The OER study involves optimizing pain control during childbirth. In the Netherlands nulligravida with a request for analgesia may receive pethidin, or epidural analgesia. Both analgesics have their side effects. Pethidine may cause nausea, hallucinations, respiratior depression to the mother and newborn child. The last side effect is important in the light that it has a 4-5 hours half life. Epidural analgesia takes tedious logistic time before the nulligravida actually receives the analgesia. It causes blood pressure drops, some women describe the feeling of witnessing their delivery as an outsider and there are studies reporting an 2 to 5 time increased risk of instrumental delivery. Recently at the ward of the Sint Lucas Andreas hospital a great deal of successful experience was gained with Remifentanil patient controlled analgesia (PCA) on the delivery ward. Remifentanil has a half life of just a few minutes. We experience less nausea than with pethidin. From studies it is already known Remifentanil breakdown from aspecific blood esterases is also active in the newborn child. We know that epidural analgesia of all means is superior in pain control. However, considering the side effects just mentioned, we are about to conduct a study (De OER-studie) to compare epidural analgesia and Remifentanil PCA on the delivery ward. The primary clinical out come is patient satisfaction. This study will be conducted by researchers of the department of anesthesiology, Jenny Vieveen, Eva Koetsier and supervisor dr. Maarten vd Elsen and dr. Celine Radder of the OBGY in the St. Lucas Andreas hospital.