What is a Walking Epidural?

A walking epidural is an anesthetic technique used during labor and delivery to minimize pain for the mother while allowing her to remain ambulatory. This option is not safe for all pregnancies and may not be offered in all facilities. People interested in using the walking epidural for pain management should discuss it with their obstetricians while developing a labor and delivery plan to learn more and make appropriate arrangements ahead of time.

Using a technique known as combined spinal-epidural anesthesia, a walking epidural involves the administration of low doses of anesthetic medication to the nerves involved in relaying signals from the pelvis. This limits pain as women undergo contractions and get ready to deliver, but does not render the legs entirely nonfunctional. Most women with a walking epidural can walk safely, although some require assistance and support, and a small number may not be able to walk due to dangerously low blood pressure or a feeling of unsteadiness in the legs. Other women may be able to walk, but choose not to for various reasons.

Some women like the option of moving around during labor while still receiving pain management, or want more control and may feel more comfortable with a walking epidural. Most hospitals require careful monitoring of patients receiving this type of anesthesia, and some patients find the increased scrutiny, including regular blood pressure checks and fetal heart monitoring, intrusive. Women considering this option may want to ask about the level of monitoring required in the facilities where they will be delivering to learn more about what to expect.

The walking epidural must be placed and monitored by a trained anesthesiologist or anesthesia technician. It takes several minutes to take effect and women are generally warned to get anesthesia early in labor if they want it, as once they enter advanced labor, it may not be possible to offer pain management. An obstetrician and anesthesiologist can work with the patient to determine the best timing for the administration of pain medications.

Patients may not be considered good candidates for a walking epidural if they have had adverse reactions to anesthesia in the past or if the pregnancy is high risk. Recommendations for anesthesia during labor are based on the doctor's experience and the patient's medical history. It is important to provide a complete and informative medical history to the doctor as seemingly minor medical issues could be indicators of serious complications and need to be addressed.