Does It Matter When In Labor You Get an Epidural?

There is interesting new research out about epidurals.  To date, the research has been mixed about whether getting an epidural earlier in labor leads to more complications and interventions in comparison with getting it later.  This new study, published by the esteemed Cochrane Library, analyzes a number of the existing studies collectively to show that the timing does not increase or decrease interventions.  It is still true that epidurals in general are associated with longer labors and greater use of pitocin, instrumental delivery, and Cesarean sections for fetal distress (but not of Cesarean sections overall).  However, this most recent study found that labor length, and risks of instrumental or Cesarean birth are not increased or decreased based on the timing of the epidural.  Helpful information for expecting parents to use in their decision-making!

Interestingly, as explained further in a blog post from Science and Sensibility, the study also uncovers additional data showing that different physician groups have widely different rates of Cesarean section or instrumental (forceps or vacuum) deliveries, independent of epidural timing, even among groups of mothers that are scientifically selected to have the same level of initial risk for interventions.  This insight underscores the influence that individual physician or midwife practice patterns have on your likelihood to have a Cesarean birth, and the importance of finding out specific doctor or midwives’ Cesarean and instrumental delivery rates when selecting one.  

For the New York Times’ coverage of the study’s findings, click here.