The commonest indication for epidural block is the relief of labour pain, there are many other reasons for placing 'an epidural'. These indications include maternal distress caused by painful uterine contractions not adequately relieved by simpler forms of analgesia, caesarean section, provision of anesthesia for instrumental delivery, treatment of pregnancy-induced and -associated hypertension, analgesia for repairs to birth canal tears, breech delivery where the presence of an epidural in situ gives the obstetrician increased flexibility to intervene expeditiously should the need suddenly arise, multiple delivery where anesthesia may be required urgently to deliver the second (and subsequent) infants, in cases of cardiac disease or pulmonary hypertension during labour and to restoration of coordinate uterine activity when the endocrine response to stress and pain has induced abnormal uterine activity.