Epidural analgesia is effective in relieving pain during labor. However, concerns as to compromised labor progress and outcomes arise. This study aimed to assess the effect of patient-controlled epidural analgesia (PCEA) with ropivacaine on uterine electromyography (EMG) activities and outcomes in labor. A total of 213 pregnant women were divided into three groups: the PCEA with ropivacaine group (n = 78), the PCEA with levobupivacaine group (n = 66), and a control group that did not receive PCEA (n = 69). Uterine EMG activities were recorded during the first stage of labor. Maternal and fetal outcomes also were assessed. The primary outcomes of this study were EMG activities. No significant differences were observed in patient demographics or neonatal weight among the three groups. Compared to the PCEA with levobupivacaine group, the control and PCEA with ropivacaine groups had lower rates of oxytocin administration (P < 0.05) and shorter durations of the first stage of labor (P < 0.05). For the EMG activities, the PCEA with ropivacaine group showed a higher power (P < 0.01) and higher peak frequency (P < 0.05) than the PCEA with levobupivacaine group. With ropivacaine, the EMG activities remained stable 30-120 min. Compared with levobupivacaine, the use of ropivacaine in PCEA has no suppressive effect on uterine EMG activities during the first stage of labor. In addition, ropivacaine leads to labor progress and delivery outcomes similar to those in the control group, as well as similar and favorable analgesic satisfaction with the use of levobupivacaine.