Epidural analgesia has been associated with a slight extension of the first stage of labor. Evidence suggests that epidural analgesia may extend the first stage of labor by approximately 30 minutes when compared with alternative forms of analgesia
Impact of epidural analgesia on labor duration
- First stage of labor: The use of epidural analgesia has been associated with a slight extension of the first stage of labor by approximately 30 minutes
- Second stage of labor: The second stage of labor may also be extended by approximately 15 minutes with the use of epidural analgesia
- Overall labor duration: Despite these extensions, the overall impact on labor duration is considered clinically negligible
Guidelines and recommendations
- Neuraxial anesthesia: The AAFP 2021 guidelines recognize that neuraxial regional anesthesia provides superior pain relief compared with systemic analgesia, without increasing rates of assisted vaginal delivery or cesarean delivery, regardless of whether initiated in latent or active labor or continued in the second stage of labor
- Patient mobility: The SOGC 2016 guidelines encourage patients receiving an epidural to maintain mobility and flexibility in positions of comfort throughout labor
- Low-dose epidural: The SOGC 2016 guidelines prefer low-dose epidural over high-dose epidural for labor analgesia and in promoting mobility in labor
In conclusion, while epidural analgesia may slightly extend the first stage of labor, the overall impact on labor duration is considered clinically negligible. The use of neuraxial anesthesia is recommended for superior pain relief, and maintaining patient mobility during labor is encouraged