An epidural is a local anaesthetic that numbs all sensation from the waist downwards. It's a high-tech procedure and has to be administered by an anaesthetist, so can't be given at home. There are various kinds of epidural, and you should ask your midwife which are available at the hospital you plan to attend.
A fine hollow tube (catheter) is inserted into your lower back and the local anaesthetic drug goes in through the tube. When local anaesthetic is injected into the space around the spinal cord - the epidural space – the nerves are numbed and although you can feel touch, you don't feel the painful sensations coming from your abdomen. The epidural will last for about two to four hours but can be 'topped up' through the catheter.
A `mobilising' epidural involves the same procedure, but the end of the catheter is attached to a pump which administers a small amount of anaesthetic with an opiate at regular intervals.
Alternatively, you may be offered a spinal anaesthetic - a `one' off' injection into the base of your spine. An epidural catheter is also put in position, but not yet used. This gives a couple of hours of pain relief and if you want longer, the epidural tube will be used as in a traditional epidural, once the spinal has worn off
Epidurals, unlike the other treatments listed here, give many women complete relief from labour pain. They can help you feel 'in control' if you have felt overwhelmed by your contractions. If a caesarean operation becomes necessary, the epidural can be used as an anaesthetic for that.
However, once you have an epidural your blood pressure, contractions and the baby's heartbeat will be monitored and a drip will be put in your hand. Unless your hospital can offer you a 'mobile' epidural, you will have to remain on the bed and are more likely to require instrumental help (forceps or ventouse) to deliver your baby.