Reasons You Can't Have an Epidural

Couple in Labor Holding Hands

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Epidural anesthesia is the most popular form of medicinal pain medication for labor and birth. Many women decide on using an epidural prior to labor and don't even look at other forms of pain relief for labor and birth.

This is not necessarily a wise choice for labor and birth because there are many reasons why an epidural may not be in your future. Here are a few of the reasons you might not be able to have an epidural.

You're Taking Certain Medications

Medications that you take can affect how likely you are to be able to get an epidural. The biggest culprit is blood thinners.

Your Blood Work Isn't Just Right

If you have a low platelet count or sometimes other problems with your blood work may make the placement of an epidural riskier.

The Doctor Can't Find the Right Space

Sometimes, due to the normal growth of your back, your weight, or back problems (including scoliosis), it may be impossible for the anesthesiologist to find the epidural space. Therefore an epidural with scoliosis may not work.

You're Bleeding Heavily

If you are bleeding heavily or are suffering from shock, you will not be given an epidural for safety reasons. Since many women tend to have lower blood pressure with an epidural, this may be made even more dangerous with the lowered blood pressure of some of these problems.

You Have an Infection of the Back

It is not in your best interest to have your anesthesiologist place an epidural through an area that is infected. This can cause the infection to spread to the spine and other areas of your body and can potentially cause a great deal of damage.

No Anesthesiologist Is Available

Your hospital may only have an anesthetist available during certain hours of the day or days of the week. You may also have an anesthesia department that covers an entire hospital and not just the labor and delivery unit.

Labor Restrictions

Some hospitals will place restrictions on when you can have an epidural. It may be that you must be at a certain point in labor, like four (4) centimeters before an epidural can be given. Other hospitals may decide that epidural should not be given after a certain point of labor, for example when you've reached full dilation (10 centimeters).

What to Do If You Can't Have an Epidural

You might be able to find out beforehand that an epidural is not in your laboring future. If this happens you are able to prepare by looking at other methods of pain relief for labor.

A good childbirth class that focuses on many different types of pain relief from medications to natural forms of relief of pain may be the best option for filling your birth bag with many tools to cope with labor, particularly for the surprise revelation that you can't have an epidural.

Enlist support for getting through labor. Labor is hard work, with or without pain medications. Consider hiring a doula, even if you prefer an epidural.

A professional labor assistant can help you and your partner through different pain relief options including natural pain relief like relaxation, positioning, massage, etc. She will also be trained in letting you know what your other options are for pain relief like Transcutaneous Electrical Nerve Stimulation (TENS), IV medications, etc.

If you are concerned about your options for dealing with pain during labor, to be sure to talk to your doctor or midwife about your fears.

It's also possible and highly recommended in some cases to actually visit the hospital and have a consultation with the anesthesiology department. They may do a physical exam of your spine, take a medical history, etc. This can help answer questions you may have about epidurals and labor. Being informed ahead of time is your best solution.

3 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Goodier CG, Lu JT, Hebbar L, Segal BS, Goetzl L. Neuraxial Anesthesia in Parturients with Thrombocytopenia: A Multisite Retrospective Cohort Study. Anesth Analg. 2015;121(4):988-91.  doi:10.1213/ANE.0000000000000882

  2. American Pregnancy Association. Epidural anesthesia.

  3. The American College of Obstetricians and Gynecologists. Medications for pain relief during labor and delivery.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.