Going Pain-Free During Labor Not As Risky as You Thought

January 13, 2009 01:28 PM
by Cara McDonough
Having an epidural or spinal anesthetic for pain may be considerably less dangerous than past numbers indicated, according to a new British study.

Pain Relief is Very Safe for Most Patients

In a study performed at Bath’s Royal United Hospital in England, researchers found the risk of harm from the procedures was as low as one in 23,000, 10 times lower than previously estimated.

Epidurals are most commonly used during labor and for hip and knee replacements, reported the BBC. "I think patients have probably been under the impression that the risk was greater than it actually was and this could have put them off the procedures,” Charlie McLaughlan, of the Royal College of Anaesthetists, told the BBC.

The risk to expectant mothers may be even lower than for other procedures, according to the study, with a risk of permanent harm in only one in 80,000.

Past estimates have “varied wildly” reports The Times of London. One of the most recent British studies estimated permanent risk from epidurals at one in 675 and a study in the United States said the risk was one in 800.

Tim Cook, a consultant anaesthetist who led the study, said that the new numbers will most likely become the “definitive estimate” of the possible complications, which means “we are able to inform patients with much greater clarity of what the risks are,” he told The Times.

It is unclear from the current study whether past risks were simply overestimated, or the risk related to epidurals have gone down because the procedure has been improved.

The study found that when permanent damage did occur, such as paralysis or even death, the epidural complications were judged to be unavoidable; that the complication was a result of an individual’s reaction to the procedure, and not a mistake on the doctor’s part. Furthermore, in most cases where permanent injury or death resulted, the patients being treated were elderly. Older patients commonly have more medical problems in the first place and are therefore more at risk, the study concluded.

Opinion & Analysis: Epidurals and childbirth

Information surrounding childbirth is constantly changing, and many mothers take decisions surrounding their labor and childbirth–including the decision to have an epidural – very personally.

Kristin Ketteringham wrote a piece for Associated Content in June 2007, for instance, extolling the virtues of an epidural-free childbirth experience. “Is there a right answer? I believe there is one. Natural childbirth is definitely the best decision any mother can make for their newborn child,” she wrote.

But many women feel strongly that they should not be made to feel guilty for pain relief during labor, and the subject is popular on pregnancy discussion boards. One woman posted her feelings recently on the U.K. version of the Web site Baby Center: “I realise everyone is different and are entitled to own opinions but surely surely I’m entitled to mine—medication is there this day and age to help us so why can't we use it without being judged?”

Dr. Marjorie Greenfield writes on the pregnancy and child care Web site Dr. Spock that women have a range of feelings about natural childbirth versus having an epidural, and that there is no “right answer.”

She lays out the arguments for a birth with an epidural and one without in her article. She reminds expectant mothers that “there are no martyr awards for avoiding pain medication, and the end result, a baby in your arms, happens regardless of your choice of anesthesia,” but also writes that an epidural-free birth can be “a powerful experience which often gives a tremendous sense of achievement.”

Related Topic: Cesarean sections

The question of having a C-section versus a natural delivery has been a popular topic in childbirth news recently, as well, with many varying opinions and studies. A recent study found that C-sections performed at 37 weeks, when pregnancies are considered full-term, carry more risk for babies than previously thought, and that performing the procedure at 39 weeks is much safer.

The study comes as C-sections are on the rise worldwide, concerning many doctors and mothers-to-be, as well. In the United States, approximately one out of three births is a C-section.

Reference: Epidurals, pregnancy


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