Effect of epidural analgesia on labour and outcome

decades ago for pain relief in labour, controversy has persisted about its effect on the labour process. As a result of this, considerable research has been performed and findings have led to changes in practice. Epidurals have been creditedwithprolonginglabour; increasingoxytocin requirements, instrumental and operative delivery rates; and causing maternal pyrexia and postpartum back pain. There is increasing evidence that refutes some of these claims. Despite ongoing controversies, epidural rates have increased; 25% of women in the UK and 66% of women in the USA receive epidural analgesia in labour. The following statement from the American College of Obstetricians and Gynecologists summarizes the background to these figures: ‘labour results in severe pain for many women. There is no other circumstance where it is considered acceptable for a person to experience untreated severe pain, amenable to safe intervention, while under a physician’s care.’