Women In Labour Who Have An Epidural Could Reduce Their Chance Of Needing Intervention By Lying Down

Were you in a lying down or upright position when you gave birth?
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First-time mums who have an epidural could increase their chance of giving birth without intervention by lying down when in later stages of labour, a study has found.

According to researchers at the University of Birmingham, having an epidural leads to an increased risk of an instrumental vaginal birth - with forceps or a suction device.

But among the 3,093 women they studied who had an epidural, those who lay down in the later stages of labour had more “spontaneous” births without intervention (41.1%), than those who were in an upright position (35.2%).

The authors stated in a report published in the British Medical Journal (BMJ) on Wednesday 18 October: “The intervention appears to be easy and cost-free to adopt.

“This evidence will allow pregnant women, in consultation with their healthcare providers, to make informed choices about their position in the second stage of labour.” 

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The study was funded by the National Institute for Health Research and included women in 41 UK hospital labour wards between October 2010 and January 2014.

Among the 3,093 women, there were 1,556 in the upright group and 1,537 in the lying down group. The women were aged 16 or over and opted for a low dose epidural. 

For women lying down during labour, the researchers stated: “No disadvantages were apparent in relation to short or longer term outcomes for mother or baby.”

However, the researchers outlined some limitations in the study, with one being that NICE guidelines currently recommend women with an epidural should be encouraged to adopt an upright position in late labour.

The women in the lying down group were less likely to remain in that position for the rest of their labour and the authors believe this could be due to the current guidance.

“If that was the case, lying down may be even more effective at increasing the chance of a normal birth,” they added.

It’s also unclear what the findings mean for women without an epidural or for those who have given birth before.

In response to the study, a statement given to HuffPost UK from the Royal College of Midwives (RCM) read: “This is an interesting study looking at first-time mothers using an epidural for pain relief and the effect of their position when actually giving birth. It adds to our evidence on the effect of an epidural on the processes of labour and birth.  

“We do know that having an epidural can make it harder for the baby to turn into an optimal position during labour if they are not already there before the epidural is inserted. An upright posture can assist this rotation.

“This evidence looks at position for birth. Midwives can be assured that a supine [laying down] position for birth will increase the spontaneous birth rate in this group of women.”