What is a spinal block and how does it work?
A spinal block is very similar to an epidural but is faster to administer and cannot be 'topped up'. A local anaesthetic-analgesic mix is injected directly into the cerebrospinal fluid in the small of your back using a very fine needle in a single injection. You will need to lie on your side and stay very still for the anaesthetist to insert the needle. There is no need for the insertion of a catheter. As with an epidural, the spinal numbs the nerves that transmit pain from the uterus and cervix, also similar to a full epidural, you are very likely to lose the feeling in your legs and so experience limited mobility.

Pain relief is as effective as with an epidural, but with the advantage that it sets in more quickly. However, once the effect wears off, somewhere between two and four hours, the spinal cannot be topped up.

When can I use a spinal block?
Because of the speed with which they are administered and take effect, spinals are often used during the pushing stage of labour when there may not be enough time for an epidural. Spinals are also often used in emergency situations where intervention such as a ventouse or forceps birth is necessary, and in some hospitals they are routinely given for caesarian sections.

Advantages

  • A highly effective form of pain relief, most women experience complete relief from pain
  • Faster-acting than epidurals
  • Requires only a single injection and doesn't require a catheter in your back
  • The anaesthetic does not affect your state of mind
  • An spinal for a c-section allows you to be conscious for the delivery of your baby
  • Can be used to give you a break during labour and allow you to regain strength for delivery
  • In the case of intervention being necessary, a spinal is far safer for both mother and baby than a general anaesthetic

Disadvantages

  • Lasts only 2-4 hours and cannot be topped up as an epidural can
  • Numbs the feeling in your legs and so limits mobility
  • You might experience side-effects of itching, shivering, nausea and difficulties urinating
  • A low-pressure headache is more likely to occur than with an epidural

Availability
Spinal blocks can only be administered by a qualified anaesthetist which means they are not available for home births. Spinals are usually available in hospitals, but the hospital policy on administering spinals may not fit with your requirements, so it's best to check in advance. Also, you should remember that there may not be an anaesthetist available when you decide you want a spinal, although when administered as an emergency measure you will have priority.