Cochrane Summaries

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Discontinuation of epidural analgesia late in labour for reducing the adverse delivery outcomes associated with epidural analgesia

Torvaldsen S, Roberts CL, Bell JC, Raynes-Greenow CH
Published Online: 
8 September 2010

Not enough evidence to suggest that stopping an epidural late in labour lowers the risk of instrumental delivery or other unwanted outcomes.

Epidurals are used for pain relief in labour, but they increase the risk of instrumental delivery (vacuum/forceps). Stopping epidurals early aims to allow women to feel the pushing urge and so reduce the chance of having an instrumental birth and possible problems associated with such a birth. There is not enough evidence from the five included trials, involving 462 participants, to show whether stopping an epidural really does lower the risk of instrumental delivery or of any other unwanted outcome. The results show that women whose epidural is stopped report more pain than women whose epidural is continued until the birth of the baby. More research is needed.