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This book examines the future of birthing practices, particularly by focusing on epidural analgesia in childbirth. It describes historical and cultural trajectories that have shaped the way in which birth is understood in Western, developed nations. In setting out the nature of epidural history, knowledge and practice, the book delves into related birth practices within the hospital setting. By critically examining these practices, which are embedded in a scientific discourse that rationalises and relies upon technology use, the authors argue that epidural analgesia has been positioned as a safe technology in contemporary maternity culture, despite it carrying particular risks. In examining alternative research the book proposes that increasing epidural rates are not only due to greater pain relief requirements or access but are influenced by technocratic values and a fragmented maternity system. The authors outline the way in which this epidural discourse influences how information is presented to women and how this affects their choices around the use of pain relief in labour.

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1. Introduction

2. The Epidural in Context

3. The Politics of Birth

4. Institutional Culture: Discipline and Resistance

5. A Dialectic of Risk

6. A Circle of Trust

7. Closing the Circle

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Elizabeth Newnham is a midwife academic at Trinity College Dublin, whose research interests centre on cultural and political analysis of birthing practice and the role of midwives in promoting physiological and humanised birth.
Lois McKellar is the Program Director for the Bachelor of Midwifery at the University of South Australia and an advocate for improving the well-being of women and their families through collaborative research and education.
Jan Pincombe is an Adjunct Professor at the University of South Australia and Fellow of the Australian College of Midwives. She is one of 4 editors for the first midwifery textbook in Australia and New Zealand for practicing and student midwives.

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