- Getting an epidural during labor is associated with a reduction in severe maternal morbidity (SMM) after giving birth.
- While an epidural can be an effective pain management technique during labor, it can also help relax muscles and lessen strain on the body.
- Experts agree it’s important to support and educate all women, when it comes to making decisions about pain management options during labor.
Getting an epidural during labor is linked with a decrease in severe maternal morbidity in the first few weeks after delivery. These severe complications can include heart attack, heart failure, sepsis, and hysterectomy.
The findings were published in The BMJ this month.
Researchers looked at Scottish National Health Service data for 567,216 mothers in labor between 2007 and 2019 who gave birth naturally or through unplanned cesarean sections.
What is severe maternal morbidity?
Severe maternal morbidity describes unexpected adverse labor and delivery outcomes which can lead to short and long-term health issues.
Kecia Gaither, MD, double board-certified in OB/GYN and Director of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx, provided a list of risk factors:
- Postpartum hemorrhage
- Infection/sepsis
- Preeclampsia/eclampsia
- Heart attack
- Enlargement of the heart and weakening of the heart muscle
How an epidural lowers the risk of severe complications
The study results found 22% of women had an epidural in labor. Additionally, severe maternal morbidity occurred in 4.3 per 1,000 births.
The study authors found that getting an epidural was associated with a 35% decreased risk reduction in severe complications.
Experts say epidurals aren’t just about relieving pain, they can help lower the danger of high-risk pregnancies.
“Based on my experience and the study mentioned, I do believe that an epidural, when suitable, is a safe and beneficial option for pain relief during labor,” said Matthew Casavant, MD, the founding physician of South Lake Obstetrics & Gynecology. “Epidurals not only help manage pain effectively but can also reduce severe maternal morbidity (SMM) by lowering the physical strain on the mother, which is crucial for high-risk pregnancies.”
“The benefits of pain management extend beyond comfort—they can directly impact maternal and neonatal outcomes,” Cassavant stated. “For example, I’ve observed that mothers who have had epidurals often experience reduced instances of high blood pressure spikes and less physical stress, which can decrease the likelihood of complications like pre-eclampsia.”
Tina Hendrick, MD, board-certified OBGYN points out that epidurals affect the muscles themselves.
“Epidurals have quite a few benefits, including pain relief, relaxing muscles in the pelvis to allow a baby to descend, and affording rest to mothers during labor. I personally have had epidurals with both of my children and had great experiences,” Hendrick stated.
Although the study shows the benefits of an epidural – particularly for patients with severe maternal morbidity – not everyone is a candidate for the procedure.
“As an underlying, neuraxial anesthesia – referring to epidurals – have been touted as a safe procedure for carefully selected patients. Patients, for example, who have an underlying bleeding diathesis are generally not candidates for the procedure,” Gaither explained.
Talking with a physician about an epidural
Experts agree ensuring equitable access to epidural analgesia is essential.
Casavant added: “We must support all women, regardless of background, in making informed decisions about pain management options during labor. This involves comprehensive education and discussion throughout prenatal care, tailored to each patient’s unique medical history and needs.”
Patients should be provided with all the information regarding a procedure in order to make an educated decision.
“When I am counseling a patient on epidurals, I am sure to include how it can benefit care when underlying comorbid conditions are present,” said Hendrick. “I also point out risk factors or why a patient would not be a candidate for an epidural. However, it is ultimately the patient’s decision and I support her regardless of the choice.”
Takeaway
A new study showed having an epidural is linked with a decrease in severe maternal morbidity (SMM) after giving birth.
Although an epidural can assist with pain management during labor, it’s vital to ensure you are a candidate.
Health professionals agree it’s essential to inform all women regarding the importance of making safe and healthy decisions about labor pain management.
Getting an Epidural During Labor Drops the Risk of Severe Complications by 35%
Source: Pinoy Lang Sakalam
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