Epidural analgesia for low risk labour determines the rate of instrumental deliveries but not that of caesarean sections

Summary We analysed retrospectively the link between the incidence of epidural analgesia and the frequency distribution of instrumental delivery, caesarean section, labour induction and parity in a selected group of women with a low risk labour profile in all (85) obstetric units in Flanders (Northern Belgium). A group of 104 932 women with presumed low risk labour profile was subjected to analysis. The main outcome measures were the incidence of obstetric intervention in each obstetric unit in relation to the extent of their use of epidural analgesia. There was a wide variation in the rate of epidural analgesia (3-75%), labour induction 'for convenience' (4-48%) and instrumental delivery (4-50%) among the Flemish obstetric units. The incidence of instrumental delivery in a given unit was greatly influenced by the rate of epidural analgesia and labour induction for convenience (P < 0.001). However, the incidence of caesarean section in a given unit was not determined by either the rates of epidural, labour induction, attempted instrumental delivery or the size of the unit