Epidural? It’s Up To You

A study of 15,752 first-time mothers shows that whether the epidural is taken early or late does not affect the need for a Caesarean section.

AsianScientist (Oct. 13, 2014) – When a woman is in labor, the appropriate time to give an epidural during childbirth is when she asks for it, a new study suggests. Published in The Cochrane Library, the systematic review compared early and late epidurals during labor and found that they had very similar effects.

An epidural is a pain relieving local anesthetic that is given as an injection into the spine. It is commonly offered to women in labor who request pain relief and is effective in reducing pain. However, previous studies have suggested that the timing of an epidural can prolong the duration of labor as well as increase the chances of needing a Caesarean section. With this in mind, Cochrane researchers collected the best available evidence on early and late epidurals and compared their effects.

“The right time to give the epidural is when the woman requests pain relief,” said lead researcher Dr. Sng Ban Leong, who is also the Deputy Head and Senior Consultant of the Department of Women’s Anesthesia, KK Women’s and Children’s Hospital (KKH), Singapore.

“If they request an epidural early during their labor, the evidence we have does not provide a compelling reason why this should be refused.”

The Cochrane researchers reviewed data from nine studies involving 15,752 first-time mothers who were randomly assigned to “early” or “late” groups. During labor, those in the early group were given epidurals when they were less than four to five centimeters dilated, while those in the late group waited until they were four to five centimeters or more dilated.

When the results were analyzed, those who had early epidurals were no more or less likely to need a Caesarean section than those who had late epidurals. Earlier epidurals made no difference to the likelihood of needing an assisted birth involving forceps or suction, or to the amount of time spent in the second, ‘pushing’ stage of labor. For other aspects that were measured, early and late epidural also had similar effects.

Although the researchers found no effect of early epidural on the length of time spent in the pushing stage, they were unable to reach firm conclusions about effects on the time to reach full cervical dilation.

“We can’t rule out the possibility that starting epidural pain relief earlier may lead to shorter labor,” said Sng. “This is because there was a lot of variation in the results of the studies we looked at in terms of the length of the first stage of labor.”

The article can be found at: Sng et al. (2014) Early Versus Late Initiation of Epidural Analgesia for Labor.

—–

Source: Wiley; Photo: george ruiz/Flickr/CC.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

Asian Scientist Magazine is an award-winning science and technology magazine that highlights R&D news stories from Asia to a global audience. The magazine is published by Singapore-headquartered Wildtype Media Group.

Related Stories from Asian Scientist