Encouraging Word On Epidurals

There's new research that could help ease women's concerns about a widely used and very effective method of reducing pain during childbirth.

The Early Show medical correspondent Dr. Emily Senay explains that standard medications injected directly into the bloodstream during labor are often inadequate to completely eliminate the mother's pain, and can cause unwanted nausea and grogginess.

A popular alternative is an epidural, or anesthetic injected near the lower spine. An epidural completely numbs the body below the injection site, bypassing the bloodstream and allowing a woman to be alert and pain-free during childbirth. Because the drugs bypass the bloodstream, epidurals are considered preferable to traditional injections, because there is also less chance of negative effects of the drugs on the health of the baby.

Senay points out that there have been concerns that using an epidural too soon during labor might raise the risk of complications requiring delivery by surgical cesarean section, or c-section. Some doctors and pregnant women worry that the numbing effect of an epidural might prolong labor.

But a new study in the New England Journal of Medicine indicates that, when an epidural is given early in labor, it does not raise the risk of a c-section.

The researchers looked at a low-dose epidural called "combined spinal epidural," in which a small dose of pain reliever is first injected into the spinal fluid, followed by the epidural. This technique was compared to injecting pain-relieving medicine directly into the bloodstream, with the epidural postponed as long as the woman could tolerate the pain. The c-section rate for both methods turned out to be the same -- around twenty percent.

"These were first-time moms," , "these were spontaneous deliveries. This was not induced labor. So hoe generalize-able these results are to all women out there who are in labor right now is not so clear, but at least in this study, for these women, there was no higher risk of cesarean."

What's more, the study showed that an epidural early on might actually shorten the duration of labor. Labor was ninety minutes shorter with an epidural for women in the study. But the researchers say it's not clear if those findings apply to all women. More study is needed to see whether higher doses of epidural anesthetic or medically-induced labor raise the risk of a c-section.

A woman should consult with her doctor about her individual situation, but this study suggests women in pain shouldn't wait to request epidural relief during childbirth, Senay observes.

As for any possible effects on the baby: An anesthetist is present to administer and monitor the effects of an epidural on both mother and baby during childbirth. Medications given by epidural can reach the baby through the mother's circulation, but with the lower dose used commonly in epidurals these days, experts say the amount is not thought to be enough to have a significant effect on the baby.
  • Brian Dakss

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