Objective To evaluate the application of dose‑escalation method for programmed intermittent epidural bolus of ropivacaine in delivery of pregnant women with gestational hypertension. Methods A total of 136 women with hypertensive disorder complicating pregnancy (HDCP) in labor were selected as subjects. According to the random number table method, they were divided into two groups: a control group and an observation group (n=68). Both groups underwent epidural puncture and catheterization. The control group was administered with a fixed concentration of anesthetic agents during labor (the fixed dose method), while in the observation group, the dose of anesthetic agents gradually increased according to the progress of labor (the dose‑escalation method). Both groups were compared for general information, time to analgesia onset, analgesic effective time, duration of analgesia, duration of labor (the first stage of labor, the second stage of labor, and the third stage of labor), changes in systolic blood pressure and diastolic blood pressure before analgesia, 5 min after analgesia, and 10 min after analgesia. Plasma cortisol and epinephrine concentrations were measured before anesthesia (T0), at the time of delivery (T1), at the time of fetal birth (T2), 5 min after delivery of the placenta (T3), 1 h after delivery of the placenta (T4), and 6 h after delivery of the placenta (T5). Their Visual Analog Scale (VAS) scores were compared before anesthesia (t0), 10 min after anesthesia (t1), 30 min after anesthesia (t2), 1 h after anesthesia (t3), 2 h after anesthesia (t4), at the opening of the uterine orifice (t5), and at delivery (t6). The satisfaction with analgesia and the incidences of adverse reactions 24 h after labor were recorded in both groups. The generalized estimating equation (GEE) method was used to assess the effect of fixed‑dose and dose‑escalation‑ methods on the total duration of labor and blood pressure. Results Compared with the control group, the observation group showed significant decreases in systolic and diastolic blood pressures 5 min after analgesia and 10 min after analgesia (all P<0.05), the observation group presented significantly shortened maternal second stage of labor, third stage of labor and analgesic effective time, and significantly prolonged analgesic time (all P<0.05). There was no difference in general information, systolic and diastolic blood pressures before analgesia, during the first stage of labor, the second stage of labor and the third stage of labor, the first stage of labor and the time to analgesia onset between the two groups (all P>0.05). The control group presented higher plasma cortisol and epinephrine concentrations at T1 to T5 than the observation group (all P<0.05). The control group showed significantly higher plasma cortisol and epinephrine concentrations at T1 to T5 than those at T0 (all P<0.05), while the concentration of epinephrine at T2 in the observation group was significantly higher than those at T0 (P<0.05). Both groups showed lower VAS scores at t1 to t6 than those at t0 (all P<0.05), whereas the VAS scores in the control group significantly increased at t4 to t6, compared with the observation group (all P<0.05). The multifactorial corrected results showed that the interaction among the control group and total duration of labor, diastolic blood pressure and systolic blood pressure was statistically significant (P<0.05), and that the interaction between the observation group and total duration of labor was statistically significant (P<0.05). The control group presented significantly lower analgesic satisfaction than the observation group (P<0.05). The total incidence of adverse reactions was significantly higher in the control group than that in the observation group (P<0.05). Conclusions The dose‑escalation method for programmed intermittent epidural pulse of ropivacaine is effective in perioperative analgesia for pregnant women with gestational hypertension, which facilitates to stabilize perioperative blood pressure and reduce the incidence of adverse reactions.