An interesting article that suggests epidurals do not lead to more intervention

[WardInJarndyce]

from the Washington Post

That is exactly what my obstetrician told me 3 years ago when I was pg with DC1. Have now had 2 DCs both with epidurals, no intervention (15 mins pushing both times), and definitely did not slow down labour with DC2 - 3.5 hours start to finish. So glad there is now some positive research being published.

I have had five epidurals and I think they can actually speed labour up! Two midwives at two different hospitals have said to me, pretty much word for word 'You're dilating nicely now, that's because you're so relaxed'. Have only had any intervention in fifth labour as the baby swivelled around at the last minute and had to be rotated by ventouse before I pushed it out (without assistance). And I was jolly glad I'd had an epidural!

I just ignored all the doomsayers but I have friends who really wish they'd had them. I think they get an unfairly bad press.

Mothers in the UK have been told for many years that there is no strong link between epidural use and higher rates of c-section.

The study this refers to was published last year in September. The conclusion notes:

"Epidurals ...led to more use of instruments to assist with the birth. Caesarean delivery rates did not differ overall and nor were there effects of the epidural on the baby soon after birth; fewer babies needed a drug (naloxone) to counter opiate use by the mother for pain relief. The risk of caesarean section for fetal distress was increased. Women who used epidurals were more likely to have a longer delivery (second stage of labour), needed their labour contractions stimulated with oxytocin, experienced very low blood pressure, were unable to move for a period of time after the birth (motor blockage), had problems passing urine (fluid retention) and suffered fever."

In other words - it's not saying 'epidurals don't lead to higher rates of intervention', it's saying 'epidurals don't lead to higher rates of c/s'. Epidurals CLEARLY are linked to higher rates of augmentation and instrumental birth.

Would also want to point out that that 'all but 5 studies' out of the 38 studies reviewed compare epidural to opioids, which are known to affect women's mobility. In other words what these studies will be comparing are outcomes for labours where women probably have low levels of mobility and high levels of continuous monitoring across all arms of the trial.

I also suspect that none of the studies control for one to one care in labour, which is known to reduce the incidence of c/s. In the UK low risk women labouring with an epidural in place will get one to one care. Low risk women labouring in a CLU without an epidural very often DON'T get one to one care.

I'm more persuaded by the results from the recent 'place of birth' study in the UK, which found that low risk mothers who have booked to give birth in CLU's (where approximately 1 in 3 women will use epidural pain relief), have more than 3 times the rate of emergency caesarean section, compared to those women who book to have their baby at home or in a free-standing midwife led unit.