It is a common misconception that mom's who decide to birth with with pain-relief medication won't benefit from in-person doula support. I totally understand where this misconception comes from. People assume that once a mama gets an epidural or other pain blockers, she is instantly pain-free, she can sleep until her body is ready and then out slides the baby. Although that it is the case for some, it isn't exactly the case for others. There is still a need for educational information, position changes, emotional support, advocacy, and if the epidural doesn't fully take, hands on physical support for pain management.
The decision to have an unmedicated or medicated birth is an incredibly personal one. It’s a choice that requires a lot of thought and consideration, and it is extremely important that a woman feels supported in whatever decision she makes. It's widely known that doulas are beneficial for unmedicated births. You don't have to look far to hear stories of doulas attending home births where they did hip squeezes and counter pressure to help mama manage her labor, but when it comes to medicated birth, sometimes the role of the doula is lost.
If you want the drugs, get the drugs... and here is how a doula can support you with them.
Educational Information.
This one is hella important, especially for medicated births. A doula can help provide insight on:
Different pain-relief options.
The benefits and risks to each option.
The process of how the medication is administered.
What to expect.
Next steps once medication is given.
Interventions that might be presented.
There are endless ways a doula can support a medicated mama educationally. I would even go as far to say that doulas are used more for educational purposes at a medicated birth, then at an unmedicated birth.
Position Changes.
Research studies have shown that epidurals are linked to longer second stages of labor (Dekker) but with position changes every 30 minutes to an hour, this can be helped. Its crucial to support what is happening internally with the positions you are in. If you lay stationary to one side with an epidural in place, not only will most of the medication drain to the side you are on, leaving the other side not numb, but it also causes your cervix to thin unevenly, leading to a cervical lip.
Positions like Flying Cowgirl, Side-lying Release, and Modified Walchers are amazing resources doulas know that encourage engagement and movement down and out the pelvis. Doulas can also help the birthing woman find comfortable positions to labor and push in. Just because you have an epidural doesn't mean you have to push on your back!
Emotional support.
Whether unmedicated or medicated, birth is an extremely emotional and transformative experierence. A doula will help explain what is happening during labor, and make sure the mama and partner are comfortable and well cared for throughout the process. Sometimes pain-relief is not initially a part of the birth plan, but as things progress in labor, mama might change her mind. When a planned unmedicated birth becomes medicated, it can be hard for mama and her partner to process. Having a doula present can help everyone process the emotions, provide reassurance and encouragement when things get challenging.
Advocacy.
Doulas help to advocate for the mother’s needs and make sure that her wishes are respected. They can also help to ensure that the mother is informed of any medical interventions that may be necessary, and that she is comfortable with the decisions that are being made.
Physical Support.
Pain-relief medication in labor doesn't always equate to pain-free birth. Sometimes epidurals work amazing, sometimes they work only on half the body. In some cases, they don't work at all, or it's administered too late and the mama doesn't get the full effect. The challenging part of an epidural not working to its full capabilities, is the laboring woman now being stuck in bed and feeling pain and discomfort. In this situation, the woman's mental psyche is in need of emotional support because she was expecting relief but is not receiving it, and her body is need of physical support. She is going to need her doula performing counter pressure and hip squeezes even more than before because she is stuck to a bed and can't move the way her body is instructing. A doulas physical support can help the laboring women over the hurdle of an unsuccessful epidural.
In Summary.
Doulas can be an invaluable source of support for a mother who has chosen to have a medicated birth. They can provide physical and emotional support, help to manage pain, and ensure that the mother’s wishes are respected. Doulas are for all birth, unmedicated or medicated!
Citation.
Dekker, Rebecca. “Effects of Epidurals on the Second Stage of Labor.” Evidence Based Birth®, 20 Mar. 2018, https://evidencebasedbirth.com/effects-of-epidurals-on-the-second-stage-of-labor/.