title: ACOG Committee Opinion number 269 February 2002. Analgesia and cesarean delivery rates. American College of Obstetricians and Gynecologists.
abstract: Various studies report conflicting data with regard to the level of risk of cesarean delivery for nulliparous women who receive epidural analgesia before 5 cm of cervical dilatation. As a result, some institutions are requiring that laboring women reach 4-5 cm of dilatation before receiving epidural analgesia. The American College of Obstetricians and Gynecologists wishes to reaffirm the opinion published jointly with the American Society of Anesthesiologists that while under a physician's care, in the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor. Decisions regarding analgesia should be coordinated among the obstetrician, the anesthesiologist, the patient, and support personnel.
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010146:Pain / Q000188:drug therapy*; D010298:Parity; D011247:Pregnancy