Spinal Headache

Woman getting an epidural in labor
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About 60% of women in the United States get an epidural for their labor and delivery experience. About 1% of these women will experience a complication known as a spinal headache. It doesn't matter if it was a vaginal or cesarean birth.

Definition: A severe headache that happens after you've had a spinal or epidural.

When you get an epidural or spinal anesthesia, there is a risk that the dura, the covering of the spinal cord, will be pierced.

If this happens a severe headache can occur. The risk of this complications is about 1/100. You can help lower your risk of the spinal headache by holding still while the needle is being placed. It is more common with a spinal than an epidural, but possible with both. The epidural is not intended to puncture the dura as a part of the procedure, whereas the spinal anesthesia does, this is why it is more common to have a spinal headache with this type of anesthesia. Many women talk about this being the most severe headache they have every experienced.

"I couldn't see straight," said Amanda. "I could only think about how badly my head hurt. I didn't want to hold the baby. I didn't even notice the pain from giving birth. It was all about my head hurting. They made me lay flat on my back, I couldn't sit up at all. They made the room dark and cool. They gave me your typical drugs you would take for a headache and a bunch of caffeine, but nothing touched the headache.I was afraid of the blood patch but it was brilliant relief.

I am so glad I agreed to it and I wish I would have agreed sooner - I had no idea how I would go home with that baby."

 Treatments are available, including medications and a blood patch. A blood patch is where they draw your blood and put it into the space to help it heal. It can be done at any point but some research indicates that you are likely to get more relief with just one treatment if you wait 48 hours after doing the blood patch.

Earlier blood patches were more likely to need to be repeated for incomplete pain relief or a reoccurrence of the symptoms.

At one point it was believed that having a higher body mass index (BMI) put you at a greater risk for having a headache if there was an accidental puncture of the dura. Though recent studies actually showed that the risk of a headache was lower for women with higher body masses.

Also Known As: epidural headache, postdural puncture headache

Examples: After my epidural, I had a spinal headache for days.


Planning Your Childbirth: Pain Relief During Labor and Delivery. American Society of Anesthesiologists. Accessed February 24, 2016

Kokki M, Sjövall S, Keinänen M, Kokki H. Int J Obstet Anesth. 2013 Nov;22(4):303-9. doi: 10.1016/j.ijoa.2013.04.012. Epub 2013 Jul 31. The influence of timing on the effectiveness of epidural blood patches in parturients.

Peralta F, Higgins N, Lange E, Wong CA, McCarthy RJ. Anesth Analg. 2015 Aug;121(2):451-6. doi: 10.1213/ANE.0000000000000802. The Relationship of Body Mass Index with the Incidence of Postdural Puncture Headache in Parturients.

Sachs A, Smiley R. Semin Perinatol. 2014 Oct;38(6):386-94. doi: 10.1053/j.semperi.2014.07.007. Epub 2014 Aug 19. Post-dural puncture headache: the worst common complication in obstetric anesthesia.

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