•Any woman who is in established labour (or whose labour has been or is about to be induced by ARM).•Absolute contraindications to epidural analgesia are rare, but include maternal refusal and severe coagulopathy. Other relative contraindications may include mild coagulopathy, spina bifida and previous spinal surgery.•If there is any concern whether a woman is suitable for epidural analgesia then the advice of the Duty Obstetric Anaesthetist must be sought before a woman is refused epidural analgesia.•Any woman about whom there is a concern regarding their suitability for epidural analgesia, should be referred antenatally to the Anaesthetic Pre-assessment Clinic to allow the formulation of a management plan for labour analgesia