Spina bifida and childbirth: Can I have an epidural?

I have mild spina bifida, and I'm pregnant with my first child. Is it true that I can't have an epidural because of my spina bifida?

- Mary / Colorado

Mayo Clinic obstetrician and gynecologist Roger Harms, M.D., and colleagues answer select questions from readers.

Answer

It depends on the extent of your spina bifida. Because the condition is different in every person, there are no standard guidelines for giving an epidural to a woman with spina bifida. Your doctor should monitor your condition, and may consult an anesthesiologist before your due date to determine if you can be given an epidural. Your anesthesiologist may want to review your medical history to develop a plan to manage your labor pain safely. Complications from the epidural could include:

Unintended puncture of the sacs containing your spinal fluid (dural puncture)
Post-dural puncture headache
Ineffective anesthesia
Prolonged second stage of labor
Urine retention

If you have spina bifida occulta, a mild form of spina bifida, your risk of complications may be lower than that of women with more serious spina bifida. Usually, the epidural injection can be given above your spinal bifida lesion, relieving your labor pain. If you have spina bifida cystica, a more serious form of spina bifida, your risk of complications may be significantly increased, since the abnormalities in your spine may make administering the epidural difficult.