Home' Trinidad and Tobago Guardian : February 8th 2014 Contents A32
body & soul
Guardian www.guardian.co.tt Saturday, February 8, 2014
While a shot to relieve labour pains
is known to increase the time it takes
for women to deliver babies, a new
study says the increase may be longer
than originally thought.
Researchers found some women
who received epidural anaesthesia dur-
ing labour took more than two hours
longer to deliver their child, compared
to women who didn t get the pain
"The effect of epidural can be longer
than we think and as long as the baby
looks good and the women are making
progress, we don t necessarily have to
intervene (and perform a Cesarean
section) based on the passage of time,"
Dr Yvonne Cheng told Reuters Health.
She is the study s lead author and
a specialist in maternal-fetal medicine
at the University of California, San
Cesarean sections, or C-sections,
are now used for about one of every
three births in the US, according to
the Centers for Disease Control and
Prevention. That s about 50 per cent
more than in the mid-1990s.
C-sections come with longer hos-
pital stays and extra risks for mothers
Cheng and her colleagues write in
Obstetrics and Gynaecology that two
common reasons for performing C-
sections are that it appears labour has
slowed and that the baby is not pro-
gressing through the birth canal.
Traditionally, doctors are taught
that women who receive epidural
anaesthesia will take about an extra
hour to complete the second stage of
labour, which is the pushing part.
But the researchers write that it s
unclear where the data for what s con-
sidered a "normal" labour came from
and that the extra hour of labour is
For the new study, they compared
data from over 42,000 women who
delivered their children at the Uni-
versity of California, San Francisco
between 1976 and 2008. About half
of the women received epidural anaes-
thesia and the other half did not.
Specifically, the researchers were
looking at the length of the second
stage of labour at the 95th percentile,
which is an extreme. That means 19
out of 20 women would complete that
stage of labour within that time.
For women who had never had a
child before and were in the 95th
percentile for length of labour, the
second stage took about three hours
and 20 minutes to complete without
anaesthesia and five hours and 40
minutes with the shot.
Women who previously had a child,
who usually have shorter labours to
begin with, took about an hour and
20 minutes to complete the second
stage of labour without anaesthesia
at the 95th percentile. That compared
to four hours and 15 minutes with an
Overall, the researchers found the
second stage of labour took about two
hours longer at the 95th percentile
when women got an epidural.
For women who have a more typical
delivery, the epidural probably adds
less time, Dr Karin Fox said. "It s prob-
ably difficult to know for each indi-
vidual patient," she told Reuters
Fox is a specialist in maternal-fetal
medicine at the Baylor College of
Medicine and Texas Children s Hos-
pital in Houston. She was not involved
with the study.
While she said the results are not
surprising, there may be reasons
besides the epidural why some
women s labours last longer.
She also said women shouldn t stay
away from epidural anaesthesia just
because it will prolong labour. "There
are many reasons for having an
epidural," she said.
Dr Christopher Glantz cautioned
that although the health of babies in
the epidural and non-epidural groups
was similar, mothers tended to have
more complications if they had longer
Glantz was not involved with the
study but is a high-risk pregnancy
specialist at the University of Rochester
Medical Center in New York.
"It would appear that the upper
limit of what can be tolerated is greater
than what was previously thought,
which takes away some of the impetus
to intervene (with C-section) in what
appears to be a premature fashion,"
Cheng and her colleagues write that
while doctors should not only rely on
this paper to establish how long
labours may last, these findings and
previous research suggest current def-
initions are not sufficient.
"All the experts in the field should
get together to look at the evidence
that s out there and come up with
informed definitions," Cheng said.
YOUR DAILY HEALTH
News and Advice
Dr Christopher Glantz cautioned that although the health of babies in the epidural and non-epidural groups
was similar, mothers tended to have more complications if they had longer labours.
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