There's a common misconception in the birth world that doulas only support unmedicated homebirths in a tub with flickering twinkle lights. While some doulas do only attend homebirths, this is absolutely not true for our team!
Do doulas support epidurals?
In 2023, 88% of our clients had hospital births. Some used epidurals for pain relief, and some didn't. Some hired a hospital midwife to assist their birth, and some hired an OB.
Note: studies show midwives have the best outcomes for low-risk birthers, and you can absolutely still use epidurals with midwife care! An anesthesiologist is the specialty of doctor who comes in to place an epidural, and a midwife or an OB can order that for you.
As your birth doulas, we don't care what's on your birth plan. We've attended planned & unplanned c-sections, unmedicated hospital births, scheduled inductions, planned epidurals, and out-of-hospital births (and transfers).
What we care about is that you know your options and you make the decision that's best for you.
We don't ever want you to look back at your pregnancy, labor, birth, or postpartum and think "wow, I wish I'd known about ___".
Every doula on our team has their specialties of course, and we do our best to try and match your preferences with a doula who shares your style. So if you're planning a hospital birth with an epidural, we'll match you with a doula who is great at that! But if you're planning a home birth and decide to transfer for an epidural, rest assured that your doula from our team will be 100% onboard with your change in plans.
"I thought doulas were for "crunchier" moms than me. That they were better suited for out-of-hospital births, less medicalized approaches. Not true! Bria works with moms in all settings, with all sorts of approaches to medications, no matter who your doctor or midwife is." - Alexandra, mom of 2
Why hire a doula if you're planning to use an epidural?
Doula care is about sooooooo much more than just pain relief. We don't just feed you ice chips and squeeze your hips. So why hire a doula if you're planning to use an epidural?
1 - Improved outcomes
Studies show that doula care improves outcomes for birthers:
39% decrease in the risk of unwanted C-section
15% increase in the likelihood of a spontaneous vaginal birth
10% decrease in the use of any medications for pain relief
Shorter labors by 41 minutes on average
38% decrease in the baby’s risk of a low 5-minute Apgar score (read more about what Apgar scores are here)
31% decrease in the risk of being dissatisfied with the birth experience. Birthers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff
2 - Prenatal care
Our doula team spends an average of 15 hours with clients prenatally. This is significantly more than the average 1.5-2 hours that OBs are able to spend with clients prenatally (roughly 15 visits, averaging 7 minutes each), but absolutely doesn't replace your OB/midwife visits. Your medical provider is monitoring your health. Our visits are focused on diving deep into childbirth education, processing your personal fears, teaching your partner how to get involved (if they want), providing resources for common discomforts or concerns, preparing you for feeding your baby and recovering postpartum, and coming up with a solid plan for your birth.
Clients also have unlimited access to us via text/phone/email. We always encourage you to reach out to us first, before going down the scary google rabbit hole!
3 - Continuous support in labor
There is no time limit to our support during labor, and we don't work in shifts. You can call us in as early as you'd like and we'll join you at your home or birth place. Depending on when you plan to get an epidural, you might want to call us in to help make early labor more comfortable.
We stay with you until a few hours post birth to help you recover and start feeding your baby. We're also on-call for our clients, meaning you have a pretty high chance of getting your primary birth doula during labor, not a back-up. You already have a relationship with your doula, and trust us. This is an important relationship to have in a hospital birth where you likely don't know the nurse or OB/midwife on call.
4 - Advocacy
Part of our job is to make sure your wishes are heard and respected during labor. We'll discuss what this looks like prenatally, and come up with an advocacy plan that's right for you. We never speak for you during labor, but we do amplify your voice, ask questions that you might not be thinking about, and make sure you know all of your options.
5 - Baby positioning
Epidurals are the most effective pain relief option we currently have for laboring people. But one of the downsides is that they limit movement by numbing the lower half of your body. This means you won't move intuitively to help your baby navigate your pelvis in the same way you would if you were unmedicated. Our doula team is trained in baby positioning, and part of our job is to help you find positions with your epidural that encourage baby to keep descending and rotating.
While you're limited to staying in bed (for safety reasons!), you're not limited in the way you can move with an epidural. You absolutely don't have to be stuck on your back. We like to utilize side-lying positions, supported squats using a bar and lowering the foot of the bed, or even going onto hands-and-knees if you have enough control of your legs.
6 - Pain relief
I hate to break it to you, but epidurals don't always take away all of your pain. Most of the time, they're great! But sometimes you might have a little "break through" pain, where you can feel contractions in one spot. You might feel intense pressure right before, and during, pushing (the goal of an epidural is to take away contraction pain, but they can't remove the pressure of the baby's head as baby gets really low in your pelvis). Or, worst case scenario, your epidural might not work at all.
In any of these cases, a doula is here to help you navigate improving your epidural, or using alternative pain relief measures.
7 - Postpartum care
When you hire us for your birth, our team visits you in your home twice in the first few weeks after birth. Your primary birth doula will come to debrief your birth, and a lactation consultant will come help you with any feeding issues (breast/chest, pumping, or supplementing) for baby. We generally see clients before their scheduled 6-week follow-up visit with their medical provider, which allows us to help you troubleshoot any issues you're having before they escalate. We also have postpartum doulas available to come support you more regularly.
Ready to hire a doula?
So, do doulas support epidurals? At the end of the day, doulas have a wide variety of styles, and there is a doula for every birther! We recommend you interview multiple doulas (from our team, or others!), and hire the one you vibe with most. Reach out to us today, to set up a free consultation!
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