Study Backs Light, Early Epidurals

Pregnant women can be given a low-dose epidural early in labor without raising their chances of a caesarean section, according to a study that could change the way obstetricians practice and make childbirth less painful.

The finding could lead doctors in the U.S. to consider offering early epidurals to hundreds of thousands more women in first-time labor each year.

Though medical authorities recently dropped their reservations about giving women epidurals early in labor, some doctors and patients prefer to wait until labor is further along. They worry that the painkiller’s numbing effect could interfere with a woman’s ability to push, prolonging labor and prompting a C-section.

The study appears to debunk the notion about C-sections and calls into question the one about prolonged labor.

“Women often feel guilty or weak when they request an epidural early in labor. I hope this study will help women see that there is no shame in asking for an epidural,” said lead author Dr. Cynthia Wong of Northwestern University. “The message for women and their obstetricians and gynecologists is that there is no reason why women who want an epidural should not get it when they first request it.”

The study was reported in Thursday’s New England Journal of Medicine.

More than 3.5 million women go into labor each year in the U.S. Epidural use has greatly expanded over the last decade, to more than 1.5 million women annually.

Epidurals deliver numbing medicine through a skinny plastic tube that is threaded into the back, close to spinal nerves, mostly bypassing the mother’s bloodstream. More recent techniques, sometimes called “walking epidurals,” provide lighter doses, allow women to push, and enable them to walk throughout labor.

Doctors have welcomed epidurals as an alternative to “systemic” pain medicine through the bloodstream, which can leave a woman feeling nauseated and doped-up and can enter the fetus’ body.