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"Epidural may aid a woman's long-term health"

Globe and Mail

Source: Globe and Mail

Published: 02 Sep 2022

Category: Pharmaceutical

Rating: (2 stars)

Keywords: pregnancy epidural labour childbirth

what they said (Hover the mouse cursor over underlined words for more info)

It's one of the most charged decisions a woman faces in childbirth: Whether to have a pain-relieving epidural or to try to hold off and have a drug-free birth. Many proponents of natural childbirth paint the epidural option as a choice with many negative consequences, including slowing down labour and separating a woman from the experience.

But a new study out of Australia has found that an epidural may play a positive role in women's health long after the baby is delivered by reducing damage to the pelvic floor muscles...

The original article can be found at:

how did it rate? (more information)

Criteria Rating
Total Score 4 of 10
Availability of Treatment Satisfactory (?)
Novelty of Treatment Satisfactory (?)
Disease Mongering Satisfactory (?)
Treatment Options Not Satisfactory (?)
Costs of Treatment Not Satisfactory (?)
Evidence Satisfactory (?)
Quantification of Benefits of Treatment Not Satisfactory (?)
Harms of Treatment Not Satisfactory (?)
Sources of Information Not Satisfactory (?)
Relies on Press Release Not Applicable
Quantification of Harms of Treatment Not Satisfactory (?)

what we said (Hover the mouse cursor over underlined words for more info)

One of the main problems in the reporting of this Australian study is that it will be drawn on to support the use of epidurals in childbirth on the basis of the measurement of surrogate markers. The use of surrogate markers, in this case "levator microtrauma", implies pelvic floor injuries however, the story does not indicate whether there is sufficient evidence to link this microtrauma to serious pelvic organ prolapse.

The real concern for pregnant mothers, as inspired by the anecdotes included in the report, is that pelvic floor problems may lead to incontinence or sexual dysfunction- however, we don't know this for sure. The take away message for expectant mothers appears to be: "have an epidural and avoid future incontinence"- a message that is very captivating and very misleading.

The report does not discuss the potential harms associated with epidurals and does not indicate that there were conflicted researchers involved in the study. Furthermore, the inadequate quantification of the treatment benefits makes the study results even less informative; all we know from this report is that women who received an epidural experienced a "lower incidence of tearing". How much lower? We don't know. Did this "lower incidence" result in reduced pelvic organ prolapse? The story isn't clear.

There are many unanswered questions arising from this story and it seems fair to say that readers have been short-changed on important study details.

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