How Epidurals Affect Babies: Facts For Parents-To-Be

How Epidurals Affect Babies: Facts For Parents-To-Be

When you consider that 50–80 percent of women in high income countries will have an epidural during labour, it’s surprising how little women know about the impact this procedure can have on their babies.

Most care providers believe epidurals have little to no effect on babies.

But new research is beginning to paint a different picture.

Researchers from the University of Granada (Spain) looked at the births of over 2,600 babies and found epidural use has some adverse effects on newborns.

These effects include: low Apgar scores, higher risk of resuscitation, reduced early breastfeeding, and admission to a neonatal intensive care unit.

Breathing Problems For Baby

Babies whose mothers have an epidural are more likely to develop respiratory distress syndrome in the period immediately after birth. The most common form of epidural used is a local anaesthetic with a narcotic or opioid.

Most care providers believe the small amount of epidural medication that reaches the baby is not enough to cause any ill effects. We know, however, that opiates can cross the placenta during labour and cause respiratory depression. This means the baby is not getting enough oxygen and can’t excrete enough carbon dioxide.

Babies who develop respiratory distress syndrome will need help with breathing. In some cases, babies cannot breathe efficiently on their own at birth and will need resuscitation, which is an emergency and can be a very stressful and frightening experience for parents.

There is also medication that can reverse the respiratory depression caused by opiates in babies. This medication is given intravenously (through a vein) and the effects are usually quick and last for about 2 hours.

Lower Apgar Scores

If babies are born with breathing trouble, following an epidural, it makes sense they will not have high scores on their Apgar chart.

The Apgar score is a quick test performed on newborns at 1 and 5 minutes after birth. The 1-minute score shows how well the baby tolerated labour and birth. The 5-minute score determines how well the baby is doing outside the mother’s womb.

The test looks at:

  • Breathing effort
  • Heart rate
  • Muscle tone
  • Reflexes
  • Skin color

The Apgar score is based on a total score of 1 to 10. If the score is lower than 7 the baby will need medical attention.

Post Birth Separation

After having breathing problems and poor Apgar scores, babies who have been affected by epidurals, as a follow-up measure, will probably be taken to a neonatal intensive care unit (NICU) for observation and continued medical attention.

While staying in the NICU doesn’t seem to be harmful in itself, it means that mother and baby are separated immediately after birth. This can have significant effects on the baby’s physical wellbeing, as well as on the emotional wellbeing of both mother and baby.

Babies who are separated from their mothers are less likely to experience early breastfeeding. Being held skin to skin promotes oxytocin production in both mother and baby. Oxytocin stimulates the milk let down reflex, and promotes mother-baby bonding. The production of this hormone in mothers, however, is lowered when epidurals are used.

Babies are also more likely to have problems regulating their temperature when they are separated from their mother’s body. Separation also increases a baby’s distress; babies are biologically developed to signal to their mothers to be held, fed and kept safe. If these needs are not met, babies can go into what is known as a despair state, where they become still and quiet.

Tips For Post Epidural Support

The choice to have an epidural is a personal one, and should be made while taking into consideration the risks and benefits. You might wish to avoid an epidural, but perhaps your care provider has a high induction rate (epidurals are more common with inductions), or you have a fear of birth and worry about coping with the pain of labour. Ensure you are well informed about your options for birth, so an epidural doesn’t have to be automatic at some point.

If you do choose to have an epidural, being aware of how this might affect your baby will help you to work with your care providers so as to provide the best start to your baby’s life. Here are a few ways you can promote a positive experience after birth:

  • Leave the umbilical cord:  while the cord is left intact babies are receiving vital oxygenated blood stores. If your baby’s breathing isn’t ideal after birth, he will still be getting oxygen for several minutes while the cord continues to pulsate.
  • Keep your baby near you: talk to your care provider about providing resuscitation methods on the bed, where you and your baby will be after birth. Most resuscitation methods can be provided simply, such as giving oxygen via a mask, or stimulation.
  • Keep your baby close: skin to skin contact is one of the most vital aspects of post birth support for your baby. Your baby will feel warm and safe. If you aren’t able to do this for some reason, ask your partner to strip off his shirt and hold baby close to his chest and heart.

If your baby needs more help and support in NICU, talk to your care provider about having as much skin to skin, and breastfeeding support, as possible. BellyBelly has more information here about coping with a baby in NICU.

Recommended Reading: Epidural During Labour – Everything You Need To Know.

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Sam McCulloch enjoyed talking so much about birth she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she writes novels. She is mother to three beautiful little humans.


  1. Hi, I found your article very interesting. I had a induction and was 7cm dilated and waters had broken when they asked if I wanted an epidural. It wasn’t the plan at first but it was so sore and I wasn’t myself that I said yes. Biggest mistake of my life. 20 min later I was rushed to theatre and baby taken out within minutes and he wasn’t breathing. His heart rate dropped dramatically once epidural was administered. Your article doesn’t directly state that it could also be a factor, but could it have been due to the epi? I am convinced it was. The doctor denies it. Also, no one, even during prenatal classes, mentioned that there are any risks to epi’s. This was 7 years ago (in SA) so hope things have changed. Thanks for shedding light on a little known subject.

  2. I had the epidural. I labored for 14 hours without it and when it felt like every bone in my lower body was being crushed, I begged for the epidural. I went from 4cm to 10cm in less than 15 minutes after the epidural was given to me. and since my baby had been at +1 most of the entire time I was in labor, I was ready to start pushing. It did take me 1 hour to push him out, no doubt because of the epidural but who knows how long it would have taken me to dilate without it because I couldn’t relax enough to dilate. I have no regrets. I was all about doing it 100% natural. I had a doula on my birth team, I “prepared” but nothing prepared me for that kind of excruciating pain. For all the women who have their noses high and mighty because they did it without medical interventions, good for you!

    Lastly, unless this “study” compares mothers who received an epidural but went into labor naturally and were not given pitocin at any point during labor (like me) to mothers who were artificially induced and then given an epidural, it weighs no merit! because yes, there should be a difference in baby outcomes!

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