Do Epidurals Placed at a Lower Level Improve Labor Analgesia?

Do Epidurals Placed at a Lower Level Improve Labour Analgesia

The investigators wish to compare the analgesia provided by epidurals placed high in the lumbar spine versus epidurals place low in the lumbar spine.

Inclusion Criteria:

• women in active labor

Exclusion Criteria:

• known contraindications to epidural analgesia
• moderate to severe systemic illness as evidenced by an American Society of Anesthesiologists (ASA) score of 3 or higher.
• known abnormalities of the spinal column
• any neurologic illness
• multiple gestations, fetal abnormalities or fetal presentation other than vertex
• recent history of analgesic usage
• an inability to communicate in English or French
• Body Mass Index greater than 40
• patients in pain requesting an immediate epidural