Does Epidural Analgesia Affect the Rate of Spontaneous Obstetric Lacerations in Normal Births?
Version of Record online: 24 DEC 2010
2007 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 52, Issue 1, pages 31–36, January-February 2007
How to Cite
Albers, L. L., Migliaccio, L., Bedrick, E. J., Teaf, D. and Peralta, P. (2007), Does Epidural Analgesia Affect the Rate of Spontaneous Obstetric Lacerations in Normal Births?. Journal of Midwifery & Womens Health, 52: 31–36. doi: 10.1016/j.jmwh.2006.08.016
- Issue online: 24 DEC 2010
- Version of Record online: 24 DEC 2010
- keywords: childbirth;
- epidural analgesia;
- genital tract lacerations;
- perineal trauma
The precise relationship between epidural use and genital tract lacerations in normal childbirth is unclear. Data from a clinical trial on measures to lower genital tract trauma in vaginal birth were used for a secondary analysis. The goal was to assess whether epidurals affect the rate of spontaneous obstetric lacerations in normal vaginal births. Maternal characteristics and intrapartum variables were compared in women who did and did not use an epidural in labor, and also in those with and without any sutured lacerations following vaginal birth. Variables that were statistically different in both cases were entered into regression equations for simultaneous adjustment. Epidural use was not an independent predictor of sutured lacerations. Predictors of sutured lacerations included nulliparity, a prolonged second stage, being non-Hispanic white, and an infant birthweight greater than 4000 grams. Elements of midwifery management need further research.