It is well recognised that labor is painful. Analgesia is therefore required by the vast majority of parturients during labor and delivery. Central neuraxial blockade is the most effective form of analgesia in labor and also the most desirable type of anesthesia for peripartum operative interventions. Inadequate hemostasis is a contraindication to central neuraxial blockade. This chapter will discuss all forms of analgesia available to the laboring woman with a hemostatic or thrombotic disorder, and the implications of abnormalities of hemostasis, with particular emphasis on central neuraxial blockade.