Early Epidural Does Not Make Birth Longer Or More Difficult

10/10/2014 15:47 | Updated 20 May 2015

Early epidural does not make labour longer or more difficult

Women giving birth should be given epidural pain relief as soon as they ask for it - because the timing of the injection does not prolong labour or lead to complications, according to the latest research.

Currently women in labour are often advised to hold off having an epidural until they are at least four centimetres dilated, which for some women can take hours or even days.

But a Cochrane Review of nine studies involving nearly 16,000 first time mothers has found that this wait is not necessary.

The review found that giving the epidural before or after a woman was four centimetres dilated made no significant difference to the length of labour or whether she experienced complications.

Women having an early epidural were no more likely to have a caesarean section delivery, forceps or ventouse and the pushing stage was no longer. There was also no difference in the health of the babies shortly after birth.

Lead researcher Dr Ban Leong Sng, said: "The right time to give an epidural is when the woman requests pain relief.

"If they request an epidural early in labour the evidence we have does not provide a compelling reason why this should be refused."

An epidural is administered via an injection into the spine. For most women it will block out pain entirely. An epidural does increase the risk of an assisted or caesarean section delivery, but this study found that the timing of that epidural did not matter.

Guidance from the National Institute for Health and Care Excellence already states that women should not be denied early pain relief if they request it, yet many hospitals still have policies of not providing epidurals in the early stages of labour.

This is often because epidurals can only be administered by anaesthetists.

Virginia Beckett, spokesman for the Royal College of Obstetricians and Gynaecologists told The Telegraph that women who are coping well with labour pains should be encouraged to try other methods of pain relief first.

However she added: "If it is clear that you will need an epidural you should have one when you first require it and you might as well have it early.

"Where it will be beneficial is for women who are induced and whose labour is therefore likely to be slower. It is definitely beneficial to have one early then."

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