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Epidural analgesia is commonly used during childbirth, but there is concern about whether it leads to more C-sections among nulliparous women. This study randomized 761 nulliparous women to either continuous epidural analgesia or a combination of spinal and epidural analgesia that maintains motor function and allows ambulation. All patients were in spontaneous labor and had requested epidurals.
There were no significant differences between the analgesia groups in the C-section rate, incidence of dystocia, maternal or fetal complications, or patient satisfaction. More women using the combination analgesia developed pruritus and requested additional anesthetic. Risk factors associated with dystocia and C-section included epidural administered …