as a one-off dose though, whilst an epidural can be topped up regularly.

“It was the epidural that was topped up (which meant I couldn't feel my legs at all) before I was taken to theatre, in case I had to have a C-section. Fortunately the ventouse and forceps worked though!”

“During my labour I had an epidural (I laboured up to 6-7cm dilated) and it took effect instantly," says Gabrielle from our MadeForMums community.

"I could feel my legs as normal and move them around (probably couldn't have walked though), the only difference was all the pain vanished - yay!

“An epidural is not as strong as a spinal block - they actually limit the dose when you need to push so you can feel when to.

“I had an emergency section in the end and had a spinal as I could feel it with the epidural (or at least I was paranoid I could!).

“The spinal completely paralyses you and you can’t move or anything until it wears off (in my case about 4 hours.) after that I was walking around etc.”

Olivia is a bit of a seasoned pro when it comes to spinal blocks – and was pretty happy with the majority of the pain relief it gave her.

“I had 3 spinals - with my first they had to get in quick, and although I could feel the sensation of the cut etc, it didn’t hurt at all .

“(I was supposed to tell them if I could feel anything, but not a chance - as I said, it wasn't painful at all!!)

“The second was perfect - nothing felt, no problems at all!

“The third - nothing at all felt, but unfortunately my blood pressure dropped to 34/17 and I felt horrific!!

“The block was bit too high, so I had to sit up as soon as they'd done, and I had drip/ medication for my BP.”

Jessica actually preferred the spinal block to the epidural… because it meant she didn’t have a needle in back throughout the birth.

“I had a spinal with my C-section 5 weeks ago and it was fine,” she says.

“I liked that you didn’t have the needle stuck in your back as well like with the epidural. It was just one shot in your back and done.

“Then they kept spraying my sides and under my arms with a cold spray until I couldn’t feel the cold to make sure I was numb, a very strange sensation!!

“I didn’t feel any pain sorry that’s a bit obvious isn’t it - but could feel all the tugging and them putting in the stitches which was quite unpleasant.

“But I guess it’s the same as a natural delivery as soon as its over you forget all about the pain!"

“My spinal wore off about 3 hours later,” says Ellis, who teamed her spinal block pain relief with pethidine later on.

“It was weird as I felt like my legs were still bent even though then weren’t all throughout the op.

“They were bent when spinal went in and as they went numb that’s how I felt they still were.

“I was grateful for the spinal as once it wore off the pain was quite horrific. A few shots of pethidine saw to that!”

Finally, Anna’s experience of spinal block will come as some relief to those phobic of needles – she was terrified, too!

“I am seriously phobic of needles, especially in the spine. When I was a child I had meningitis which involved lots of intrusive procedures including a lumber puncture which is draining fluid off the spinal chord, so I had an immense fear of any needle being inserted into that area.

“However, I did it, my son was delivered by C-section 2 years ago (planned as breech) and I can honestly say I didn’t feel a thing.

“Basically I had some local anaesthetic cream placed around the area where they insert the spinal block (I also had the cream on the back of my hands prior to inserting the venflon [needle type] for the drip) this was all done a good hour before the procedure.

“I won't lie to you, I was terrified when they took me to theatre and had the mother of all panic attacks!! However I promise you I didn’t feel a thing and I had a spinal.

“The only sensation I had was similar to a very quick electric shock go down my buttock and back. Within mins I was numb from the chest down.”

Images: Getty Images

Read more:

• What other pain relief options are there for labour?
• Are epidurals the right pain relief for you?
• Do epidurals actually make labour last longer?