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Harvard Health Blog
Contrary to popular belief, epidurals don’t prolong labor. Phew.
- By Hope Ricciotti, MD, Editor in Chief, Harvard Women's Health Watch
About the Author
Hope Ricciotti, MD, Editor in Chief, Harvard Women's Health Watch
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If and whenever possible women need to feel what their bodies are telling them throughout labor, not the verbal cues from someone who isn’t experiencing the pain and pressure. Would anyone really believe this when the U.S. has such a high maternal mortality rate due to increased intervention during labor? Additionally, make sure you know what you’re talking about before writing an article. Clearly epidurals were given in both cases.
Excuse me? The study did not compare laboring women with an epidural vs without an epidural. This is a completely misleading headline and article. Shame on you Harvard – I thought you had higher standards. Now this false headline – which does not accurately describe the research if you read the actual study, will be making the rounds on social media. Most average people only read headlines -and certainly if Harvard says that epidurals don’t prolong labor, this will probably influence decisions made by pregnant mothers.
Please note that women in both groups had an epidural As the authors note:
“All women [in both the control and experimental groups] received epidural analgesia for the first stage of labor using 0.08% ropivacaine with 0.4 micrograms/mL sufentanil with patient- controlled epidural analgesia.”
So this is not really a test of the effects of an epidural, it is a test of the effect of an epidural in the second stage of labor:
“At the onset of the second stage of labor, women were randomized to receive a blinded infusion of the same solution or placebo saline infusion. “
The study was not about epidurals in general. All women had an epidural for their labour. It was about having the epidural continued in the 2nd stage vs not. It showed that epidurals need not be stopped in the second stage of labour. The headline is misleading as is the commentary. The issue of whether epidurals given in labour early or late do or do not increase the cesarean section rate remains unanswered. There are no studies that compare epidurals to physiological management. All RCTs compare epidurals to narcotics. Epidurals given in today’s high cesarean environments may or may not further increase the cesarean section rate when given before or after active labour is established.
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