Length of Labor With Epidural

Assumption: Getting an epidural does not affect the length of labor in most women.

FALSE
This new (2014) study confirms that for most women, an epidural adds about 2 hours to the length of a normal labor prior to vaginal birth.  The study reviewed the cases of over 42,000 births and compared the length of the second stage of labor (the pushing stage).  The authors point out that standard practice is to intervene when stage 2 is one hour longer than a “normal” labor.  This study indicates that maybe more time should be given before medical intervention is begun.

http://journals.lww.com/greenjournal/Abstract/publishahead/Second_Stage_of_Labor_and_Epidural_Use__A_Larger.99536.aspx

My Views:
I realize than many women will choose a longer labor without the pain to a shorter labor with the pain, but I think it is only fair to tell women they may be extending the time of their labor so they can make that choice themselves.  It would also be wise for the medical practitioners to give as much time as possible to the laboring woman if baby and mom are healthy.  Beginning interventions just based on the clock may be causing unnecessary interventions, including cesarean sections.  So, with this study in mind, if the clock does remain important, maybe they could extend the “expectant management” (waiting and watching) time to 2 hours instead of 1 to give women a better chance to birth their babies vaginally and without expensive and intrusive interventions.

Epidural Pain Relief

Assumption: Epidural analgesia relieves pain during childbirth with no adverse affects.

FALSE
According to studies, epidural analgesia does usually relieve pain during childbirth.  However, using an epidural often led to longer labor, stalled labor, and low blood pressure.  After the birth, women who used epidurals had more problems passing urine, moving comfortably, and were more likely to have a fever than women who did not use epidural analgesia.

http://www2.cochrane.org/reviews/en/ab000331.html

My Views:
Many women feel that the pain relief is worth these relatively minor effects.  Others do not want to experience the effects and decide instead to pursue other forms of pain relief.  The answer to the epidural/ no epidural question is as unique as each woman who answers it.  The only thing I recommend for ALL women is to know the possible effects before agreeing to the procedure.  Knowledge will empower you and help you make the decision that is right for you, your baby, and your family.