| Giving birth to your baby is much more than a medical procedure. It is an emotional as well as a physical journey. Having a doula with you can help smooth the crucial transition from pregnancy into parenthood. Both parents benefit from the nurturing care a doula provides. Although good pain relief can be obtained in 90% of epidurals, few epidurals take away all the pain. There is still a need to use other forms of comfort and pain relief at various points in the labor process itself. Some hospitals advertise painless childbirth. In actuality few women experience it that way. There are several reasons why an expectation of painless childbirth may be unrealistic. Often there is a wait for the anesthesiologist to become available. Due to the effects of the epidural on the vascular system and to prevent the complications of lowering the blood pressure there is a wait while 1-2 liters of intravenous fluids are given. The procedure itself may take up to 30 minutes. There may not be complete pain relief for another 20 minutes. Once close to complete dilation, the epidural may need to wear off, or you may experience breakthrough pain. Rarely, the epidural may give only patchy pain relief, one sided or doesn't give relief at all. If you experience any of these situations, or if your physician prefers to avoid the epidural until you are 5 centimeters and zero station thus reducing the chances of having a cesarean, your doula will be invaluable in helping you stay comfortable. She will assist you to breathe effectively with the contractions, to maintain relaxation, suggest helpful position changes, and will use non-medical forms of pain relief. She knows how to make you feel better. Over 70% of Epidurals come with mild side effects, which are unpleasant although not medically serious. These include itching, nausea, and shaking. Your doula will stay at your side, helping you cope with any side effects you may experience, and assist you with information about your options. While an epidural relieves most of the physical pain, it can not meet your emotional need for reassurance. You might expect that with pain relief, all your worries will go away. Interestingly, this does not seem to happen. Women experience the same emotions during labor whether they use epidurals or not. However, the hospital staff feel that if a woman has pain relief, she doesn't need the same attentive support that a woman going through natural delivery needs. Women often feel more frightened and worried when they sense this emotional withdrawal from the staff. Your doula will continue to focus on what you are feeling, and will give you the reassurance and comfort you need. Your doula has made a commitment to you emotionally. Help in coping with pain is only one small part of your doula's role. Epidurals do not hold your hand, rub your shoulders, explain what is happening or help you make decisions. Epidurals do not get you ice chips or remind you to urinate. Epidurals cannot suggest position changes that help labor to progress. Epidurals will never advocate for you or help you get what you need from the hospital staff. Epidurals or doula? You may want both! If you are considering using an epidural for pain relief, choose a doula who will support that decision. Talking about your options and feelings with your doula in advance of your birth will make your labor much smoother. Thus leaving you free to concentrate on the birth of your baby. |
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Epidural Facts Although several familiar publications such as American Baby have published a study stating epidurals do not lead to increased cesarean rates, I beg to differ. In that same write up, they also stated that women who had epidurals were 8 times more likely to have a cesarean section. They contradicted themselves. My personal experience at over a 1000 labors in five different hospital settings is...Yes, an epidural does lend itself to creating a cascade of medical interventions that ultimately may lead to an unplanned and often unnecessary c/section. I have seen this in my hospital practice. My personal C/section rate dropped to 4.9% when I worked in a hospital where epidurals were only available as a last resort! In a different hospital where every one who wanted one, got one when they were 5 centimeters, the cesarean rate was extremely high 30%!!! Epidurals do slow a normal labor!
Epidurals numb a mothers instincts thus prolonging second stage, as women can not sense the pushing sensation necessary for birth. If the hospital is attached to Freidman's curve, this increases the risk of cesarean, a procedure that increases a woman's chance of death 4x that of a vaginal delivery. |