Epidurals in labour: Does walking around help?

Walking around during the first stage of labour may be an option for many women using an epidural. But it may have very little influence on the labour or the birth.

With modern low-dose or light epidurals, many women might be able to get up and walk a bit during the first stage of labour. This is the early part of labour, where the cervix (opening of the uterus) thins out and opens fully. This is called achieving full dilation. You can read more about epidurals in our Fact Sheet.

There are differing opinions about the pros and cons of walking with an epidural. Some women will not be able to or will not want to. Possible disadvantages include the chance of falling or having a drop in the woman's blood pressure. On the other hand, there is a theory that suggests walking early might make the later parts of the birth easier.

Epidurals increase the length of the second or pushing stage of labour, as well as the risk of a so-called instrumental delivery or assisted birth. That means a birth where forceps or a vacuum extractor is used to help with the baby's birth. Some midwives and doctors suggest this could be partly because contractions might not be as effective when lying down, and gravity cannot help the baby come down.

In order to better judge the pros and cons of walking in early labour with an epidural, researchers from the University of Sydney analysed the five trials that tried to answer these questions, involving over 1,100 women.

In those trials, women were encouraged to get out of bed for between 5 and 15 minutes of every hour in the first stage of labour. No specific impact on the course of labour could be identified from early walking. The births were not shorter, and there was no change in the rate of assisted birth. There were no reports of women falling.

The woman being mobile had no detectable impact on the baby: the babies' heartrates during and after the birth were the same, whether or not women got out of bed with their epidural. There was also no difference in women's satisfaction with their pain relief. The researchers did not measure women's overall satisfaction with their labours.

Only one trial studied the impact of walking on women's ability to urinate during labour and avoid catheterisation. This is when a tube is inserted so that urine can be released from the bladder. This showed that some of the women who were more active avoided needing a catheter.

© IQWiG (Institute for Quality and Efficiency in Health Care)