Childbirth is not prolonged by an epidural
WOMEN don’t take longer to give birth if they have an epidural – despite NHS warnings that the pain relief jab can prolong labour by an hour.
Those who had the injection during the second stage of labour were told the delay could raise the risk of excessive bleeding and infection, or their baby being delivered with forceps.
However, a study of 400 first-time mothers has found that those given an epidural actually spent no longer in labour.
Around a third of British women choose the jab in their back when they give birth, particularly during a long or painful labour.
The injection numbs the nerves that carry pain impulses from the birth canal to the brain.
The NHS Choices website warns couples that ‘epidurals can prolong the second stage of labour’, and many doctors stop the local anaesthetic at this point.
Studies show that in up to 85 per cent of hospital deliveries women are denied pain medication during the second stage of labour, which starts when the cervix is dilated by 4in and ends with birth. But Dr Phillip Hess, a senior author of the latest research, said: ‘We found that exchanging the epidural anaesthetic with a saline placebo made no difference in the duration of the second stage.’
The US researchers said any increase in women’s pain could be justified if an epidural had a negative effect. However, they found that the second stage of labour in those who were given the anaesthetic lasted 52 minutes, compared with 51 minutes for those on a saline placebo.
It has been suggested an epidural could slow down labour by stopping a woman pushing as hard, reducing activity in the womb or causing the pelvic floor to relax, which could change the baby’s position before birth.
NHS Choices says a baby may have to be delivered by forceps or ventouse – a suction cup that pulls it out by the head.
It adds: ‘If you can no longer feel your contractions, the midwife will have to tell you when to push. This means that forceps or a ventouse may be needed to help deliver the baby’s head.’
However, the US study also found no difference in the number of forceps deliveries between women who received an epidural and those who did not. Epidurals did not affect the baby’s position or the likelihood of having a caesarean section, according to the study led by the Beth Israel Deaconess Medical Centre in Boston and published in the journal Obstetrics & Gynaecology.
Dr Hess, from Harvard Medical School, said: ‘We didn’t see any negative effects.’
Dr Patrick O’Brien, spokesman for the Royal College of Obstetricians and Gynaecologists, said the US study was ‘fascinating’.
He added: ‘The conclusion is that there is no downside to having an epidural during the second stage of labour, while it is associated with less pain.
‘Labour can be a very painful experience, although the intensity experienced differs from woman to woman.
‘The decision to have an epidural, which is a very safe form of pain relief, should lie with the woman, in consultation with her midwife or obstetrician, and she should be supported in her birth choice.’