In May, The Independent newspaper in Britain published an article entitled 'Epidurals are for wimps'.

No doubt, with that emotive title they were hoping to start a heated debate over the breakfast/dinner or boardroom table. When you read the text of the article it wasn't nearly as punitive as the title suggested but it was the author's stated opinion that women who opt for epidurals are missing out on one of life's most enriching experiences.

Talking about pain relief and childbirth is always difficult. Women tend to come down on one side or the other ? natural birth or medicalised birth.

But I would suggest that it can never be that straightforward. As a mother of five and a childbirth educator, I have experienced, seen, listened and taught about pain in labour and feel strongly that each woman and each birth is unique and should be treated as such.

What is it that makes labour painful and why is it that it seems so much more painful for some than others? No one knows exactly why labour hurts. It is a unique type of pain, since it is not associated with injury or disease but is the result of a normal, healthy bodily process: childbirth.

What is important is that we recognise that the perception of labour pain is extremely complex and includes more than just the physical sensations of uterine contractions, the cervix opening followed by the birth of the baby. There is a huge psychological and emotional element to the whole birth experience which is something that every couple contemplating labour should be encouraged to explore beforehand.

It probably won't surprise you to hear that what your own mother and friends say about their experiences of labour can greatly influence your expectations.

Why is it that everyone wants to tell you about the worst birth stories? Also how much you understand about what is happening to you can influence how you cope with the pain as does your ability to relax. The less tense or anxious you are the less something is likely to hurt.

There are good physiological reasons why fear makes pain worse and relaxation can reduce it. This will explain why so many of the non-drug methods of pain relief for labour are aimed at encouraging women to be calm and relaxed.

These will include things like massage, touch, music, aromatherapy, visualisation, distraction techniques and so on. Some women ask for pain relief because they are frightened and do not have confidence in their own abilities. Sometimes it is the partner who, alarmed at seeing his beloved in such discomfort, asks "can't you give her something for the pain"?

Perhaps it can be summed up by a comment I read recently: "The meaning of birth pain is different from the pain of say, tooth or earache, broken bones or colic. It is the pain of creative activity. It is pain with a purpose. This is not to trivialise the sensations. Yet it is profoundly affected by what is going on in your mind and the attitudes of those helping you."

It might be helpful to note that labour pain serves some very important purposes. The first painful contractions tell the mother that she is in labour; if mothers felt nothing at all, babies would run the risk of being born in some very unsuitable places!

The gradually increasing strength of the contractions gives the mother an indication of how far on in the labour she is so that as the time approaches for her baby to be born, she can go to a safe place to give birth.

In everyday life, we respond in instinctive ways to pain. If you drop something on your foot, you automatically rub yourself because rubbing causes your body to make endorphins which are natural pain-killing substances. If you have a bad stomach ache, you would probably lie down and curl up in a ball with a heatpad because warmth and being in a particular position are very comforting. It would seem that pain tells us how to help ourselves recover from injury. In labour, there is no injury taking place, but the pain teaches the woman how to give birth. She is led by it to try a variety of positions to increase her comfort and by moving around and using different positions, she is also helping her baby's head to press down firmly all around the cervix so that it opens up evenly.

Later in labour, her changes of position cause the baby to be shifted one way and then the other, helping him to find the easiest way down through the pelvis. It is also really important for women and their partners to realise that for most, labour is so intense that almost everyone will come to a point where they would find it hard to refuse pain relief if it were offered, even if they are committed to birthing without pain relief.

This is especially true near the end of labour, just before it is time to push. If they are surrounded by strong and loving support, it may be easier to get past that point without medical pain relief. So sometimes, what a woman needs in labour is firm reassurance that she (and her body) know what they are doing and the opportunity to follow her instincts.

Many people comment: "Why in this age of advanced medicine should women feel pain in labour? Why would anyone choose to?"

Most of the drugs that make a significant positive impact on the pain also have significant negative implications for the progress of labour and sometimes the baby. For example, pethidine, if given within four hours of the baby's birth, can lead to breathing and feeding difficulties. In the case of an epidural, there is a greatly increased risk of needing help to birth the baby as the woman is necessarily confined to the bed and is generally unable to feel the urge to push.

As one doctor put it: "There is no ideal analgesia for labour. The use of any drug is ultimately a compromise between benefits for the mother and possible risks for her baby."

There is also no doubt that for those women who are supported through labour and manage to cope with the pain without drugs, that the naturally induced endorphin high once the baby is born and the feeling of empowerment and fulfilment is indescribable. The life-enriching experience that the author of the original article was alluding to.

So back to where we started ? are epidurals for wimps, is using medical pain relief wrong? The answer is a resounding "no". This is not a question of right or wrong. It is a question of what is good and right for that particular woman in that labour.

There is nothing intrinsically good about suffering and nothing intrinsically bad about relieving that pain and suffering by using any of the drugs available.

Many midwives/obstetricians will testify that when medication is used appropriately and at the right time and in the right dosage it has enabled many women to remember the birth of their baby as a happy, wonderful experience when without adequate pain relief it would have been remembered as a nightmare of pain, loss of control and loss of self.

The important things is that women go into their birth experience properly prepared, understanding the process of labour and having the opportunity to explore fears and hopes and to have the information to make informed choices about all aspects of their births but particular how to cope with the pain of childbirth.

"To be able to give birth without pain relief is not to come out top in some kind of endurance test. The tools you need are at hand ? choose the right ones for you."