More Women Choosing Longer Labor With Less Pain, And Opting For Epidurals

Women Prefer Longer, Less Painful Delivery With Epedurals
Women increasingly favor epidurals for a longer but less painful delivery, according to new research. Shutterstock.com

Women prefer the longer but less pained childbirth labor made possible with the use of epidurals, according to a new study from Stanford University researchers.

Brendan Carvalho and his colleagues surveyed 40 pregnant women who were scheduled for induced labor, giving them the questionnaire after they’d arrived at the hospital but were not yet experiencing painful contractions. They also gave them the same survey within 24 hours of giving birth, to see if attitudes had changed. Essentially, the survey attempted to measure perceptions about the trade-off between time spent in labor and avoiding the pain of “natural childbirth.”

“Would you rather have pain intensity at two out of 10 for nine hours or six out of 10 for three hours?” the questionnaire asked.

Carvalho and his colleagues determined the pain preference ratio for the women by dividing the percentage of participants who preferred epidurals to those who preferred to just get it over with. The overall hypothetical pain burden was then determined by multiplying intensity by time, the researchers wrote in the study.

However, some scientists aren’t convinced epidurals even necessarily prolong labor, making the comparison irrelevant. Ruth Landau, director of obstetric anesthesiology and clinical genetics research at the University of Washington, says the evidence for such a claim is not universally supported.

“Obviously if we could control pain and duration, dial them both up and down based on what women wanted, we would do that, but we don’t have a way to dial up or down duration of labor,” she told The Huffington Post. “What we can do and should do is better inform women that we know that most women prefer low intensity of pain, particularly first-time moms,” she said.

Carvalho says doctors have a limited ability to assess pain in patients, although the zero to 10 scale of pain intensity is a practical tool. “Labor’s got a lot of factors to it, it’s difficult to capture in one score,” he said.

The researcher also dismissed the idea that most women were uninterested in natural childbirth or unduly afraid of pain. Rather, women generally preferred a lower level of manageable pain.

“The one good thing that does happen in labor is we use patient controlled analgesia,” he said. “Women control how much medication they get, which is better than getting prescribed a set dose from start to finish.”

Source: Carvalho, B., Hilton, G., Wen, L., et al. Prospective longitudinal cohort questionnaire assessment of labouring women's preference both pre- and post-delivery for either reduced pain intensity for a longer duration or greater pain intensity for a shorter duration. British Journal of Anaesthesia. 2014.

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