As a working doula, what can I say about epidurals today? I have three things to say about them. First, if you are giving birth in a non-rural part of the U.S., you should decide what you think about having an epidural prior to your birth. You should read about them and discuss them with your care provider (doctor or midwife) and also your doula.
Second, please realize that most mothers can give birth without an epidural and that there are distinct advantages to not having an epidural. All the mothers who have spoken to me about giving birth without pain medication have been glad that they did it! Not just some of them, all of them! That is significant. They may have different reasons, but moms who have a pain-med-free birth are proud of themselves. They have conquered their rite of passage into motherhood. They have accomplished something that no one can ever take away from them. Ever.
That isn’t to say that moms who have an epidural (or other pain medications in labor) won’t have a lovely birth. They can also be proud of themselves and their births. It isn’t the same sort of birth, though. When a mom chooses to have an epidural, she really becomes a patient. That makes the flow of the birth more medical. She has to follow the safety protocols for epidural labor, which usually include continuous fetal & contraction monitoring, continuous IV, staying in bed for the rest of labor, catheterization for urinating, and more.
Finally, epidurals are big medicine. That is, they produce a big effect and they can have some big side-effects as well. Here is one side-effect people don’t usually talk about (luckily, your doula will talk about anything!): having an epidural in labor often makes moms feel more vulnerable. The labor is being guided by doctors and medicine instead of mom. There is a catheter in her back that is there to stay until after birth. Mom feels like she couldn’t do it without outside help. Mom feels tied down to the bed.
So when you are thinking in advance how you feel about epidurals, think of how this will affect you, because it is your birth!