Buzz
Do epidurals extend labor? This week’s headlines might make you believe we’ve conclusively settled the debate, suggesting epidurals have no significant impact. However, the study focused on what occurs if you already have an epidural and decide to deactivate it during the pushing phase.
The Headline: Epidurals Don’t Lengthen Labor (New York Times)
The Story: The research examined epidurals’ effects during the “second stage” of labor. But let’s be honest—how many of us truly understand what the second stage entails? Obstetricians do, but I doubt most headline writers and social media commentators do.
What most people consider “labor” is actually the first stage: when the cervix dilates, contractions intensify, pain peaks, and you prepare to head to the hospital. Once there, you realize there are still hours ahead, leaving you wondering how you’ll endure it all—ow, ow, ow, ow.
The second stage of labor begins once you’ve reached full dilation at 10 centimeters, and it’s time to push. For first-time mothers, this phase might last one to two hours. If you’ve given birth before, pushing could be over in just a few minutes.
(There’s also a third stage, which occurs after the baby is delivered.)
What did this study reveal about the pushing phase? Researchers examined 400 first-time mothers at a Chinese hospital who received epidurals during the first stage of labor. During pushing, some continued receiving the anesthetic, while others were given a saline placebo. The goal was to determine if epidurals should be deactivated during this stage.
Ultimately, both groups—those with active epidurals and those with placebos—delivered their babies in nearly the same time (51 minutes versus 52 minutes on average). However, a 2014 study showed that epidurals extended the pushing phase, with averages of three hours versus five and a half hours—a significant gap.
The 2014 study analyzed medical records of women who either received or didn’t receive epidurals, without using placebos. This means the two studies addressed entirely different questions. The recent study focused on whether the anesthetic itself affects pushing, while the 2014 study encompassed the entire birthing experience, including doctor biases, mobility limitations from epidural equipment, and other real-world factors influencing outcomes when an epidural is administered.
The Takeaway: If you’re considering an epidural, your main concern is likely whether it will extend your overall labor time, not just shorten the pushing phase. There is evidence suggesting epidurals do lengthen the first stage (the typically painful and lengthy part) of labor, and this recent study doesn’t dispute that. However, whether epidurals prolong the pushing stage remains uncertain.
