Study Suggests Misplaced Fears in Longer Childbirths

Epidural anesthesia lengthens the second stage of labor, the one in which women push. But a study published on Wednesday has found that epidurals are associated with an even longer duration in the second stage than is generally recognized, suggesting that some women may be subject to unnecessary interventions by doctors who wrongly fear labor has become prolonged.

The finding indicates that “clinicians might need to wait later before
intervening with oxytocin, forceps, vacuum or a cesarean,” said Dr. S.
Katherine Laughon, an investigator at the National Institutes of Health
who was not involved in the study, which was published in Obstetrics and
Gynecology. Still, she added, “clinicians and women need to balance
benefits of vaginal delivery with potential increases in risk for mom and
Current guidelines by the American Congress of Obstetricians and
Gynecologists, or ACOG, define an abnormally long second stage as more
than three hours for women who received an epidural and are giving birth
for the first time, and more than two hours for first births without an
The new study suggests a normal second stage can take as long as 5.6
hours for women who get epidurals during their first births, and as long as

3.3 hours for those who do not get epidurals.
For women who have given birth previously, the group’s guidelines
define an unusually long second stage as two hours with an epidural, one
hour without. The new study found that the second stage for these women
can be as long as 4.25 hours and 1.35 hours, respectively.



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