Epidurals during labor significantly decrease birth complications, according to new study

One of the biggest hot-topic conversations about labor and delivery among pregnant people seems to be whether or not to have an epidural. Some argue that there are more risks involved with epidurals than going unmedicated, while many expectant mothers would rather not be in excruciating pain during the labor and delivery process. However, according to a recent study, there may be more pros than cons to getting the big needle.

In a study published in The BMJ, getting an epidural during labor does more than reduce pain—an epidural can actually keep the mother safer during birth. 

According to the study, an epidural can reduce the risk of organ failure, pre-eclampsia/eclampsia, and obstetric shock—complications that fall under the umbrella of “severe maternal morbidity” (SMM)— and the epidural helps relax muscles, which puts less strain on the body during labor. 

Data from 657,216 mothers in labor, delivering vaginally or via an unplanned cesarean section, between 2007 and 2019 in Scotland were analyzed in the research. Their medical records were used to identify incidence of SMM from the date of delivery to 42 days postpartum.

Factors that may affect SMM incidence, such as maternal age, weight, ethnicity, pre-existing conditions, birth location and gestational age at birth were also considered. Of the women included, 22% had an epidural and SMM occurred in 4.3 per 1000 births. Receiving an epidural during labor was associated with a 35% reduction in SMM incidence in all women in the study.

In the study, women with a medical indication for an epidural had a 50% reduction of risk of SMM, compared to a 33% reduction in those without. Women who delivered prematurely saw a 47% decrease in risk with epidural use, compared to those who delivered post or post-term.

Kecia Gaither, MD, double board-certified in OB/GYN and Director of Perinatal Services/Maternal Fetal Medicine at NYC Health & Hospitals/Lincoln in the Bronx said in a Healthline article that other risk factors included with SMM are sepsis and infection, a heart attack, postpartum hemorrhage, and “enlargement of the heart and weakening of the heart muscle.”

Matthew Casavant, founding physician of South Lake Obstetrics & Gynecology also noted in the article, “The benefits of pain management extend beyond comfort—they can directly impact maternal and neonatal outcomes.” 

“For example, I’ve observed that mothers who have had epidurals often experience reduced instances of high blood pressure spikes and less physical stress, which can decrease the likelihood of complications like pre-eclampsia,” he said. 

Regardless of where you stand on the issue, the important thing is that your healthcare provider gives you all the information and options for you to make your decision on receiving an epidural, including whether or not you’d be a good candidate for one. Your healthcare provider should support your decision regardless of your choice.

“We must support all women, regardless of background, in making informed decisions about pain management options during labor. This involves comprehensive education and discussion throughout prenatal care, tailored to each patient’s unique medical history and needs,” Casavant said.

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