breech delivery and epidural analgesia objective to examine the effect of epidural analgesia on the progress and outcome of spontaneous labour in women with a singleton breech presentation at term greater than or equal to 37 weeksdesign a retrospective studysetting data bank aberdeen maternity hospitalsubjects 643 women 273 primiparae and 370 multiparae with a singleton breech presentation and spontaneous onset of labour at termoutcome measures duration of labour augmentation of labour with oxytocin infusion caesarean section ratesresults epidural analgesia was associated with a significantly increased need for augmentation of labour with oxytocin infusion p less than 0001 and longer duration of labour p less than 0001 irrespective of parity comparing women who had epidural analgesia with those who did not there was no significant difference in caesarean section rates in the first stage of labour in primiparae odds ratio 179 95 ci 088363 or multiparae odds ratio 097 95 ci 048196 epidural analgesia was associated with a significantly increased likelihood of caesarean section in the second stage of labour both in primiparae odds ratio 543 95 ci 2461195 and multiparae odds ratio 537 95 ci 2071387 the increased likelihood of caesarean section in the second stage in primiparae with epidurals was independent of the extent of cervical dilatation less than 3 cm or greater than or equal to 3 cm on admission however in multiparae with epidurals the difference in second stage caesarean section rate was significant only when initial cervical dilatation was less than 3 cm odds ratio 365 95 ci 1141165conclusion epidural analgesia was associated with longer duration of labour increased need for augmentation of labour with oxytocin infusion and a significantly higher caesarean section rate in the second stage of labour