Early epidural controversy.

A study titled "The Risk of Cesarean Delivery with Neuraxial Analgesia Given Early versus Late in Labor" was published in the February 17, 2005 issue of The New England Journal of Medicine. It was circulated by the Associated Press (and hence several other newspapers) as "'Early Epidurals Don't Raise C-section Risk;' which is very misleading.

There were several flaws in the study, including a very small sample size (728 women), which is too small to be able to detect even a moderate difference in C-section rates. It was not endorsed and funded by an external group, such as the National Institutes of Health, but was supported by the Department of Anesthesiology at Northwestern University, where most of the authors are affiliated. This in itself, is a potential conflict of interest.

In order to aid parents and birth professionals in interpreting this study, The Maternity Center Association has critically reviewed the article and posted information on their website: www.maternitywise.org/nejm_epidural_response.html. This will help you, your clients and students to better understand this controversial study.