BACKGROUND:
Epidural analgesia is a common method of pain relief during labour and is associated with a prolonged second stage. While a longer second stage has been linked to adverse birth outcomes, few studies distinguish between the passive and active phases - an important distinction in settings where delayed pushing is practiced.

OBJECTIVES:
To examine the effect of epidural analgesia on the duration of the passive and active phases of the second stage of labour, as well as on mode of birth, in nulliparous women.

METHODS:
This retrospective observational cohort study included birth records from 1131 full-term nulliparous women who reached the second stage of labour. Descriptive and comparative analyses were conducted, and multivariate regression models were used to adjust for potential confounders. Median durations of the passive and active second stage were compared based on epidural use. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated for mode of birth.

RESULTS:
Analyses are ongoing. Preliminary findings show that 64% of participants received epidural analgesia. The median duration of the passive second stage was 40 minutes without epidural and 110 minutes with epidural (p < 0.001). The active second stage lasted a median of 34 minutes with epidural and 37 minutes without (p = 0.517). Epidural use was associated with increased odds of non-spontaneous vaginal birth (aOR 2.62; 95% CI 1.77–3.88).

CONCLUSIONS:
Preliminary results suggest that epidural analgesia significantly prolongs the passive, but not the active, phase of the second stage. It is also associated with increased likelihood of non-spontaneous vaginal birth. Midwives should provide evidence-based counselling on pain relief and support strategies that promote physiological birth.

KEY MESSAGE:
Epidural analgesia prolongs the passive but not active second stage of labour in nulliparous women. Poster session 1 (Group A)