Epidural analgesia in labour

Since epidural analgesia was introduced four decades ago forpain relief in labour, controversy has persisted about its effecton the labour process. As a result of this, considerable researchhas been performed and findings have led to changes in practice.Epidurals have been credited with prolonging labour; increasingoxytocin requirements, instrumental and operative delivery rates;and causing maternal pyrexia and postpartum back pain. Thereis increasing evidence that refutes some of these claims. Despite ongoing controversies, epidural rates have increased;25% of women in the UK and 66% of women in the USA receive epiduralanalgesia in labour. The following statement from the AmericanCollege of Obstetricians and Gynecologists summarizes the backgroundto these figures: ‘labour results in severe pain for manywomen. There is no other circumstance where it is consideredacceptable for a person to experience untreated severe pain,amenable to safe intervention, while under a physician's care.’