I have very mixed feelings about epidurals. I'm glad we have the option - some labours are so difficult it's good to know that there's an 'escape door' there.
BUT - I worry about epidurals becoming routine for labour, particularly for first time mums, like they have done in some countries. At the moment the majority of women in the UK feel they can cope with the pain of labour without an epidural, and the majority who don't have an epidural are happy with their decision. But what if you knew as a pregnant first time mum, that almost everyone has an epidural - how would that impact on your confidence about your ability to cope with pain? And how would it impact on midwives - their training (so many already have a poor understanding of physiological birth because they see so little of it) and their ability to support the small minority of women who would chose not to have epidurals?
And here in the UK I worry about the impact it would have on the delivery of maternity services - this thread has already thrown up the issue of care in labour - how the only way to ensure you get continuous one to one care in labour is to opt for an epidural, otherwise so much of the time you're lef with it cope on your own. Imagine how, say, a 20% increase in the use of epidurals would impact on the care of those women who choose not to have one.
I can see us slipping into a situation where normal birth without an epidural starts to seem like a weird, primitive thing that only hippies do. It'll be like what's happened with breastfeeding. Years ago almost everyone did it and the vast majority coped fine. Now only a small minority of babies are breastfed for more than a few weeks, women have loads of anxiety about it and worry about whether they'll be able to cope with even unproblematic,normal breastfeeding, and health care professionals and others within the community have lost their knowledge and their ability to help mums overcome problems.
Re: childbirth in the past (and in developing countries today)... one way I used to help myself overcome my own anxieties about childbirth was to imagine myself in the shoes of say, a poor Somalian mother facing the birth of her first baby, while living in a remote village with no access to medical help.
I think about how differently she'd feel about childbirth if someone could have waved a wand and provided her with the sort of antenatal care that I had in my pregnancies, and if she could be reassured that her chance of suffering serious injury or death during birth was as small as mine here in the UK (ie, very, very, very tiny), if she knew that she'd have a fully trained midwife (or maybe two) to attend to her during her labour, and access to obstetric help if she needed it, plus special care for her baby if it was ill at birth.
Doing this always helped put my own fears about birth in perspective...... We are so, so lucky not to have to fear childbirth in the way these women do, or the way women did in the days before anaesthetics and c-sections.