brand new baby newborn on mothers chest

Doulas and Epidurals: Are They Mutually Exclusive?

Is a doula only needed if the mother (or birthing parent) is planning an unmedicated birth? What if they know they want an epidural?

While it is true that many of my clients plan for and do have unmedicated labors and births, I love supporting people whose plan all along was to get an epidural. There are so many things doulas do to help these clients prenatally, during birth, and postpartum.

Getting Prepared

Before my clients go into labor, I am there for them to answer any questions they may have. I help them feel prepared for what labor will feel like and walk them through the choices they may encounter. Many parents feel excited but also a bit fearful and I have come to realize that so much of the fear they experience is fear of the unknown. So, I walk my clients through their fears, and in the end they feel so much more prepared facing anything that may unexpectedly come up.  

During Labor

Once they’re in labor and things get more challenging, they eventually want the epidural. There is usually still some time before the anesthesiologist arrives, and during that time, I am there to help them get through each contraction.  I might apply counter-pressure or hold onto them as support during the contractions. I often will squeeze their hips to give them just enough relief that they feel they can handle it until their epidural is ready. 

Finally the Epidural is Here!

After the epidural is placed and my client feels relief, the baby still needs to come out and the most effective way to get the baby out is to move. Generally speaking, people who get epidurals cannot move the lower two-thirds of their body, so it is my job as a doula to help them change positions. I like to see them moving every 30 minutes on average. So, I help rotate their body for them and put them into positions that help to open their pelvis. Continuous movement helps the baby descend into the pelvis and it helps to keep labor from stalling. However, if labor has stalled I can target acupressure points to stimulate the uterus into contractions again, in hopes of preventing the need for Pitocin.  

Feeling comfortable with the people in your birthing space is important and I am there to help ensure that my client feels comfortable. Yes, they are probably not in pain anymore, but is someone speaking too loud? Are the lights too bright? Do they need to release their fears? I can help with that.

What Your Birth Doula Will Do to Support You

The body is still in labor after an epidural happens. My clients may not feel it but their body is still contracting, they still get hot and cold off and on. I am there with a cold or hot compress, or maybe a bucket if they need to vomit (a common occurrence during transition.) I am there to remind them to hydrate. I am there to reassure them if they need it and I am there to help be a sounding board for any decisions they may need to make. 

When they’re ready to push, I am there telling them they can do it and that they ARE doing it! I may be holding a leg up for them, holding their hand, and/or keeping them cool because pushing a baby out is HARD work! 

And when their baby is born, I am there to congratulate them and celebrate the new life they just brought into the world. I am there to help them initiate breastfeeding if that is their preference, and to answer any questions they may have about their new baby’s care. After that, I’m never more than a call away if they have questions or need support after they get home (this is where lots of clients can benefit from dedicated Postpartum Support!)

My clients that have had an epidural have been equally satisfied with my care as those who have had unmedicated labors. Feeling supported, regardless of birthing plans or choices, is key to looking positively at their birth experience — and support is what I do! 

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