Anyone who's ever designed their own birth plan knows how quickly your vision of aromatherapy candles, inspirational music, and self-hypnosis exercises can be replaced by the reality of forceps, vacuums, and caesarean sections.
But a new study says something as simple as lying down on your side after getting an epidural can lower the chances of needing medical interventions in first-time mothers.
The U.K. study, published this week in The BMJ, is based on a randomized controlled trial of just over 3,000 first-time mothers in the second stage of labour (when the cervix is fully dilated) at 41 different hospitals. All the women in the study had opted for epidurals, a pain medication administered through a thin catheter inserted in a woman's back.
The epidural rate for vaginal births in Canada is 57.8 per cent, according to the Canadian Institute for Health Information.
Of all the women in the U.K. study, 41.1 per cent of those who lay down on their left or right side in the later stages of labour had "spontaneous" vaginal births without intervention, compared to 35.2 per cent of those who were in an upright position.
Changing tide on epidurals
It's already been established that women who use an epidural for pain relief are more likely to have an instrumental vaginal birth, the U.K. researchers note.
However, 2016 research in the journal Obstetrics & Gynecology suggested the long-held belief that epidurals can slow labour may be wrong. Women in the Chinese study took roughly the same amount of time to push out their babies, about 52 minutes, whether they received epidurals while pushing or not.
A U.S. study published earlier in October also added to evidence that epidurals don't slow labour. Researchers found that epidural use during pushing had "no effect on the duration of the second stage of labour, normal vaginal delivery rate, incidence of episiotomy, the position of the fetus at birth or any other measure of fetal well-being."
An epidural allows a mother to remain awake and alert for the delivery, Health Link B.C. notes, but can lead to back soreness at the injection site. In about two out of every 100 women, a severe headache can result from accidentally puncturing the spinal cord sheath, the health information service says on its website.
Pregnant women, in consultation with their healthcare providers, can now make informed choices about their position in the second stage of labour.Professor Peter Brocklehurst
There are limits to the new U.K. study, lead author Peter Brocklehurst said in a news release, and researchers can only speculate about why lying down increases a woman's chances of a spontaneous vaginal birth.
"However, the evidence we have found from this large trial group provides an easy and cost-free intervention in our labour wards. Pregnant women, in consultation with their healthcare providers, can now make informed choices about their position in the second stage of labour," Brocklehurst said.
There were no apparent disadvantages for short or longer term outcomes for mother or baby, the researchers noted.
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