Harvard researchers bust epidural myth

They say thinking on labour impact is ‘out of date and misguided’

Epidurals do not slow down labour, according to Harvard researchers, who suggest the long-held practice of reducing or stopping an epidural in the later stages is "out of date and misguided”.

Their study of 400 nulliparous women has found that a low concentration of the drug in the second stage has no effect on progress.

In the double-blind, placebo-controlled trial, all received epidural analgesia for the first stage of labor, using 0.08% ropivacaine with 0.4µg/mL sufentanil with patient-controlled epidural analgesia.

At the onset of the second stage of labour, women were randomised to receive a blinded infusion of the same solution or placebo saline infusion. 

Reporting in the journal Obstetrics and Gynecology, the researchers wrote that “maintaining the infusion of epidural medication had no effect on the duration of the second stage of labour compared with a placebo infusion”.

Maternal and neonatal outcomes were the same.

As expected, the women whose drugs were halted experienced increasing levels of pain as labour progressed.

"Twice as many women given the placebo reported lower satisfaction with their pain relief compared to those provided the anesthetic", said lead author Dr Philip Hess, an associate professor at Harvard Medical School.

You can access the study here.