Epidural Found Not to Increase Chance of C-Section

According to new research, epidural analgesia during labor does not appear to increase a woman's chances of having a cesarean section, as had been previously reported. The findings were published in the July 2001 issue of the American Journal of Obstetrics and Gynecology.

The research also showed that epidural analgesia does not increase the chances for a difficult birth. However, it does prolong labor by an average of 25 minutes. More than 50% of pregnant women in the United States receive epidural analgesia to relieve the pain of labor. Some obstetricians have been concerned that the procedure may also slow down labor and thus increase the chances that a woman may need a cesarean section

The researchers examined the labor records of women who gave birth before and after the time when the rate of epidural use rose from 1% to 80% in an army medical center because of a new policy. They found no difference in the rate of cesarean section or in the incidence of difficult vaginal births between the two groups. However, the women in the "after” group experienced an average increase in labor duration of 25 minutes as compared to the "before” group. The increase in duration was confined to the second stage of labor, from the time when the woman's cervix is completely dilated until the baby is actively expelled. In general, the timing of procedures using forceps or vacuum extraction occurred later in the "after” group, when the baby was farther along in the birth canal. This translated into a reduced risk for those infants and mothers, since the procedure carries a slight risk of injury.

The study was conducted by researchers at the U.S. National Institute of Child Health and Human Development and Tripler Army Medical Center (Hawaii, USA). "The length of active phase of labor appeared unchanged; however, labor epidural analgesia likely prolongs the second stage of labor,” they concluded.