We note the Health Secretary's widely publicised comments about the provision of labour epidural analgesia in NHS hospitals.

We fully support 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.

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. The Royal College of Midwives website (accessed 27th January 2020)

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