I don’t need a doula, I’m getting an epidural

‘I don’t need a doula, I’m planning to get an epidural.’

This is something I have heard many times and it is simply not true!  Doulas are not just for women who want an unmedicated birth, though that seems to be the impression people have of our role. As a doula, my job is to support my clients in whatever they choose to do.  It is their birth and their choices. This is whether a woman decides from the beginning that she will be getting an epidural or has planned on not getting one, but labor takes an unexpected turn and she changes her mind.  Having a doula there to support you will always be helpful, no matter the goal nor the outcome.

Doulas are important and necessary for all pregnant people! There are labor and hospital procedures to do before you can get the epidural so having a doula to support both you and your partner during that time is invaluable. Knowing what will happen helps to alleviate fear and stress.  A doula can walk you through that. 

Once a woman gets an epidural, the doula’s job is just as, if not more important. We help them as they make their decisions to understand all that is involved. We make sure that the client and partner are comfortable so they can get some sleep and help her change her position periodically to keep the baby in a good position and for labor to progress. We work to keep side effects of the epidural as limited as possible, since there can be negative effects on labor such as slowing of contractions and artificial fever. Pushing can sometimes be challenging when a woman has an epidural, so supporting her and helping her to tune in to her body and her baby as she pushes that baby out is an important task.  And then we support her afterwards with the baby and skin to skin and encourage that baby towards the breast if that’s one of the mom’s choices. We also help her as the epidural wears off after birth, helping her get into the most comfortable position to hold baby skin to skin and encourage baby to breastfeed.

Believe it or not, doulas also support people who have a planned cesarean. We make sure they have a good plan for help and support when they bring baby home.  We stay with the clients beforehand when they’re nervous and preparing for the surgery. Surgeons and staff move quickly, so we help them make sure they get their questions answered and their desires met. For example, they want music playing during the surgery or want to keep the baby with them and go from OR to recovery to the postpartum room as a family of three. 

The deep breathing and relaxation that I teach in my childbirth classes is just as important during a cesarean birth as it is during a vaginal birth. Staying relaxed and calm when you can’t feel the bottom half of your body is really difficult. Sometimes there’s a lot of movement and tugging and pushing that can be really scary. Doulas are present postpartum as parents meet their new baby and maybe start breast-feeding for the first time, do skin to skin and help dad figure out what mom needs post-surgery when she can not move around in bed easily or even get out of bed in the first hours.

And our job does not stop there.  I check in often and do at least one postpartum visit in the week after the baby is born. I check on how mom and dad are doing and watch for signs of postpartum depression or feelings (from mom or dad!) of being overwhelmed.

Doulas are for all kinds of births; our roles might change a little or support might look different, but it is all important.  We help parents find their voice and get their questions answered. If I see during labor that mom has gotten to the point of suffering, not just being in pain and she needs medical pain relief, as her doula, it’s my job to make sure the medical staff is listening to her and she gets what she needs.  It is not our job to bar the door and tell them that because they said they wanted an unmedicated birth, that’s what they have to do.  

As I tell my clients during prenatal meetings and when teaching childbirth class – you can plan for birth and what you hope to do, but you never know what’s really going to happen and during labor you then have to make the choices that are best for you.  They might not be your first choice, but they might be the choice that works best for you now. As your doula I will always support you in those choices!