An epidural does not cause a cesarean
Settled, and the old advice was wrong.
Across 40 trials and more than 11,000 women there was no difference in cesarean rate between epidural and non-epidural pain relief (relative risk 1.07, not significant).
Epidurals did increase forceps and vacuum deliveries overall (relative risk 1.44), but in trials done after 2005 using modern low-dose techniques that effect disappeared (relative risk 1.19, not significant). Long-term backache showed no difference at all (relative risk 1.00).
Asking early does not cost you anything either. Across 9 trials and 15,752 women, early and late epidural placement produced essentially identical cesarean rates (relative risk 1.02).
Where this comes from:
189. Anim-Somuah M, Smyth RMD, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018;(5):CD000331.
190. Sng BL, Leong WL, Zeng Y, et al. Early versus late initiation of epidural analgesia for labour. Cochrane Database Syst Rev. 2014;(10):CD007238.
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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.