Epidural? 6 Ways a Doula Can Support


There is a myth out there that doulas only support unmedicated birth.  Doulas support all types of birth and moms planning to use an epidural for pain management absolutely can benefit from the services of a doula.  I have put together 6 ways that doulas can provide support to moms using an epidural. 

Epidural? 6 ways that a doula can support.

These are just 6 of the ways that doulas can support with an epidural, but there are so many more!  A doula supports her clients even before labor begins with birth planning.  She often meets a client at home in early labor and helps her decide when to leave for the hospital.  There are so many ways in which a doula can support a mom planning an epidural.  I hope the myth about doula and unmedicated births can finally be disproven!


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  • Alice Turner
Comments 6
  • Erin

    I had a doula and planned to have an epidural, but labor happened quickly and much more naturally than I’d planned. (I got a spinal block just before pushing, and my doula and doc barely showed up in time for baby.) I think I would have benefited from my doula encouraging me to make some preparations for managing pain if for some reason the epi took a while. Also, my doula and husband were able to be in the room while I got my spinal block, and I remember her showing me how to bend and helping me stay still and calm during contractions while the spinal was placed. One other thing I wished — as a patient with an epi, you have less feeling and control. My case was different because it was so quick and the on-call doctor was such a jerk that he was later investigated by the state board for how he handled my delivery, but I really would have liked my doula to be more proactive in telling me what was going on, as there were procedures done I didn’t feel or know were happening. I know there’s a fine line for doulas, but I wish mine had gotten closer to that line and helped me work with an unfamiliar doc through a pain-blocked delivery.

  • Alexander Butwick
    Alexander Butwick

    I am a little concerned with the tone of the language in the schematic about epidurals. Obstetric anesthesiologists are very sympathetic if mothers choose to change their decision about pain relief during the course of labor. Care providers on the labor and delivery unit tend to work collaboratively to ensure that maternal quality of care is optimized, which includes the provision of effective epidural labor pain relief. The language in the text implies that all epidurals are ineffective in providing adequate pain relief. I think it’s important to note that many patients are extremely happy with the quality and efficacy of labor epidural pain relief. Plus, if there are concerns about breakthrough pain, that anesthesia care providers are available to help manage the breakthrough pain if or when this occurs. The reinforcement of negative stereotypes about epidurals is disingenuous and does a disservice to the important work of all obstetric care providers, especially anesthesia providers.

  • Susan Young
    Susan Young

    I would add:
    Help know what to expect during procedure, like that all family and doula will need to leave the room for a time, and what to expect during epidural and during pushing.
    Keep the focus on birth as sometimes it tends to get sidetracked after the woman is “comfortable” and I feel like sometimes this stalls labor.
    Help mom navigate further decisions like Pitocin to augment labor that may get pushed more aggressively given the context of the epidural. Each decision should be taken on its own merits and sometimes that gets lost.
    Help initiate breastfeeding after birth.

  • Shannon

    Absolutely 100% love this! I wish wish wish all doulas acted this way and supported moms who are choosing medicated births. I had a wonderful doula, who inspired my own journey to become one, and she was incredible in her support of my epidural birth. In my community, there are alot of doulas who have their own agenda or their own view of what birth should be, and seem to (often) forget that they are there to support their clients birth experience, not relive their own.

  • Bethany Sawhill
    Bethany Sawhill

    Kelly, I also know of doulas who feel the way that you described, and it is baffling to me. As a professional, it is not my place to pass any personal beliefs or judgments whatsoever on a family’s birthing choices. At. All. It’s extremely discouraging when others claim to “hold space” for all birthing mothers, but really mean that they support those whose wishes align with their own. There is a vast difference between education and steering.

  • Kelly Johnson
    Kelly Johnson

    I’d actually like to say this is a myth, and it surely isnt my philosophy in supporting birth clients. However, I have actually heard from “some” doulas that they only support natural and or home births. How is this so when labor and birth can be unpredictable. How do you break contract with a mom who may begin her labor unmedicated and then realize she is in need of relief? I think that is very deceiving and discouraging to laboring women. Being flexible, willing to put your preferences of birth at bay AS WELL AS letting clients know beforehand where you stand will clear doulas of this awful reputation and spare birth clients of having a dissatisfied birth experience. Also educating clients who desire natural birth need to know their threshold of pain, understand comfort measures, including breathing and relaxation techniques. If all the above doesn’t help, having a doula supportive of a medicated birth is all she needs.

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