Self-service – the future of epidurals?

Giving you control over your own epidural during labour could reduce the need for medical intervention, finds study


Having an epidural on demand during labour could actually reduce how much pain relief you need


In a study of 270 women giving birth, a third tried the self-service technique and used 30% less anaesthetic than those given a steady infusion of drugs, research from the Long Beach Memorial Medical Center in California revealed.

Epidurals are usually given at a steady rate, controlled by the doctor present during birth. However, the women in the test were given control over their own epidurals, by pressing a button when they felt they needed more pain relief.

The women using the self serve method (called patient-controlled epidural analgesia – PCEA) were unable to constantly request pain relief, as after each press of the button the handheld device would lock-out for a small period of time.

The study showed that the women using PCEA were as satisfied as those who used the traditional epidural method. However some women using the self-controlled method reported more pain in the later stages of labour.

There was also evidence that the need for forceps or a ventouse to help deliver the baby was reduced for women who used PCEA.

Currently, only one fifth of hospitals in the UK have the self-service system as they come at a very high cost. Researchers are currently looking into whether the advantages of the PCEA are enough to justify the costs.


“The technique reduces the need for anaesthetic which in turn reduces the need for forceps delivery – and it gives women a feeling of control. The question is whether the small clinical advantages are enough to justify the cost of new equipment and staff training,” Dr Elizabeth McGrady, a honorary clinical lecturer in anaesthetics at Glasgow University said to the BBC.

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