A study recently published in the journal Obstetrics and Gynecology measured the second phase of labor (complete dilation until birth of the baby) for 42,268 women, comparing the length of this stage for those having an epidural to those who did not. The purpose of the study was to evaluate the current definition of “prolonged second stage”- longer than three hours for first time mothers with an epidural and two hours for those having their second (or later) child with an epidural according to the American College of Obstetricians and Gynecologists (ACOG).
The study concluded that “the current definition of prolonged second stage of labor may be too stringent.” The authors also noted that their finding support the recent joint statement from ACOG and the Society for Maternal-Fetal Medicine suggesting that an increase in the acceptable length of labor’s second phase could help reduce the number of primary cesarean births (more on this statement here).
Highlights from “Second Stage of Labor and Epidural Use: A Larger Effect Than Previously Suggested”:
• The length of second stage has increased over time for all mothers – first time, multiparous, with epidurals, and without.
• The 95th percentile length of second stage labor for first time mothers with epidurals was 2 hours and 19 minutes longer than those without.*
• Mutiparous women using an epidural had a 95th percentile second stage length of 2 hours and 54 minutes more than those who gave birth without an epidural.*
*In obstetrics, the 95th percentile threshold (the point at which 95% of patients have reached a certain point in labor) is often used to determine guidelines for what is and what is not normal.
This study also supported other information we know about epidural use including:
• Women whose labors were induced or augmented with oxytocin were more likely to have an epidural.
• The number of mothers who had epidurals increased during the 1976 – 2008 time period the study covered.
Read the full article at: http://cfpcwp.com/MCDG/wp-content/uploads/2013/12/Epidural-.pdf