Does an Epidural Increase the Risk of Other Interventions During Labour?

You may have heard that getting an epidural can “slow labour” or “lead to more interventions.”
It’s a common concern — but what does the evidence actually say?

Does an Epidural Slow Down Labour?

Epidurals can make the second stage (pushing phase) a little longer — usually by 15–30 minutes.
The medication partially numbs the lower body, which can slightly reduce the urge to push.

However, studies show this does not increase C-section risk.

ACOG (2019): “Epidural analgesia is not associated with a higher rate of cesarean delivery.”

So while labour might last a bit longer, the overall safety and birth outcomes remain the same.

Does Epidural Increase the Chance of Forceps or Vacuum Delivery?

Possibly — but only slightly.
Older, higher-dose epidurals sometimes made pushing harder, which led to more assisted births.

With modern low-dose (mobile) epidurals, this risk is much lower.

Cochrane Review (2018): “Epidural analgesia increases the chance of assisted vaginal birth but not cesarean section.”

You may still feel pressure and push effectively with current methods.

What About Other Interventions?

Epidurals can cause temporary drops in blood pressure and mild slowing of contractions.
To manage this, your care team might:

• Give IV fluids before or during the procedure
• Use continuous fetal monitoring
• Occasionally use oxytocin (Pitocin) to strengthen contractions

These are routine measures — not complications.

Does Epidural Increase C-Section Risk?

No.
Multiple large studies confirm epidurals do not raise C-section rates, regardless of timing or dosage.

BMJ (2020): “Epidural analgesia is not associated with an increased risk of cesarean delivery.”

The Real Picture

• Labour may last slightly longer.
• Assisted deliveries can be a bit more common.
• C-section risk remains unchanged.
• Low-dose epidurals have reduced most older concerns.

Epidurals remain one of the safest, most effective pain relief options for labour. The key is understanding your options and making a decision that helps you feel calm, comfortable, and in control.