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Application for ESRA Abstract Prizes:Background and Aims Historically, it was common belief that childbirth should be painful, as quoted in Genesis: ‘In sorrow thou shalt bring forth children’. The first documented use of ether for labour in 1847 was met with societal criticism. It was only after Queen Victoria’s use of chloroform during childbirth in 1853 that labour analgesia met with growing acceptance. However, limitations included serious adverse effects including respiratory depression. Nitrous oxide was adopted in 1881, providing inhalational analgesia, albeit incomplete pain relief. In 1907, morphine and scopolamine were tried, but their favour rapidly declined due to adverse foetal outcomes and reduced maternal satisfaction due to amnesic effects.Methods In 1898, Bier described how cocainization of the spinal cord abolished lower abdominal pain. A year later, Kreis performed the first spinal anaesthesia in labour. Stoekel modified the technique, injecting in the caudal epidural space without dural penetration, limiting incidence of headaches. Aburel threaded a catheter through the caudal epidural space, allowing repeated injections for analgesia without needing to repeat the procedure. This approach was superseded by lumbar epidural by Hingson, who described preserved motor function with improved control of sympathectomy and extent of block.Results Advancements continued in the late 20th century - discovery of safer and longer-acting amide local anaesthetics, exploitation of synergism using intrathecal opioids, refinements to the spinal needle tip and introduction of patient-controlled analgesia. Today, epidural analgesia remains the gold standard for labour pain.Conclusions The revolutionisation of labour analgesia by lumbar epidural arguably represents one of the greatest achievements of medicine in history.