As mentioned, epidurals are usually performed by anaesthetists, although some obstetricians and general practitioners also have experience with the technique.

To perform an epidural it is necessary for the back to be curved forward as much as possible in order to open up the spaces between the vertebrae. Some anaesthetists prefer you to lie on your side with your legs curled up underneath your abdomen as far as possible. Others prefer you sitting forward over a pillow on the edge of the bed with your feet resting on a stool.

After cleaning the skin with an antiseptic solution, the anaesthetist injects some local anaesthetic under the skin in the small of the back. This stings for just a few seconds. A special epidural needle is then advanced gently until the epidural space is found. A fine epidural catheter is then usually inserted through the needle and the needle is then removed. Sometimes the catheter touches a nerve and causes a brief shock or "twinge" to pass into the leg. This is perfectly harmless and goes away within a second.

Once the epidural catheter has been taped to the skin and the first dose has been given, you will be encouraged to lie on your side until it takes effect. The blood pressure is checked a few times to begin with because this usually falls to some extent after having an epidural. If necessary, the intravenous infusion is increased in order to give you a "fluid load". The anaesthetist will stay with you until you feel comfortable and make sure that everything is satisfactory.