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Epidurals May Reduce Serious Childbirth-Related Complications

A new study involving over 500,000 women found that epidural anesthesia may help lower the risks of heart attack, blood infections, and other life-threatening complications associated with labor and delivery.

In the United States, over 3.5 million babies were born in 2023. While the majority of those births had a good outcome, Centers for Disease Control and Prevention (CDC) data shows that the maternal mortality rate in the U.S. is rising, from 20.1 deaths per 100,000 live births in 2019 to 32.9 deaths per 100,000 live births in 2021.

Because of this concerning trend, health officials say that finding ways to reduce maternal health outcomes associated with childbirth is critical.

According to a 2022 study, using epidural anesthesia during labor and delivery might be one strategy for reducing childbirth-related mortality. The results showed that epidural use during vaginal delivery was associated with a 14% lower risk of severe maternal morbidity.

Now, a new study recently published in theBMJ found more evidence that having an epidural may lower the risk of potentially fatal complications occurring after delivery.

The research, led by scientists from the University of Glasgow and the University of Bristol, involved 567,216 women in labor at hospitals across Scotland. The women delivered their babies vaginally or through an unplanned cesarean section, and 22% had an epidural administered during labor.

The researchers found that overall, having an epidural reduced the risk of serious complications, including heart attack, heart failure, and hysterectomy, by 35%.

What's more, mothers with specific risk factors for complications, such as those with obesity, were 50% less likely to experience adverse childbirth-related health issues if they used epidural anesthesia. In addition, women who delivered their baby prematurely and had an epidural were 47% less likely to develop complications.

In a University of Glasgow press release, lead study author Professor Rachel Kearns said, "Our research reveals that epidural analgesia during labor is linked to a substantial decrease in severe maternal health complications. This finding underscores the need to ensure access to epidurals, particularly for those who are most vulnerable — women facing higher medical risks or delivering prematurely."

Are epidurals safe?

Estimates indicate that about 80% of women in developed countries choose to have an epidural to reduce pain during childbirth. Overall, epidurals are considered safe and effective for relieving pain associated with labor and delivery.

To administer an epidural, an anesthesiologist places a thin tube into the epidural space in the spine. Once in place, medications that stop pain signals from reaching the brain are fed through the tube.

About 75% of women who choose this type of anesthesia are satisfied with the level of pain relief it provides.

Despite its pain-relieving benefits, there are risks associated with epidural anesthesia.

These include:

  • A drop in blood pressure which can lead to dizziness or nausea
  • Fever
  • Urination problems due to lack of feeling
  • Itchy skin
  • Post-epidural pain where the catheter entered the back

Permanent damage to the spine or inflammation resulting from the procedure is extremely rare. However, some women may experience a "spinal" headache if the needle used to administer the epidural pierces the spinal cord. The small hole allows spinal fluid to leak, resulting in a severe headache that worsens when sitting or standing upright.

While most spinal headaches resolve on their own, a healthcare provider can treat this complication by applying an epidural blood patch over the hole.

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