What are epidurals?

• The mobile epidural is set up in the same way as a standard epidural. It may even be possible to switch from the mobile to the standard if this becomes necessary (for instance if you needed an emergency Caesarean). The difference between the two is in the combination of the drugs used. These are maximised for pain relief while limiting the loss of sensation in the legs.

• Mobile epidurals can be started at any time during labour (as long as three hours have elapsed if a strong analgesic/painkilling injection, such as Diamorphine or Pethidine, has been provided). They can be given in the first stage if the contractions become unmanageable - or even earlier if there is a fear, which some women do have, about being in pain.

• The difference between the two lies in the anaesthetic solution. A mobile epidural uses a very diluted concentration of a local anaesthetic (usually Bupivacaine) mixed with an opiate (an analgesic, like Fentanyl and/or Pethidine), which helps block pain without impairing the motor (muscle) function in the legs, or causing leg weakness or numbness. It's not compulsory to move around. Often the relief gained allows the woman to have a rest. The control can last for as long as it takes to deliver the baby. There is a continuous supply of medication, patient controlled, at the push of a button.

• Excellent pain relief

• A mobile epidural takes effect in three to five minutes and allows the woman to move her legs. The effects last approximately two hours

• Total bed rest is not necessary

• Being in an upright position tends to speed up the dilation of the cervix (neck of the womb), labour and delivery

• Assisted delivery (instrumental or medical) is less likely than with a standard epidural

• Minimal, or no, drug affects on the baby, so that foetal distress - often a consequence of standard epidurals - is much rarer

• Increased maternal satisfaction now that the optimal medication has been determined

Disadvantages:

• All the drawbacks that follow the standard, traditional epidural, including the occasional spinal headache - caused by getting the needle in the wrong place - which is only temporary, and easily treated

• The amount of movement may be very limited

• Many hospitals do not offer mobile epidurals; the midwife in charge of a particular patient will be able to supply this information