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Share Epidural anesthesia may lengthen deliveries more than previously thought

Armando @armando_bastida

Epidural anesthesia, baptized by many mothers as "blessed epidural" and by many others as "better without you" has been with us for a long time, making women give birth with hardly any pain, but in a different way to the natural and, therefore, with more contraindications, side effects and, it is said, even with a worse taste when compared with deliveries without epidurals.

It is known that the epidural causes the births to go more slowly, that the dilation stops and that, on average, the baby takes about an hour more to leave. However, a new study seems to show that no, that in fact deliveries are even longer and that many caesarean sections for "stagnant births" could be avoided if this is taken into account.

Study data

The study I am talking about was recently published and aimed to compare the time it took for women to give birth when they did not receive epidural anesthesia, as well as to know what the difference was when it was administered.

To do the study, the stories of 42, 268 women who gave birth through a vaginal delivery in San Francisco between 1976 and 2008 were examined. To analyze the deliveries, they observed those that were part of the mean time (the average between those who gave birth faster and those that took longer) and those that happened in the 95th percentile (those that gave birth later, at the time when most had already had their baby).

They observed that those who had received epidural anesthesia in the 95th percentile of the second stage of labor (that of active dilation) and had not had children previously gave birth in 336 minutes, while those who had not received it did so in 197 minutes on average. The difference between the two is 2 hours and 19 minutes .

If they compared women who had already been mothers, also talking about those in the 95th percentile (those who take longer to give birth) the second phase of labor lasted 81 minutes without an epidural and 255 minutes with it, the difference being much more remarkable being 2 hours and 54 minutes, making the active dilation phase three times longer.

And cesareans for detained births?

The authors of the study quickly realized that, if the professionals rely on waiting an hour to determine that a delivery is stagnating, one hour regarding what a normal delivery without epidural would last, and then start assessing whether to do or not a cesarean section, it could be soon. That is to say, knowing that in reality the epidural can cause a birth to stop in up to two hours, it would be logical to wait longer before saying that a birth is stopping .

Yvonne Cheng, author of the study explains it this way:

The effect of the epidural can be longer than thought and as long as the baby and the mother are well and everything progresses without complications we would not have to intervene (and perform a cesarean) as a function of time.

Three times the time?

On the other hand, leaving aside the issue of cesarean sections that could be avoided, I think it is worthwhile to influence the duration that can be reached by the delivery of a woman who has previously given birth. Without epidural anesthesia, those that take longer to dilate do so in one hour and twenty minutes, whereas with epidural they go more than four hours. I think it's worth assessing a moment (or a long moment) the possibility of giving birth without using this anesthesia. Not only will the baby be born before, much earlier, it is also that recovery is better, breastfeeding is established before and there are, in general, fewer complications .

Via | El Economista, Abstract of the study in Pubmed Foto | dizznbon on Flickr in Babies and more | Childbirth without epidural, does it hurt a lot ?, Childbirth without an epidural, an option for all pregnant women ?, Pregnant women who claim their right to an epidural