Wide Variation in Use of Pain Relievers During Labor Across U.S.

Bottom Line: Pain relief for pregnant women in labor is commonly given in the form of epidural, spinal or combined spinal-epidural blockade, which is collectively referred to as neuraxial analgesia. This study used birth certificate data and found wide variation in neuraxial analgesia use across the United States. Among 2.6 million pregnant women who underwent labor in 2015, neuraxial analgesia was used by 73 percent, with the lowest frequency in Maine and the highest in Nevada. Variation between states was only partly explained by state-level factors, which suggests other unmeasured patient-level and hospital-level factors likely were at play. It’s important to understand the main reasons behind the variation and to know whether it influences health outcomes for women and newborns.

Authors:  Alexander J. Butwick, M.B.B.S., F.R.C.A., M.S., Stanford University School of Medicine, Stanford, California, and coauthors

Visual Abstract:

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jamanetworkopen.2018.6567)