Inclusion Criteria:  All women aged 18 years and above. In established second stage of labor. 3-7 cm dilation at time of insertion. Women with BMI < 40 kg/m2  Exclusion Criteria:  Known contraindication to epidural insertion. Inability or unwillingness to provide written consent. Previous difficult epidural insertion. Previous failed epidural. Imminent instrumental or operative delivery. Dural puncture. Combined spinal epidural analgesia. High BMI > 40 kg/m2