HEALTH: LESS PAIN, ALL GAIN

About six out of every 10 U.S. women giving birth receive an epidural--a combination of a local anesthetic and a narcotic injected through a catheter inserted in the lower back. Yet traditionally, doctors worried that administering one before the cervix opened four or five centimeters (a process that takes eight to nine hours, on average) would slow labor and increase the risk of C-section. Last week a randomized, controlled study of 750 first-time moms, published in The New England Journal of Medicine, delivered some good news: early epidurals actually shortened average labor time by 90 minutes--and did not increase the incidence of C-section. Why? "Our gut feeling is that somehow the whole process of relaxing and not being in pain actually speeds the process of labor," says Northwestern Memorial Hospital obstetric anesthesiologist Dr. Cynthia Wong, lead author of the study.

The American College of Obstetrics and Gynecology currently recommends waiting for the four- to five- centimeter dilation "when feasible" and has no immediate plans to revise its guidelines. But Dr. Jeffrey Kuller, chair of ACOG's obstetrics committee on practice bulletins, is bullish on the new results. "They will allow patients to feel a little bit more confident and not feel guilty if they want an early epidural," he says. The take-home message: don't feel bad about wanting pain relief fast.

© 2005