Unlocking maternal health: labour epidurals and severe morbidity

In its guidelines for intrapartum care to improve the experience of childbirth, the World Health Organization recommends epidural analgesia for healthy pregnant women who express a desire for pain management during labour, depending on individual preferences.1 Common maternal concerns expressed during the informed consent process are whether epidural analgesia will have negative effects on both mother and baby or the delivery. Evidence to address these concerns, however, remains limited. In a linked paper, Kearns and colleagues (doi:10.1136/bmj-2023-077190) report the results of an investigation into a less commonly discussed concern of epidural analgesia during labour—the effects on severe maternal morbidity (SMM).2 Their findings showed a notable positive association, with epidural analgesia linked to a 35% reduction in SMM. This important benefit was particularly noticeable among women with a medical indication for epidural analgesia during labour and those undergoing preterm birth. The implications of these findings for obstetric anaesthetic practice and maternal health warrant careful consideration and further exploration.

Regardless of …