AbstractObjective: The aim of this review was to examine the possibly increased risk of cesarean section or instrumental delivery when epidural analgesia was given to nulliparous women in spontaneous labor at term. Method: Using the terms ”vaginal delivery”, ”spontaneous delivery”, “normal labor”, “nulliparous”, “epidural analgesia”, “cesarean section”, “instrumental delivery”, ”obstetrics”, Pubmed and Cochrane databases were searched in order to find relevant studies. The result of this assignment is based on six randomized controlled trials comparing different regimens of epidural analgesia with other types of pain relief. Opioids were given to those women not receiving epidural analgesia.Results: In all six trials, there was no increased risk of cesarean section in the epidural group compared to the opioid group. In four of the trials, the rates of instrumental delivery were examined. Two studies showed no significantly increased risk of instrumental delivery in the epidural group while two showed the opposite. Conclusion: Epidural analgesia appears to be effective in reducing pain during labor. However, women receiving epidural pain relief run an increased risk of having an instrumental delivery. There seems to be no increased risk of cesarean section when epidural analgesia is given.