An epidural is a type of anesthesia delivered through a catheter placed just outside your spinal cord. When placed properly, it eliminates most of the pain of childbirth. While many women swear by epidurals (about 60 percent choose to get them these days) there are also plenty of reasons why many women opt not to. First, there are risks involved (which usually stem from placing the anesthesia into the spine instead of just outside it). Although most physicians are good at spotting problems before they becomes serious, side effects can include a sudden drop in your blood pressure, changes in the fetal heartbeat, increased risk of c-section delivery (although in some cases an epidural can facilitate a vaginal birth by keeping Mom from becoming too tired to push), and, in very rare cases, nerve injury and paralysis.
Some moms-to-be forgo epidurals because they prefer to have a drug-free birth experience -- they may feel that breathing or relaxation techniques are enough to get them through labor. Also, having an epidural may make it more difficult to be mobile during labor, and some pregnant women prefer the option of being able to move around or try out different birthing positions. And sometimes, epidurals aren't an option. Since an anesthesiologist needs to be available, women who choose to give birth outside major medical centers where these doctors aren't on call may not be able to get them. There are also medical conditions that can prevent you from having an epidural. For example, one possible side effect of epidurals is difficulty breathing, so women with chronic respiratory conditions may not be good candidates. In addition, spinal abnormalities like scoliosis (an irregular curvature of the spine) can also make placing the epidural needle difficult. But just because you have one of these conditions doesn't mean you have to grin and bear it -- talk to your obstetrician (before going into labor) about other pain-relief choices that might be better for you.