Influence of Lumbar Ultrasound on Resident Learning Curve for Lateral Labor Epidural Placement

Pregnant Subjects Inclusion Criteria: * pregnant women * 18 years or older * in early labor (cervix dilated \< 5 cm * pain visual analog score (VAS) \< 3, or both) requesting consultation by the anesthesia team for anticipated epidural pain relief. Exclusion Criteria: * absolute contraindications of neuraxial anesthesia including patient refusal * uncorrected coagulopathy * infection at the skin site of epidural placement * increased intracranial pressure, or untreated hemodynamic instability. * In addition, patients with a history of scoliosis or spine surgery * body mass index (BMI) \>40 kg/m2 * allergy to local anesthetic, or allergy to opioids will be excluded. Anesthesiologists Inclusion criteria: * Anesthesia residents or fellows who are performing the epidural technique in pregnant subjects who agree to be part of the study. * Anesthesia residents or fellows with prior experience in the lumbar epidural technique, defined as having placed 20 or greater lumbar epidurals during their residency and prior to enrollment. Exclusion criteria: * individuals who do not want to participate in the study.