birth support

Epidural and the Doula– When an Epidural is the Plan and Received

This is part 2 of my Epidural and the Doula series. Part 1 is here.

How do I support a mother planning on an epidural?
Well, I start by asking questions. Why is she planning on an epidural? It could be that everyone she knows has had one and she hasn’t really ever considered not having one. It could be that she’s really afraid of the pain of childbirth. It could even be that she would rather not feel any of her labor if at all possible.

These are good things for me to know, because it changes how I support her. If she hasn’t considered anything else, I can give her options, including the idea of a “walking epidural” rather than the typical dose. She can then feel more informed and confident going into her birth.

If she’s afraid of the pain, we can talk about comfort measures to use until she’s able to get the epidural, including other pain medication options (many hospitals have policies against using an epidural too early in labor) and ways to help with her fear.

If she would rather feel as little as possible, there are ways that I can help a labor along even with early use of the epidural. It’s good to know in advance to plan on things like that. It takes a lot of patience and a little extra time, but it can result in a very beautiful, peaceful birth.

So, after asking questions, I can come up with a rough plan. Comfort measures such as a warm bath or shower, counter pressure, massage, and breathing techniques can be hugely beneficial while waiting for the anesthetist/anesthesiologist to administer the medication. There are also several IV narcotics available to help dampen the pain. We can talk in prenatal visits or during early labor about what comfort measures sound best.

During the placement, I mostly step out of the way. The woman in labor is busy signing consent forms, asking questions, staying still, and still laboring. Her partner may be able to hold her during the placement, and I can take the opportunity to take some pictures if they’re wanted. It often ends up looking something like this.


After placement, she’ll most likely be confined to bed with continuous monitoring. I can help her labor to continue progressing by helping her to change positions regularly, using a peanut ball to help keep her pelvis open for baby’s descent, and more. I will fetch water, ice chips, food, blankets, and whatever else might be needed. This is a good time for partners to connect. Hand holding, cuddles, and talk about what is to come can all help raise oxytocin levels, which keeps labor moving along.

(If the epidural doesn’t work fully, I can help keep the pain to a minimum. That may require creative positioning, the anesthetist/anesthesiologist re-placing the epidural or increasing the medication dosage. Rarely, an epidural doesn’t work to satisfaction, even after adjustment. In this case, I can help process the big change of plan and help move onto a new course of action. )

During pushing, I will be wherever I am needed, both by my clients and by the nurses and Dr’s in the room. I can speak quiet encouragement to the mother, hold a leg so her partner has free hands, or stand out of the way and take photos.

Planning on an epidural can lead to a beautiful birth. There are potential side effects to both mother and baby with the epidural, so I recommend talking over the risks and benefits with your healthcare provider before deciding. I would be honored to support you whatever you decide!

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