Five Epidural Myths

Although most women in the U.S. use pregnancy epidurals (and/or spinal epidurals) to relieve the pain of childbirth, myths about pregnancy epidural procedures abound. Unfortunately, these myths cause more than a little consternation for many pregnant women. Much time is spent worrying not only about the pain of labor and delivery, but also about the methods to relieve the pain. Here are five of the most widely held myths about epidurals:

* Epidurals will slow down my labor

This is a commonly believed myth, but in fact is not true. Since 2005, there have been four scientific studies published on this issue. Three of the studies found that instead of slowing down labor, pregnancy epidurals and spinal epidurals actually speed labor up – especially when pregnancy epidurals are given before the cervix is 4 cm dilated. The fourth (and largest) of the studies showed no difference in how long labor lasted, whether or not a pregnancy epidural was used. So pregnancy epidurals do not slow labor down – they may even speed it up.

* Epidurals will increase the chance that I will need a cesarean

This is an old myth will not go away, even though many studies from different parts of the world have found that pregnancy epidurals do NOT increase the chance of needing a cesarean. So why all the confusion despite solid scientific evidence? It’s because pregnancy epidurals are associated with cesareans, but they don’t cause cesareans. What do I mean by this? Well, women who have difficult, painful labors are more likely to need a cesarean. And these are the SAME women who are more likely to ask for a labor epidural – so there is an association between labor epidurals and cesareans. But the labor epidural does NOT make a cesarean more likely.

* Epidurals will cause backache

It turns out that backache is very common during pregnancy and after pregnancy. In fact many women experience backaches after they deliver that can last for many months. Scientific studies of backache after delivery have found that the chance of having a long-lasting backache is the same whether or not the mom got a labor epidural.

*Epidurals are dangerous for my baby

This is a particularly wicked myth, because it makes women feel guilty for wanting to their pain relieved. Although there are certain problems with labor epidurals that could be bad for babies, for example, a significant lowering of the woman’s blood pressure – most effects of labor epidurals are actually helpful for the baby. An example of this is the labor epidural lowering the woman’s stress level and thus getting more blood flow and oxygen to the baby during labor and delivery.

*Epidurals will prevent me from breastfeeding my baby

I hear this myth repeated all the time, but the scientific evidence is scanty, at best. Modern pregnancy epidurals and spinal epidurals use such low doses of medication that it’s hard to imagine a negative effect on breast-feeding the newborn. In fact, pain after delivery can be bad for breast-feeding. Pain reduces the amount of milk a new mother produces. And a new mom in pain may be less likely to want to interact with her new baby. So I suggest something that isn’t usually considered: think about using a very low-dose labor epidural after a difficult vaginal delivery, and certainly after cesarean. It’s the best way we have to make the mom comfortable without being drowsy.

Myths about pregnancy and epidurals have been around for years, and some are so widely believed – even by obstetricians, midwives, nurses, and others–that they’ve taken on a life of their own. During pregnancy, every woman is exposed to one or more of these myths. This is unfortunate, because hearing these myths – and believing them – influences a mother-to-be’s decision making about pain relief options. Decisions should be made after considering the facts  about pregnancy and epidurals – not the myths.

Gilbert J. Grant, MD, an obstetric anesthesiologist in New York City, is author of Epidural Without Guilt: Childbirth Without Pain.