For years, doctors and natural birth proponents have been concerned that epidural analgesia slows down how long it takes a mother to push her baby out. Many obstetricians reduce or turn off a woman’s epidural while she’s pushing in the hopes of moving things along.
But new findings published in the journal Obstetrics & Gynecology on Tuesday suggest that long-held belief may be wrong. The study found that women took roughly the same amount of time to push, whether they got drugs while pushing or not.
Researchers tracked a group of 400 first-time mothers in China who were given a self-administered epidural pump in the earlier stages of labor. When it was time to push, the women were randomly sorted into two groups. One continued to receive pain medication; the other received a saline placebo.
It is worth noting that the moms-to-be understood the nature of the trial before they went into labor, so they weren’t tricked into being in pain while pushing. And they were able to get more pain medication if they asked for it, or if their doctors determined it was necessary — though the doctors themselves did not know if patients had been sorted into the placebo group.
Overall, the women who got active pain medication while pushing took about 52 minutes to push their babies.
The women who got the placebo, on the other hand, took about 51 minutes.
“We found no difference in terms of how long it took for babies to be delivered,” study author Dr. Philip Hess, director of obstetric anesthesia at Beth Israel Deaconess Medical Center, told HuffPost. “We measured other outcomes and found no differences between the two groups.” Babies in the two groups scored about the same in test of overall wellbeing.
Hess added that some observational studies have suggested women who get epidurals take longer to push, but the new results suggest that is an association rather than cause and effect. Women who have prolonged, more difficult labors are more likely to request pain relief, but that does not mean the epidural itself is the reason behind the longer delivery time, he argued.
The majority of women who have a vaginal birth in the United States opt for an epidural, and there is ample evidence suggesting that does not negatively affect outcomes. Reviews, for example, have found that epidurals do not contribute to increased C-section rates in part because epidurals have changed significantly in the past three decades. Women are generally given much lower dosages that they are able to control themselves.
However, because the new study looked only at moms who opted for an epidural to begin with — and focused specifically on the second stage of labor — it’s too soon to say that getting an epidural does not slow childbirth at all.
“This particular study only looked at moms who had an epidural already. It did not compare moms who did and did not have [pain relief],” cautioned Dr. Lisa Levine, an assistant professor of obstetrics and gynecology at the Hospital of the University of Pennsylvania, who did not work on the study.
She added, however, that she would use the findings to reassure patients who worry that if they are unable to feel much, they will be unable to push. It’s a concern her patients raise often.
“All of this has to be considered in the context of moms’ desires and wishes. We have great options in terms of doulas, coaches, midwives and support for women who want a ‘natural’ experience without any sort of pain management,” Levine said.
“But I think there are a lot of women who want pain relief, but don’t want a C-section and are scared of the possible downstream effects,” she continued. “It’s very helpful to have a study like this that says even if you’re numb, you’re still able to push.”