An Epidural is NOT a doula
“I’m planning to get an epidural so I don’t need a doula.”
This is unfortunately the primary thought among birthing women today, particularly those who plan to choose medication for their births. Obviously, doulas have historically done a very poor job of educating the public about the role of a professional doula. To further muddy the waters, many “doulas” that have made poor impressions on society at large about doula support. They have cheapened the meaning of the words “I’ll support you” by following it with the word “if.”
I’ll support you IF you choose not to circumcise.
I’ll support you IF you want (my definition of) a natural birth.
I’ll support you IF you labor at home as long as possible.
I’ll support you IF you decide to have a home birth.
I’ll support you IF you don’t get induced.
I’ll support you IF you don’t get an epidural.
I’ll support you IF…. You do things my way.
And most of the time, these “doulas” want to see only one kind of birth: an unmedicated one. They leave once their client asks for an epidural. Beware these “doulas.” That is not a doula.
That is a birth activist posing as a doula to use a woman’s birth for her own agenda. It’s no surprise that women choosing to have medication feel like they don’t need a doula. It’s as if to say that an epidural can replace everything that a doula does. But friends, an epidural is no substitute for a professional doula.
An epidural cannot meet with you during your pregnancy, spend personal time listening to your thoughts, fears, expectations, and apprehensions about your upcoming birth.
An epidural does not personally know the care providers in your area. Therefore, it cannot get to know your personal situation and make appropriate recommendations for who may be a good match for you.
An epidural cannot help you process and discuss your previous births as you prepare for another one.
An epidural is not connected with a network of birth related support professionals to provide you with extra support prenatally and postpartum.
An epidural does not have lending libraries of priceless information for you to look through as you prepare for labor, birth, and life with a new baby; it cannot know your personal situation or preferences and make recommendations accordingly.
An epidural cannot talk you through all of your birth and baby care options, help you from your birth plan, or answer questions as you put it all together.
An epidural cannot provide reassurance that your experiences and emotions in pregnancy and are normal and it cannot sympathetically encourage you to hang in there as you wait during the last few weeks.
An epidural does not go on call for you 24/7 in the last weeks of your pregnancy to answer questions, offer physical or emotional support, or help you understand what may be a confusing and inconsistent early labor phase.
An epidural can not support your labor at home before you get to the hospital, and it cannot help you decide when is a good time to go.
An epidural cannot watch you as you labor to help you understand what stage of labor you may be in, which is sometimes a general guide for when to leave for the hospital.
An epidural cannot support you as you labor until the pain medication takes effect.
An epidural can provide you with one option for effective pain control.
An epidural is not an expert in positioning during labor in such a way that the baby has the best chance of moving through the pelvis.
An epidural cannot support your partner.
An epidural cannot communicate about your labor to other family members.
An epidural cannot help you understand the medical language that may be used around you and about you as you labor.
An epidural cannot reassure you that any medication side effects you may be experiencing are completely normal. It cannot offer you options for managing those either.
An epidural cannot massage your feet, brush your hair, or gets something to drink for you and your partner.
An epidural cannot help coach you through the pushing phase.
An epidural cannot take pictures of you, your new baby, and your partner during or after the birth.
An epidural cannot help you get into a comfortable position after the birth.
An epidural cannot help your baby achieve their first latch.
An epidural cannot follow up with you days or weeks after the birth to see how you and baby are doing.
An epidural cannot provide you with ongoing postpartum support or resources.
A doula can.
A professional birth doula will support you regardless of your birthing decisions – even an epidural.
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Have you heard mothers compare contractions to really intense period cramps? That’s not altogether inaccurate! Many times in early labor, mothers will describe what they are feeling as “just crampy” type sensations in the lower belly. Those cramps just get stronger – it’s as simple as that.
Surely labor can’t be compared with cramps! Actually, it can! While working with my clients, I realized simplicity to help partners remember valuable techniques can be very helpful. Conveniently, I found the Acronym “CRAMPS” works well to describe ways to deal with contractions.
Counter pressure may help relieve lower back pain and pressure by opening the pelvis into a more accommodating position for the baby’s passage through the pelvis. There are two types of counter pressure: hip squeeze and sacral pressure. Both of them aim to lift the mother’s sacrum bones off of where the baby’s head is. This provides a laboring woman with tremendous relief during contractions.
DEMO: hip squeeze by hand & with Rebozo
Relaxation (guided). Guided relaxation techniques include visualization and breathing exercises. During labor and birth, these can be extremely helpful for 2 reasons. First, our muscles need oxygen to function properly. The uterus is comprised of 3 muscle sets which contract during labor. Deep breathing allows the muscles to receive a good supply of oxygen, which makes the contraction feel more like radiating waves. This keeps contractions from feeling overwhelming, and women feel that they can stay on top of them.
Second, the mental-emotional state of the woman is more stable when she is deeply relaxed and focused, and this allows her to labor more peacefully.
There are 2 techniques: Most common deep slow abdominal breathing and short and fast breathing similar to painting which is a distraction method and can be helpful during last stages of labor, though in early and active labor it increases adrenaline and fights with oxytocin.
Acupressure and Aromatherapy are very helpful tools in labor. While most doulas are not certified in acupressure or aromatherapy, parents who wish to use these techniques are encouraged to research them so they have them handy in labor.
Example: P-6 inner gate nausea
Movement allows you to play a more active part of labor. A moving mom is a moving baby. The “labor dance” uses gravity to increase the effectiveness of contractions and move your baby more deeply into your pelvis. Many women feel tremendous relief in labor simply by being able to move.
DEMO: “junior high” labor dance
Positions are crucial in labor! There are many positions to labor and birth in. Trust your body to tell you what feels right. Many women enjoy laboring on their hands and knees, standing, lunging, sitting on a birth ball, and squatting, just to name a few. Position changes are important because they help encourage the baby to move through the pelvis.
DEMO: hands & knees with birth ball
Sensation There are many types of labor support that fall into this category! Hydrotherapy (laboring in a tub or shower), tens unit, hot/cold therapy, touch/massage are just a few. Some women like to be touched in labor and others don’t. Some women enjoy it for a while then suddenly can’t stand to be touched. All of this is completely normal.
DEMO: Rebozo “Shrug Hug” – Grounds the woman and keeps her eye to eye in close proximity with her partner helping release that Love Hormone Oxytocin to help labor progress more quickly.
So, to summarize:
C- Counter pressure
R – Relaxation
A – Aromatherapy or Acupressure
M – Movement
P – Positions
S – Sensations
I hope this easy to remember acronym helps you achieve more satisfying birth experiences.
I’d love to hear what you think in our comments section down below. Is this an “Aha!” moment?
Which comfort measure do you look forward to trying?