Epidural anesthesia and the progress of labor.

Epidural block remains the most effective, safe approach to pain relief for labor, and demand for its use continues to grow. Opposition to epidural block in labor, based on a widely acclaimed 1993 study, has led to the widespread discouragement of its use for laboring women and the denial of payment to some anesthesiologists who use it. Within the past year, strong evidence has emerged showing that the association of epidural block with dystocia and cesarean section is casual and not causal.