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Do epidurals slow labour or childbirth? are they safe?

Epidurals don't meaningfully slow the pushing-to-birth process itself, but research shows they add time to the second stage of labour (the pushing stage) without raising the chance of a caesarean. They are considered safe, though side effects like low blood pressure, fever, and temporary leg weakness are common.

Large randomized-trial evidence finds no clear effect on the first stage of labour, but a longer second stage and somewhat higher chance of an instrument-assisted (forceps/vacuum) delivery.

Strength of evidence

Strong

Based on a Cochrane systematic review of 38 randomized controlled trials (over 9,600 women), the highest quality of evidence for this question.

What the evidence says

Good news first: epidurals do not appear to slow the early part of labour (called the first stage, from contractions starting to full dilation). A major Cochrane review of randomized trials found no clear effect on first-stage duration.

Where epidurals do add time is the second stage — the pushing phase. The same Cochrane evidence found the second stage was on average about 14 minutes longer with an epidural, and epidurals were linked to a higher chance of needing forceps or vacuum help. Importantly, they did not increase the chance of a caesarean section.

On safety: epidurals are widely used and generally considered safe for both mother and baby. Common side effects include a drop in blood pressure, fever, itching, and temporary difficulty moving your legs or passing urine. Serious complications are rare. Newborn outcomes (like Apgar scores) are not worsened.

Bottom line: an epidural is a well-studied, effective and generally safe way to manage labour pain. It may lengthen the pushing stage slightly and raise the odds of an assisted vaginal delivery, but it does not increase your risk of a caesarean.

Sources

✓Reviewed by CH, MD, FRCPC

Reviewed by a specialist physician certified by the Royal College of Physicians and Surgeons of Canada, who has read this answer against the sources listed above and confirmed it reflects them. That is not medical advice about your child. How we review

Answer checked July 26, 2026

Educational information only. Not medical advice, not a diagnosis, and no doctor-patient relationship is created by using this. Founded Parent has not examined your child and does not know their history, so this may not apply to you. In an emergency, call your local emergency number. What Founded Parent cannot do

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