Doulas are for Women who Want Epidurals
One common misconception about doulas is that they are only for women who plan on having a drug-free (or “natural” or unmedicated) childbirth.
This is simply not true!
Doulas are for all women, even those who are think that they might want to use epidural medication during labor.
Notably, some doulas only take on clients who are planning for a drug-free birth. This is often not a form of judgment on the doula’s part but rather a matter of a doula preferring the role she plays in a planned unmedicated birth to the one she plays in a planned medicated one.
In most cases, however, you will be able to find a local doula who will support you even if you strongly desire to use an epidural during labor. (And it is always best to ask prospective doulas about the sort of support they offer when a woman chooses to use an epidural!)
Here are some of the ways that s/he can offer this support:
A doula can help you receive accurate and transparent information about epidurals before labor
Although they are generally very effective forms of pain relief during labor, epidurals are not without risks or potential negative side effects. They can lead to anything from a drop in the mother’s blood pressure to fetal distress to an increased risk of forceps and vacuum delivery.
A doula can help to explain these risks to you during a prenatal meeting so that you can make as informed a decision as possible about your birth choices. Just think–most of us don’t even want to take an over-the-counter pill without knowing its potential side effects before we take it. The same goes for an epidural!
A doula can help you to wait as long as possible before getting an epidural
Waiting as long as possible to receive an epidural can help to minimize some of the epidural risks, such as fetal malpositioning or slowing of labor progress. The physical and emotional comfort measures that a doula offers can help you to cope with contractions until you do want an epidural. And you might even find that you are coping well enough to forego the epidural and the potential negative side effects that accompany it!
And even if you are completely set on getting an epidural as soon as possible, it is very unlikely that you will be able to receive an epidural as soon as you walk into the door of the hospital! Most women have to wait–some even up to a few hours–in between requesting an epidural and actually receiving one. A doula can help you to cope with your contractions during that “waiting period.”
A doula will remain non-judgmental about your choice to receive epidural analgesia during labor
Some women who use epidural analgesia hear things like this from their friends and family members:
“Oh, I knew you couldn’t do it without drugs!” or “Yeah, I’m glad you weren’t a martyr for the pain!” or “Aren’t you glad that you just gave in and went for the drugs?!”
A doula worth her weight in birth balls would never make insensitive and demeaning claims like these! And this is partly because doulas don’t think that women need to be rescued from the pain of childbirth. All women are strong–strong enough to cope with the pain of labor, but also strong enough to choose for themselves (and not under pressure of the hospital staff or friends and family members) when they would prefer to use pain medication during labor.
A doula can stay with you for the epidural administration
Generally, anesthesiologists will allow one support person to stay with you while s/he administers an epidural. Some will allow more than one. But even if only one person is allowed to stay for the epidural, a doula might come in handy if your partner is known to get queasy or faint at the sight of needles, blood, and medical procedures!
A doula can help you to change positions during your labor
Even though epidurals greatly limit a woman’s mobility, this doesn’t mean that women must lie completely still on their backs when they are using an epidural. In fact, it is important for women to stay as mobile as possible, even while using an epidural!
Turning from side to side every twenty to thirty minutes, sitting up (with the help of someone else), or simply rotating between side-lying and sitting can help to prevent a common side effect of epidurals–namely, fetal malpositioning, which can lead to slowed labor progress and, often, cesarean section. A doula can help you to change positions–or even just to remind you to change positions–so that you can avoid these potential side effects.
A doula will ensure that you–and not the tubes and machines surrounding you–are the center of attention
Some women find that after they receive an epidural, the hospital staff and others around them almost “forget” as if they exist anymore. The focus seems to turn solely toward the fetal monitor, the blood pressure cuff, and the IV fluids and/or medication–but not toward the woman who is still laboring.
While a doula does not play as active of a role after a mother receives an epidural, her attention is still always turned toward the laboring woman. Whether she is reminding and/or assisting you in changing positions, “tucking you in” so that you can sleep, reminding you to ask questions about recommended interventions, or simply continuing supporting you emotionally, you are always her primary focus!
So don’t think that a doula “isn’t for you” if you have your heart set on an epidural. Doula support can offer benefits to all types of women–even those who strongly desire epidurals during labor!
This post is a part of my “Doulas are for All Types of Women” series honoring International Doula Month. I’m also giving away a copy of The Birth Partner by Penny Simkin for International Doula Month. Please see my original post in this series to find out how you can win!