The Effects of Combined Spinal Epidurals on Fever During Labor of First-Time Mothers

Inclusion Criteria: * having first child (nulliparous) * term pregnancy (\> 37 weeks) * vertex presentation * singleton gestation * ability to provide informed consent * request for analgesia for labor pain Exclusion Criteria: * birth of second or more child (multiparous) * preterm pregnancy (\< 37 weeks) * presentation other than vertex (ie. breech, transverse) * diabetic * admit temperature \> 99.5 * active drug/alcohol dependence * active genital herpes infection * allergy to anesthetics used