A population-based study in Scotland found that epidural analgesia during labour was associated with a 35% reduction in severe maternal morbidity (SMM), with greater effects in women with a medical indication for epidural analgesia or those delivering preterm. The study analyzed 567,216 women in labour between 2007 and 2019, finding that SMM occurred in 4.3 per 1000 births. Epidural analgesia was linked to reduced SMM, SMM plus critical care admission, and respiratory morbidity, though the latter had wide confidence intervals. Women with a medical indication for epidural analgesia had a greater risk reduction in SMM compared to those without. Preterm deliveries also showed more pronounced reductions in SMM. The study highlights the importance of expanding access to epidural analgesia for high-risk women to improve maternal health outcomes. The findings suggest that epidural analgesia may reduce the risk of severe complications during and after childbirth, particularly in women with pre-existing conditions or those at risk of preterm labour. The study underscores the need for equitable access to this treatment to address disparities in maternal health.A population-based study in Scotland found that epidural analgesia during labour was associated with a 35% reduction in severe maternal morbidity (SMM), with greater effects in women with a medical indication for epidural analgesia or those delivering preterm. The study analyzed 567,216 women in labour between 2007 and 2019, finding that SMM occurred in 4.3 per 1000 births. Epidural analgesia was linked to reduced SMM, SMM plus critical care admission, and respiratory morbidity, though the latter had wide confidence intervals. Women with a medical indication for epidural analgesia had a greater risk reduction in SMM compared to those without. Preterm deliveries also showed more pronounced reductions in SMM. The study highlights the importance of expanding access to epidural analgesia for high-risk women to improve maternal health outcomes. The findings suggest that epidural analgesia may reduce the risk of severe complications during and after childbirth, particularly in women with pre-existing conditions or those at risk of preterm labour. The study underscores the need for equitable access to this treatment to address disparities in maternal health.