• Posted May 28, 2024

Epidurals Linked to Better Outcomes After Childbirth

Women who get an epidural during delivery appear to have a marked reduction in serious complications the first few weeks after giving birth, a new study shows.

A painkilling epidural can reduce risk by 35% in women for complications like heart attack, heart failure, blood infection and hysterectomy that can occur as a result of delivery, researchers reported May 22 in the BMJ.

And the risk declines even more for women with known risk factors for these complications such as obesity, other health problems or prior delivery, researchers said.

For those women, an epidural can reduce their risk of complications by 50%, compared to a 33% risk reduction in those without such factors.

And women delivering preterm had a risk reduction of 47%, results show.

“Encouraging the adoption of, and enhancing accessibility to, epidural analgesia for women in these higher risk categories could be instrumental in improving maternal health outcomes,” concluded the research team led by Rachel Kearns, an anesthesiologist with Glasgow Royal University in the U.K.

For the study, researchers analyzed data for more than 567,000 mothers who went into labor between 2007 and 2019. Medical records were used to identify women who developed any of a series of 21 complications known as severe maternal morbidity.

Despite these benefits, few women appear to get epidurals during delivery, researchers found.

Only 22% of all women received an epidural during delivery, and just under 25% of the women at highest risk for complications got an epidural, results show.

Epidurals might reduce a woman's risk because they reduce the body's physical stress responses to labor, researchers said. These women also might be more closely monitored during labor, and doctors are more likely to intervene if needed.

The relatively low use of epidural might be a reflection of misperceptions regarding their safety and usefulness, researchers noted.

Women might think an epidural does harm to their baby, a notion that's been disproven by prior research, researchers said.

Women can personally choose whether or not to receive an epidural, researchers said, and it might pay for doctors to counsel them on the benefits of receiving the painkilling procedure during delivery.

“These findings substantiate the current practice of recommending epidural analgesia during labor to women with known risk factors, underscores the importance of ensuring equitable access to such treatment, and highlights the importance of supporting women from diverse backgrounds to be able to make informed decisions relating to epidural analgesia during labor,” the researchers concluded in a journal news release.

More information

The U.S. Centers for Disease Control and Prevention has more on severe maternal morbidity.

SOURCE: BMJ, news release, May 22, 2024