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Evidence Library · Pain relief
How American women manage labor pain
Three quarters use an epidural, and the gap by insurance is not about pain.
In 2024, 75.4% of American women having a single baby vaginally used epidural or spinal anesthesia, up from 69.8% in 2016.
80.5%
With private insurance
National vital statistics
73.8%
With Medicaid
National vital statistics
41.2%
Paying out of pocket
National vital statistics
A gap that large between insured and self-paying women is not a difference in how much labor hurts.
Where this comes from
- Valenzuela CP, Osterman MJK. Epidural or spinal anesthesia use for singleton vaginal deliveries: United States, 2016-2024. NCHS Data Brief no 553. Hyattsville, MD: National Center for Health Statistics; 2026.
Covered in the class
3Module 3. Labor pain, and what actually relieves itWhat labor pain is like, the options in American hospitals, and how well each one works.Continue
Read this inside the full program, with the questions to take to your next visit and a record of what you have covered.
Obstetric Anesthesia Preparedness →More from Pain relief
What labor pain is actually likeMost American women choose an epidural, and that number is rising.
The other optionsNitrous oxide, opioids, water, movement, and nothing.
Nitrous oxide and intravenous opioidsBoth are options. Both relieve less pain than an epidural.
If you are hoping to avoid an epiduralIn the one study that followed the intention through, 57% of women who hoped to avoid an epidural had one, and 91% of those who planned one got it.
This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you.