Stacy is right with positioning, but for me, I did not dialate until I had the epidural...24 + hours at 3-4 cm, 4-10 in less than 1 hour when I got it. The doc said some women have muscles that are soooo tight, they have a very difficult time unwinding. And we tried everything natural, and that epi was a last resort. This may not be true for everyone, but use it if you need it, and feel no shame in doing so! A healthy baby is the goal!