Epidurals are a common way to help reduce pain during childbirth. Though generally safe, they can cause a person to experience severe headaches after the delivery of their baby.
An epidural is a procedure where an anesthesiologist inserts a large needle into a person’s spine during labor. The needle goes in the area between the person’s bones and the lining that holds the spinal cord in the lower back. The anesthesiologist places a tube into the space and uses it to administer pain medication directly to the area.
Epidurals are typically safe and effective for treating labor pain. However, in some cases, headaches may arise if the needle goes too far.
In this article, we take a closer look at epidural headache pain, including causes, symptoms, treatment, and outlook.
An epidural cannot cause a migraine headache, though the pain may feel similar.
However, the stress associated with labor and delivery, having an epidural, or other situations around childbirth could trigger a migraine headache. According to the American Migraine Foundation (AMF), stress is a known trigger in about 70% of people living with migraine.
About one in four people will experience migraine within 2 weeks of delivery, and nearly half will have an episode within a month. The AMF also notes that around 5% of people who have never experienced migraine will experience one following labor.
Several factors may contribute to postpartum migraine.
One important contributor is a person’s changing hormone levels. Estrogen levels fall after labor, which can trigger an episode. In addition, several changes occurring postpartum can also contribute to the likelihood of a person experiencing migraine within a month, including stress, lack of sleep, and other changes in routine.
When an anesthesiologist inserts the needle for an epidural, they risk inserting it too far. This occurs in about 1% of all epidural placements.
When the needle goes too far, it is known as a dural puncture. A dural puncture can cause spinal fluid to leak, which can trigger a post-epidural headache within
In addition, researchers at Stanford University indicate that epidural-related headaches may be longer lasting than previously believed. They state it could lead to chronic headaches.
Symptoms typically occur within
In addition to a headache, a person may experience symptoms, such as:
- lower back pain
- double vision, although this is rare
In most cases, symptoms should clear up within 14 days of the epidural.
Treatment for a post-epidural headache can vary based on the severity.
- hydration, either by drinking or through an IV line
- pain relief medication, such as acetaminophen
- caffeine provided through an IV line or by drinking caffeinated products
- non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
In severe cases when first-line treatments do not work, a doctor may recommend an epidural blood patch (EBP). This involves inserting blood into the epidural space. The blood then creates a patch, which prevents more fluid from leaking. The procedure can reduce pain in about 85–90% of people.
In most cases, an epidural-related headache should clear within
Some evidence suggests some people may develop chronic headaches following an epidural. However, most people should fully recover within a few days following rest, pain medications, and hydration.
Headaches following an epidural can be mild or severe. They typically occur within a few days of the epidural. They occur when the needle goes too deep and creates a spinal fluid leak.
Most people should find relief with rest, hydration, and pain medications, but some may need a blood patch to relieve the pain. Even without treatment, most cases will clear within about 2 weeks.