Labour epidural pain relief is linked to a 35% reduction in severe maternal health complications during childbirth

28 May 2024

A study led by OAA Executive Committee member Professor Rachel Kearns and published in the BMJ has found that having epidural pain relief during labour is associated with a 35% reduction in severe maternal health complications. There was a greater reduction for those mothers who gave birth to a premature baby, or who had pre-existing health conditions that put them at higher risk of developing severe complications.
 
Researchers from the University of Glasgow and the University of Bristol investigated health data from 567,216 mothers in labour between 2007 and 2019 who had a vaginal birth or unplanned caesarean section. The study reported that overall, 22% of mothers had an epidural, and only one in four (24.6%) mothers at higher risk of developing severe health problems during childbirth had an epidural. Previous studies funded by OAA research grants by the same team, and by other researchers, have reported that mothers who live in more deprived areas or who are from ethnic minorities are less likely to receive epidural pain relief.
 
Professor Kearns said: “Our research reveals that epidural analgesia during labour 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.
 
“By broadening access and improving awareness, we can significantly reduce the risk of serious health outcomes and ensure safer childbirth experiences.”
 
Co-author Professor Deborah Lawlor from the University of Bristol said: “It is important that women, and their partners, have control over their treatment during pregnancy, including the use of an epidural during labour. It is also important that women who would benefit from an epidural to prevent them becoming seriously ill are provided with easy-to-understand information to help them make informed decisions.”
 
An accompanying BMJ editorial by OAA Executive Committee member Professor Sarah Devroe and Professor Steffen Rex, both from the University of Leuven, and OAA President Dr Nuala Lucas, discussed the possible explanations for the findings. This may include closer monitoring of both mother and baby during labour, blunting of physiological stress responses to labour, and allowing a swifter conversion to anaesthesia for an emergency birth, reducing the need for general anaesthesia.