A new study suggests that epidurals during labor and delivery can provide more than just pain relief. Scottish researchers analyzed 13 years of hospital data. They found that pregnant people who got an epidural were more than one-third less likely to suffer severe maternal morbidity.

The phrase “an epidural” can actually mean a lot of things. When we’re talking about labor and delivery, it refers to epidural analgesia. This is a shot given near the spine. It numbs a person from their waist to their knees without completely paralyzing them. This provides pain relief while still allowing a person to be awake, alert, and active in the birthing process.

Epidurals are common in the United States. An estimated 70-75% of people giving birth opt for this kind of pain relief. In Scotland this percentage is much lower. Researchers at the University of Glasgow studied records of 567,217 women who gave birth at all National Health Services Hospitals between January 2007 and December 2019. About 22% of these women had epidurals. Analysis of these records found that epidurals were associated with a 35% reduction in severe maternal morbidity during birth and in the first 42 days (six weeks) postpartum.

The Centers for Disease Control and Prevention (CDC) define severe maternal morbidity (SMM) as “unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health.” Possible issues include postpartum hemorrhage, pre-eclampsia/eclampsia, infection/sepsis, and heart attack. The benefits of epidurals appear to be even greater for those who deliver prematurely—these women saw a 47% reduction in SMM.

The study, which was published in the British Journal of Medicine, can’t tell us why epidurals reduce health issues. Experts say that women who have epidurals often have lower blood pressure during labor and delivery, are more relaxed, and are able to rest during labor.

The study also found that only 24% of women who were most at risk for SMM got epidurals. Earlier research by the same team also found that women in lower socioeconomic areas were more likely to have pregnancy complications. Yet, they were 16% less likely to get an epidural.

In the United States epidurals have been controversial. Some people feel that doctors and hospitals push women to have epidurals that may not be necessary. At the same time, there has been a suggestion in popular culture that women who “tough it out” without pain medication are braver. Some people refer only to vaginal birth without an epidural as “natural childbirth.” Misinformation about epidurals is also common. Some people inaccurately suggest that they slow down labor and make C-sections more likely.

The researchers responsible for the Scottish study say that more education about epidurals is needed. Professor Rachel Kearns, lead author of the study, said: “By broadening access and improving awareness, we can significantly reduce the risk of serious health outcomes and ensure safer childbirth experiences.”

It is up to each person to decide whether an epidural is right for them with the help of their doctors and partners. But we need to make sure that everyone first has access to accurate information to make that decision. Hopefully studies like this one can help.