What if I WANT an epidural? Do I need a doula?

A lot of women want an epidural right off the bat…meaning they plan on getting one as soon as they hit around 5 cm or so. And they question whether a doula would be beneficial or even needed if that is going to be the case.

The short answer? Yes.

The long answer? Yes and probably even more than a woman who is deciding to have an unmedicated birth.

Why?

An epidural is most effective when given during active labor…around 5 to 7 cm dilation. You have to get to that point and while early labor is often just uncomfortable for most women, it can be harder for others. Discomfort is subjective, not static. The more you are able to move and be up during early labor, the better positioned baby will be and the more effective labor will be. A doula can help you move in ways during that early labor that help baby’s positioning as well as the effectiveness of labor.

Because movement is still your best friend while laboring and giving birth, you need to change positions even though once you have the epidural you are bedridden. Labor will sometimes stall following an epidural…for many reasons, but the number one reason is you have to change positions every 20 minutes and unless the L& D department is really slow that day…most L&D nurses do their best to be back in 20…but they are stretched pretty thin. A doula will be there to help you change position..and not just ANY position but positions that encourage baby to move down, and encourage dilaition, which keeps labor MOVING in the right direction, thereby preventing unnecessary or unwanted interventions.

The number 2 reason? You need to empty your bladder at least every 4 hours otherwise a full bladder gets in baby’s way…and can stall contractions. Some hospitals will just catheritize you full on…but then you have to figure out HOW to move with that tube…and others will just come and empty your bladder every 4 hours with a straight cath. Either way…again a doula can keep an eye on that clock and/or the tube to make sure the bladder is staying empty.

A doula can be the buffer between unexpected birth events and the parents. One birth I served …the mom had had PROM (premature rupture of membrane) and the baby had a serious heart deceleration. The nurses ran in and began flipping her like a rotisserie chicken. Dad had been catching a cat nap and woke up to seeing the mother of his child being tossed around…I was able to tell him what was happening and why and that it was going to be okay The nurses were too busy (and rightly so) to answer his questions at that time. I could give him the brief run down and keep HIS anxiety down while mama and baby were being cared for by the nurses.

A doula is NOT just for the parent giving birth but for the other parent, or family members in the delivery room, even though mom is their main focus. They allow the other members to catch cat naps, insuring that mom is never left alone. They can answer questions the family might have. If, in the event of an emergency, they free up the other parent to go with baby to NICU so mom is not alone.

So, even if you are pretty sure you want a medicated birth…a doula is still a really good idea.