When You Can't Get the Epidural You Wanted
Sometimes pregnant people think to themselves, “I’m planning to get an epidural, so why on earth would I want a birth doula?”
If you’ve had this thought, you are definitely not alone!
Sure, not everyone wants a birth doula, which is perfectly fine. But if you’ve dismissed the idea out of hand, without much consideration, I would encourage you to think a little deeper before deciding “yea or nay” on a birth doula.
If you’re not already in the world of birth, this process can seem like a black box. You see people before they go into the black box and you see them when they come out, with no idea of what happened while they were there.
But it can seem pretty obvious to think, “My doctor or midwife will tell me what to do. I’ll get an epidural for pain. And that’s that!” To be fair, there will be some lucky people for whom it is that simple. But for most of you, birth will involve some number of things you never expected.
At a hospital birth, yes, there will be a nurse there, but likely that nurse will be in your room less than ⅓ of the time you are there, and much of that time will be spent on the computer. (2008 study from Gerrie V. Barnett). Your doctor or midwife will be even less present.
So, while your physical health may be in great hands, emotionally you may feel like you’re on your own. But with a birth doula, you will have a steady, present companion who can offer suggestions, reassurance, answer questions, “translate” medicalese, and help you cope when things inevitably don’t go according to plan.
For instance, that epidural you counted on… what if you were not able to get it?!?!
This isn’t a typical scenario, but it certainly does happen and I’ve seen it a handful of times in my doula career.
The last time it happened, I had had good conversations with the family about what their pain management goals were. We talked about non-epidural coping skills, knowing that spontaneous labor was expected, and therefore early labor would happen at home. But the plan was not to “labor at home for as long as possible.” The plan was to get to active labor, go to the hospital during the “sweet spot” when labor was well established, but manageable, and then go to the hospital with plenty of time to get checked in, get an IV placed and some fluids, and then have an epidural placed before labor was too intense.
Once labor started and began to intensify, I joined this family at home and stayed with them for about two hours to help with comfort while they rested between contractions. Labor got stronger and I suggested that it was time to call the hospital and begin to think about heading there. It didn’t look like a screaming fast labor. When we arrived, the pregnant person walked down the hall on her own and stopped to breathe through the waves when they happened.
But right when she was about to enter the labor room, her amniotic sac released and *very quickly* she felt like she needed to push. The baby was nearly there and she was told there wouldn’t be time to get the epidural she wanted.
You can imagine this was NOT what she wanted to hear in this chaotic moment.
I validated for her that this was upsetting. But here we were, and we would just have to deal with the situation we were in. I worked to ground her. I reminded her that she’d already done some of the hardest parts and that not only could she do this, but that it was already almost done. In a couple more pushes the baby was out. What a whirlwind!
Like so many others, this parent had to come to terms with a last-minute change in plan, and I was there to help her and her partner through it.
Now, as I said, not having time to get an epidural is not the norm. But there are still so many ways that we birth doulas assist when you are planning and expecting to have an epidural. Here are a just few:
Talking you through different ways that labor might start and rules of thumb about when to go to the hospital.
Walking you through how an epidural is administered, what other medical tools come with it, what you may feel, and what side effects are common with an epidural.
Talking you through coping strategies for use prior to the epidural or if the epidural doesn’t work well. During labor, we can also help you advocate for better pain control if your epidural isn’t working adequately.
Discussing your ideal timing for an epidural.
Discussing the importance of changing positions and going over great positions to use with an epidural.
Being available for you while you’re at home in early labor (with phone and text support and in-person support as well).
Answering questions you have and providing moral support
Giving breaks to your partner, so they can get a square meal or a power nap.
And the list goes on.
If you had an epidural and a birth doula, what was your experience of it?
