Media discussion about the provision of epidural analgesia in labour



There has been continued media discussion about the provision of labour epidural analgesia in NHS hospitals. The OAA fully supports the NICE guidance that if a woman in labour requests an epidural, this should be offered, even in the latent stage of labour. There is no evidence that having an epidural early in labour (less than 4cms cervical dilatation) has any more effect on the course of labour, than later on. In the second stage of labour (when the cervix is 10cm dilated) as long as the woman can maintain the position needed to insert an epidural, she should be able to have one. Although reference has been made to a ‘shortage of anaesthetists’, most hospitals have a policy for escalation when the labour ward duty anaesthetist is unable to attend within 30 minutes of a request for an epidural.

An essential component in the provision of safe labour epidural analgesia is that a woman needs to receive one to one midwifery care.
We support any analysis of factors that may prohibit the provision of an epidural to a woman in labour, but this must include an assessment of factors such as staffing and the availability of one to one midwifery care. The UK currently has a severe shortage of midwives1 and the impact of this on the delivery of labour analgesia would be a particularly important area to assess.

1 RCM article (accessed 27th January 2020)

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News and CommentMedia discussion provision of epidural analgesia in labour