If I Have an Epidural, Why Do I Need A Doula? Your doula's role is to assist you during birth, to comfort and support you. Giving birth to your baby is so much more than a medical procedure. It is an emotional, spiritual and physical journey. Having a doula with you can help smooth the crucial transition from pregnancy into parenthood. Both parents will benefit from the nurturing care a doula provides. Epidurals do not usually take all the pain away. There are many reasons why an expectation of "painless childbirth" may be unrealistic. You will still be required to use some other forms of comfort measures at times. Although good to excellent pain relief is obtained in 90% of epidurals, few epidurals take away all the pain. Some hospitals advertise "painless childbirth," but few women experience it that way. Your labor may progress too quickly for you to receive an epidural. A pre-existing medical condition, low blood pressure, low hemoglobin levels, previous spinal injuries, or prior bad reactions to anesthesia may contraindicate epidural usage. Epidurals do not provide complete relief for back labor but now confine the mother and prevent her from doing many of the positions that relieve the pain of back labor. Often you must wait for the anesthesiologist to become available. You may need to wait while you receive 1-2 liters of I.V. fluid. The procedure itself can take up to 30 minutes to perform, and you may not have complete pain relief for another 20-30 minutes. Once you are close to complete dilation, the epidural may need to wear off, or you may experience breakthrough pain. Epidurals increase the likelihood of other painful interventions: IVs, urinary catheters, continuous fetal monitoring either externally or internally, frequent blood pressure monitoring, maternal fever requiring use of antibiotics & tests on baby (complete blood count, spinal taps), pitocin, forceps, vacuum extractors, episiotomy and cesarean section. Sometimes the epidural gives only patchy pain relief, or doesn't give pain relief at all. Some women experience epidural induced pains after the birth: epidural/spinal headaches, postpartum backaches. If you experience any of the above situations, or if you prefer to avoid using the epidural until you are 5cm to reduce your chances of needing a cesarean, your doula will be invaluable in helping you use relaxation techniques, suggesting position changes, and using non-medical comfort measures. Over 70% of the time, epidurals often come with mild side effects. Although not considered medically serious, these side effects can be very unpleasant. All over the body itching, nausea, shaking ("epidural shakes"), confused nerves may send feelings of intense heat in the lower extremities... Many women find the deadened nerve sensation in their entire lower body to be very distracting and disconcerting (like having your jaw numbed for a filling). The loss of control over the legs is often distressing to some mothers. Your doula will stay at your side, helping you cope with any side effects you have, and giving you information about your options. An epidural does not affect your need for reassurance. You might expect that with pain relief, all your worries would go away. Interestingly, this does not seem to happen. Women experience the same emotions during labor whether they use epidurals or not. Many times, the medical staff or the mother's partner may feel that if a woman has pain relief, she doesn't need the same type of gentle emotional support. Women often feel even more frightened and worried when they sense this emotional withdrawal. Your doula will continue to focus on what you are feeling, and will give you the reassurance and comfort you need. Help in coping with pain is only one small part of your doula's role. Epidurals do not hold your hand, rub your shoulders, explain what is happening or help you make decisions. Epidurals do not get ice chips or remind you to urinate. Epidurals cannot suggest position changes to help labor progress. Epidurals will never advocate for you or help you get what you need from hospital staff. Additionally, epidurals have effects on babies. Some childbirth educators, nurses and doctors play down this fact. Although the medications in epidurals do not cross into the placenta as readily as IV narcotics, small amounts still eventually cross the placenta. Fetal distress can occur as the medications are transferred to the baby. Some babies have "floppy" muscle tone and poor reflexes as result of the medications in their bloodstream. ***Some babies have difficulty latching and breastfeeding for several weeks after the birth! Reasons for breastfeeding difficulty includes excessive fluid levels from IV therapy pre & post surgery causes nipple/areolar swelling and since medications that go to baby from the epidural cause excessive sleepiness and lack of interest in eating This is due to many causes directly related to epidural usage*** Epidural or doula? You may want both. If you are considering using an epidural for pain relief, make sure that you choose a doula who will support your decision. Talking about your options and feelings in advance will make your labor much smoother, leaving you free to concentrate on the birth of your baby. Keep Reading: But what if I have a Cesarean section? Return: Doula Services Index