Early epidurals don't increase risk of having a C-section
By Serena Gordon
HealthDay Reporter
(HealthDay News) -- That pain relief known as an epidural that many given to many women in labor isn't going to increase the chances that a Cesarean section might be necessary.
This concern, shared by patients and doctors alike, has been dispelled, even though earlier research had indicated an association between receiving an epidural injection and increasing the possibility of having a C-section.
An epidural is an injection of anesthesia into the area that surrounds the spinal cord in the lower back. After an epidural, the abdomen, pelvis and genital areas are anesthetized, the researchers said.
Traditionally, women in labor have been told they have to wait until their cervix is dilated 4 or 5 centimeters before they can receive an epidural. That's because past research had shown an association between epidurals and C-sections.
However, research conducted in 2005 found that there was no link between getting an early epidural and the need for a C-section. "If a woman wants to have an epidural, there's no reason she shouldn't ask for it and get it when she needs it," said study author Dr. Cynthia Wong, an associate professor of anesthesiology at Northwestern University Feinberg School of Medicine in Chicago .
To test this theory, Wong and her colleagues conducted a randomized trial that included 750 healthy, first-time mothers. Half of the group received an epidural at their first request for pain relief, while the other half received an opioid analgesic, such as a morphine-like drug.
Women in the opioid group were assessed at their second request for pain relief. If they were less than 4 centimeters dilated, they were given another dose of opioid analgesia. If they were dilated more than 5 centimeters, they were given an epidural. After the third request for pain relief, they were given an epidural regardless of their dilation status.
The researchers confirmed what they had suspected -- early epidurals didn't increase the rate of Cesarean births. In fact, the early epidural group had an 18 percent C-section rate, while the opioid group had a 21 percent rate.
However, Wong and others suspected that epidurals weren't to blame. It may simply have been that women who requested early pain relief had other risk factors for C-section delivery. For example, said Wong, a baby with a large head circumference increases the risk of Cesarean birth and also may cause more pain than a baby with a smaller head, prompting the mother to ask for earlier pain relief.
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