HealthDay News — Although the effect of early epidural on the length of time to reach full cervical dilation is unclear, the best time to give an epidural is likely when a patient asks for it, results of a study published in The Cochrane Library indicate.

“Pain during childbirth is arguably the most severe pain some women may experience in their lifetime,” explained Ban Leong Sng, MD, of the KK Women’s and Children’s Hospital in Singapore, and colleagues. “Epidural analgesia is an effective form of pain relief during labour [sic]. Many women have concerns regarding its safety.”

To investigate the effectiveness and safety of early initiation versus late initiation of epidural analgesia in women, the investigators conducted a systematic review including 15,752 first-time mothers randomly assigned to receive an epidural early or late during childbirth. Those given early epidurals were less than four to five centimeters dilated, while those given late epidurals were four to five centimeters or more dilated.

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Compared with women who had late epidurals, those who had early epidurals were no more likely to require a cesarean delivery, to need assisted birth involving forceps or suction, or to spend more time in the pushing stage of labor, reported the scientists.

“We conclude that it would appear to be advantageous to initiate epidural analgesia for labour early, when requested by the woman,” said the researchers.


  1. Sng BL et al. The Cochrane Library. 2014; doi: 10.1002/14651858.CD007238.pub2