Labor epidural analgesia (LEA) provides labor pain relief, but it is still not readily available for multiparous women as it has been known to shorten the labor length. This retrospective study comprising of 811 multiparous women found that early or late use of LEA at different cervical dilations may modify the progression of labor, postnatal blood loss and Apgar scores accordingly.

To examine the use of LEA for multiparous women.

Overall, 811 multiparous women were retrospectively registered and allocated into groups as: LEA group or non-LEA group (women without LEA). They were then allotted into 7 subgroups and investigated as per LEA usage and cervical dilation. Time intervals, loss of blood and Apgar scores were the primary outcomes. Demographic data and birth weight were secondary outcomes

LEA was used in 54.5 % multiparous women. The duration of labor stage prolonged by 56 min, blood loss increased and Apgar scores lowered in these women on LEA.

The use of LEA in women with 2 cm and 3 cm cervical dilation lengthened the duration of first and second stage of labor compared to no substantial difference with dilation of 4 cm or more.

Also, epidural analgesia in the women with 2 cm and 4 cm or more cervical dilation considerably decreased the Apgar scores compared to no difference with dilation of 3 cm.

The use of LEA may modify development of labor, elevate postpartum blood loss and decrease Apgar scores for multiparous woman. The effects of initial or late induction of LEA should be well understood and definite as with different cervical dilations.