Giving birth is an incredible, but also one of the most painful experiences in a woman’s life. Birth pain is a complex phenomenon, where painful stimulation is experienced on an individual level in accordance with emotional, social and cultural factors. Pain and anxiety can lead to adrenergic hyperactivity, hyperventilation and hypocapnia with reduced uteroplacental blood flow and uncoordinated uterine activity. Therefore, pain relief is recommended, especially in cases of maternal comorbidity. When thinking about labor analgesia, consideration should be given to the efficacy and safety of analgesia as well as possible adverse effects on mother and child and the effects on the course and outcome of labor. Epidural analgesia is considered the best method of alleviating labor pain, providing effective analgesia with minimal adverse effects. Despite the increased use and known benefits of epidural analgesia, there has been significant controversy regarding the impact of epidural analgesia on labor outcomes. Epidural analgesia can affect the duration of labor, slightly shortening first and prolonging the second stage of labor. The evidence indicates that effective labor analgesia does not increase the rate of Caesarean delivery, although it might be associated with an increased rate of instrumental vaginal delivery. It is possible to improve obstetric outcomes and reduce maternal side effects by reducing the concentration of local anesthetic. In the absence of a medical contraindication, maternal request is a sufficient medical indication for epidural analgesia in labor and it is recommended to continue with its application until the end of labor.