Do Epidurals Placed at a Lower Level Improve Labor Analgesia?

Inclusion Criteria: * women in active labor Exclusion Criteria: * known contraindications to epidural analgesia * moderate to severe systemic illness as evidenced by an American Society of Anesthesiologists (ASA) score of 3 or higher. * known abnormalities of the spinal column * any neurologic illness * multiple gestations, fetal abnormalities or fetal presentation other than vertex * recent history of analgesic usage * an inability to communicate in English or French * Body Mass Index greater than 40 * patients in pain requesting an immediate epidural