Wait, There Is No New Study on Epidural Anesthesia and Total Labor Time.
Does epidural anesthesia prolong labor? Read the headlines this week and you’ll think we’ve finally answered this question once and for all – epidurals have failed. But the study actually asked what happens if you already have an epidural and turn it off when you push the baby out.
Headline : Epidural Anesthesia Does Not Prolong Labor (New York Times)
History : A study looked at the effect of epidural anesthesia on the “second stage” of labor, and do any of us really know what the second stage of labor really is? Midwives know, but I suspect most of the people writing and posting headlines on Twitter don’t.
What we call “contractions” is actually the first stage of labor : when the cervix dilates and you feel contractions and it hurts, and you go to the hospital, and then you are in the hospital, and there are still a few hours ahead and oh god, how can I get over this, oh oh oh.
The second stage of labor is when you finally expand to 10 centimeters and start pushing. If this is your first child, it may take an hour or two. If you’ve done this before, it may take just a few minutes for the promotion.
(There is a third stage. Occurs after the baby is born.)
So what happened in this study about the pushing stage of labor? 400 women in one hospital in China, all giving birth for the first time, received an epidural during the first stage of labor. When it came time to push, some of them continued to inject anesthetic fluid into their epidurals, while others were injected with a placebo saline solution. The idea was to test if doctors should turn off the epidural when the time was right.
In the end, people who received a real epidural and a fake epidural during a push performed the exercises equally quickly (51 minutes versus 52 minutes on average). On the other hand, a 2014 study found that epidural anesthesia prolonged shock , and the number was three versus five and a half hours. A big difference.
A 2014 study simply looked at the charts of women who received and did not receive epidural anesthesia; there was nothing funny about the placebo. This means that the two studies ask completely different questions. The new study is a surefire way to investigate whether the anesthetic in an epidural is interfering with pushing itself. A 2014 study includes all the experience, including your doctor’s bias, the fact that you find it harder to get around when you are attached to epidurals, and a million other factors that influence what actually happens when you request epidurals. …
Takeaway : If you are thinking about whether to get an epidural, you are probably wondering if it will prolong the total time of labor, rather than shorten a few minutes to the pushing stage. There is evidence that epidural anesthesia does increase the first stage (the long, otherwise painful part) of labor, and this new study does not contradict this. Whether epidural anesthesia will prolong the thrust stage is not yet clear.