title: Analgesia and cesarean delivery rates.
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: D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D011247:Pregnancy