Professional birth attendants, doulas, are popular companions for the future family that is attempting a natural birth. What if you are not interested in natural childbirth? Is a doula still valuable to a family that knows they want an epidural?

positioning

Giving an epidural requires you to sit still for several minutes and usually for a few contractions. Having a doula, who is familiar with you and experienced in the procedure, can help you remain calm and relaxed during the catheter placement. This can help the anesthesiologist achieve a good placement faster, allowing you to get the comfort of an epidural faster.

After the epidural has taken effect, your ability to move will be very limited. However, movement during labor is helpful to properly align the baby and keep you comfortable. A doula can help her as she changes positions to help her get comfortable and get her labor going as quickly as possible. A doula can also help you continue to use positions and techniques to turn a baby on the back.

Other interventions

Many women do not anticipate the full scope of the interventions involved in an epidural. In addition to the catheter in the back that delivers the medication, an epidural comes with IV fluids, continuous monitoring, and blood pressure monitoring. It is common for women with epidurals to also have artificial oxytocin, bladder catheterization, and oxygen. A doula can help you understand the interventions being used and can give suggestions on techniques to help you avoid interventions that you would rather not have.

Most women find the pain relief from an epidural to be more than adequate for managing labor, however, some women find an epidural to be ineffective or only provide relief in one area. If an epidural doesn’t work well at first, a doula can help you clearly communicate additional pain management needs to hospital staff. A doula can also help you with non-medical pain relief until the anesthesiologist can make any necessary changes in medication placement.

unexpected side effects

Rather than a type of medication, epidural refers to the placement of medication. Because of this, you may experience a number of side effects depending on the medication used. These side effects range from itching and chills to nausea and fever. Doulas are ready to help you manage any discomfort caused by these side effects.

In addition to minor side effects, epidurals are associated with a slower rate of labor and a higher incidence of operative delivery. A doula can help you continue a normal labor by helping you maintain pelvic motion and adjusting to positions that use gravity to open your cervix. A doula can also help prevent back pain after an epidural by gently guiding you through these position changes.

ineffective push

A common problem with epidurals is the mother’s inability to push effectively. Two problems work together to make pushing ineffective. One is the mother’s inability to feel how her muscles work. The other is the way the epidural prevents the normal surge of oxytocin when the baby’s head puts pressure on the pelvic floor. A doula can help if she is unable to push in several ways.

One option is to have the doula help you let the epidural wear off so you can feel the contractions and gain some control of the muscles that push. As the epidural wears off, you will feel contractions again and will need to get through them without medication. Another option is to have the doula wait with you until the baby’s head can be seen, and then begin the pushing phase of labor. This prevents you from having to let the epidural wear off, but it does take time. If pushing still isn’t effective, a doula can help you change positions so the baby is in a better position for birth.

Avoid caesarean section

There is a very real increase in the chances of a C-section when a mother uses an epidural. This increase comes from labor slowing down, which can be called failure to progress, and drug interactions, which can cause the baby’s heart rate to slow. A doula can help you avoid a C-section by helping to prevent as many interventions as possible.

Research has shown that having a doula reduces medication requests, the need for interventions, and even reduces the need for a C-section. Hiring a doula can help you put off your epidural for as long as possible, minimizing the impact it will have on slowing down your labor. A doula can also help you continue to work through your labor to avoid the need for other interventions, including a C-section after an epidural takes effect.

emotional comfort

In about 90% of cases, epidurals can provide a laboring woman with all the relief she needs to get through the pain of labor. Many women find that the attitudes of hospital staff change when they receive an epidural, and even family members and loved ones change their behavior once the “pain” is gone. But giving birth isn’t just about getting through every contraction. Having someone who understands what you’re going through emotionally can be very comforting.

Doulas understand the fear of becoming a mother or becoming a mother again. Doulas don’t forget they’re in labor just because they don’t feel pain with contractions. Doulas pay attention to you, not the monitor. Doulas can answer questions about what is going on. Doulas can hold your hand during vaginal exams and other procedures that are uncomfortable even with an epidural. Doulas can cry with you, laugh with you, and listen to you no matter how long you’re in labor. A doula’s job is simply to be with you, and that job is just as important whether you feel pain with contractions or not.