New Research Suggests This Prolongs Childbirth

Well, this is both groundbreaking and terrible: Getting an epidural might actually make labor last a couple more hours. Unlike the accepted wisdom in the medical community, a new study indicates that the application of epidural anesthesia could prolong childbirth — in particular, the second stage of labor — significantly more than was thought. Oh no. Oh dear.

The rule of thumb for doctors, as recommended by the American Congress of Obstetricians and Gynecologists, is that the second stage of labor — the bit where women push — should not last more than three hours for women giving birth for the first time with epidurals, or more than two hours for first births without epidurals. For women who have given birth before, two hours with an epidural and one hour for non-epidural births are the limits before further measures, like C-sections, are taken.

But the new study suggests that these guidelines provide incredibly low cutoffs. Based on 42,268 female participants, the study's lead author Dr. Yvonne Cheng of UCSF and three other doctors determined the following:

• For women who hadn't had children before, the 95th percentile length (e.g. longest) of the second stage of labor was 197 minutes — or over 3 hours — without epidural and 336 minutes — or over 5 hours — with epidural.
• For women who had given birth before, the 95th percentile length of the second stage of labor was 81 minutes without epidural and 255 minutes (or about 4 hours) with epidural.

The study's conclusion? Most women with epidurals have labor prolonged by two more hours than originally thought. This means doctors may unknowingly be taking unnecessary measures with delivering mothers because they believe their labor is abnormally long — measures which increase the price of pregnancy.

"One of the messages of this study is, sit on your hands a little longer, don’t rush into an instrumental vaginal delivery or a cesarean, because really everything could be fine," Dr. Barbara Leighton, an obstetric anesthesiologist, told The New York Times .

We can only hope that ACOG will review this study thoroughly and update its guidelines based on the results. Childbirth in the U.S. is already a source of anxiety for many women — making delivering mothers go through unnecessary procedures certainly isn't going to help.

In the meanwhile, maybe more U.S. doctors could start giving women in labor laughing gas.