Having an episiotomy without an epidural

An epidural is regional pain relief given through a catheter in the lower back. If you do not have one, the birth team can discuss local anaesthetic, which numbs the perineal area. During an urgent birth, the team explains what is happening as clearly as the situation allows and checks whether you can feel pressure or sharp pain.

After the baby is born, the cut or any extending tear is examined and repaired with anaesthesia suited to the injury and your condition. You may feel pressure or pulling even when the area is numb. Tell the clinician immediately if you feel sharp pain so the anaesthetic plan can be reassessed.

Before birth, record your pain-relief preferences and ask what local anaesthetic is available at your birth setting. During labour, you can ask for an explanation of why an episiotomy is being considered, what alternatives are possible in that moment, and how consent will be handled.

After repair, follow wound-care instructions, use recommended pain relief, keep the area clean and dry, and prevent constipation with fluids, fibre and any advised stool-softening treatment. Perineal Repair gives further information about repair care.

Contact your maternity team if pain worsens, swelling or redness increases, the wound opens, discharge smells unpleasant, or fever develops. Seek urgent help for heavy bleeding, faintness, severe pain, inability to pass urine, or new bowel-control problems.

Ask what pain relief can be offered without an epidural, how quickly it works, how you will signal discomfort, what happens if the cut extends, and which medicines are suitable after repair.