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

JAMA Network Open


Media advisory: To contact corresponding study author Alexander J. Butwick, M.B.B.S., F.R.C.A., M.S., email Erin Digitale at digitale@stanford.edu. The full study is available on the For The Media website.

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About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. Every Friday, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.


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

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


Editor’s Note: The article contains conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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