Objective To investigate the implementation of intraspinal labor analgesia in Beijing midwifery institutions in the past three years. Methods A survey concerning the implementation of intraspinal labor analgesia was conducted from November to December 2020 in 94 midwifery institutions in Beijing using the "Questionnaire Star" online platform. Results A total of 94 questionnaires were collected in this survey. The rate of labor analgesia was extremely uneven among midwifery institutions in Beijing, with 81 (86.17%) routinely carrying out intraspinal labor analgesia and 13 (13.83%) not routinely carrying out intraspinal labor analgesia. Shortage of anesthesiologists (69.23%) was the most prominent reason for hospitals not routinely performing intraspinal labor analgesia. The number of hospitals that did not carry out intraspinal labor analgesia in 2018, 2019, and January to October 2020 were 27, 18, and 13, respectively. In 2018, 2019, and January to October 2020, the overall intraspinal labor analgesia rate was 28.59%, 35.17% and 39.96%, respectively. The rate of labor analgesia in general hospitals was 12.66%, 23.24% and 29.79%, respectively, and was 51.01%, 58.81% and 69.27% in maternity hospitals and maternal and child healthcare hospitals (hereinafter referred to as specialist hospitals), respectively. In 29 hospitals, nurse anesthetists were involved in labor analgesia, and in 69 hospitals, 24‑hour labor analgesia was provided; in 18 hospitals, combined spinal‑epidural anesthesia was the mainstay, and in 63 hospitals, continuous epidural block was the mainstay. In 52 hospitals, 1.0%‒1.5% lidocaine was given as a test dose during epidural block, and in 11 hospitals, no test dose was given or pumping fluid was given directly. Conclusions The rate of labor analgesia is very uneven among midwifery institutions in Beijing. The proportion of labor analgesia in non‑public hospitals is higher than that in public hospitals; the proportion in specialized hospitals is higher than that in general hospitals; and the proportion in pilot hospitals is higher than that in non‑pilot hospitals. General hospitals and some specialized hospitals still have much room for improvement. The lack of anesthesiologists restricts the implementation of labor analgesia in childbirth, and the management of labor analgesia is still not standardized; the participation of full‑time nurse anesthetists is helpful in the implementation and management of intraspinal labor analgesia.