Q. I'm in the process of doing some research in order to decide whether or not to use pain medication during my labor. Pretty much, the only one I'm seriously looking at is an epidural. I would definitely like to make the most informed decision possible.

A. I guess the disadvantages to an epidural that are the most concerning to me include decreased mobility or ability to walk, the necessity to have continuous electronic fetal monitoring, an IV, a blood pressure cuff (lots of tubes, wires, and lines to strap you down in the bed), risks of decreased blood pressure which may affect the baby's oxygen supply and affect his/her heart rate, causing more interventions, risks of slowing down your labor, causing more interventions (especially if done too early), possibility of low-grade fever, causing the baby to have to have a "septic work-up" for infection, even though he/she is not infected.

For more information on epidurals, read Judith Rooks' article on my website, www.midwifeinfo.com/epidurals. (Also check out the page on pain relief in labor to learn about non-drug methods to ease your labor - it's not drugs or nothing.) As you can see, I am not crazy about epidurals.

On the other hand, for abnormal, protracted (prolonged) labors with complications, they are a god-send. I tell my patients to go into labor with a flexible approach. If things go well and they have good support, they likely won't need an epidural. If there are problems, then an epidural can be done.