The epidural rate in American hospitals is very high. All birthing women need to figure out their own feelings about epidurals. Moms need to decide the parameters for whether they are willing to accept an epidural or not. My book, Doulas’ Guide to Birthing Your Way, goes into great detail about how an epidural changes labor. It can help a mom decide the epidural question for herself. Moms have reviewed the book and called it fair and understanding about epidurals. There is no single answer to this question that is right for every mother and every labor.
Keep in mind that sometimes an epidural does not do exactly what the mom is hoping it will do. Sometimes she can be so numb that she can’t feel the urge to push strongly enough to birth her baby. In those cases, she will need an instrument (vacuum or forceps) delivery or cesarean birth. Sometimes, being numb is the last thing you want during your labor.
We think of birth as a way to add to our family. We think of birth as a physiologic process. We worry about the unknown territory of birth. Birth is first and foremost, a cultural event. Why cultural? Why not a private event? What is our culture of birth?
Birth is cultural the way eating is cultural. We all need to eat to survive, but birthday cake is cultural. Much of what we eat, how we eat and who we eat with is cultural. Think of chopsticks versus knife and fork. Birth is the same way. You could give birth at home, on a park bench, in a midwife center or a hospital. I slipped in park bench, didn’t I? Who is comfortable with the idea of giving birth on a pubic park bench? That is cultural.
You might think that OB’s who supervise births in hospitals would allow women to do the physical things which help her to get her baby born. You would think that we would have incorporated into our birth practices all our eons of knowledge of what works best for mom and baby to have safe and satisfying births. But you would be wrong! Much of what hospitals and even mothers do regarding birth is based on our culture of birth. Birth culture varies within the United States. For example, here in Pittsburgh, if a mother wants to have an enema to help her with her birth, she can only have one if her midwife requests one. Most doctors won’t bother to request one. Most moms giving birth in Pittsburgh won’t have an enema even if they request it themselves. Why? Because enemas are not part of our current birth culture.
You may not care about that. Who wants an enema (unless they really need one)? Still, the culture of birth where you are birthing will dictate many things. Will you have constant fetal monitoring during labor or have a choice? Will your baby be whisked away after birth and reunited with you later? Will your baby have to “prove” it can drink from a bottle before your baby can be at your breast? It goes on and on.
How do you know what your local birth culture is? Ask moms who have recently given birth where you are planning to give birth. Write a birth vision and talk to your care-giver about it. (Our book: Doulas’ Guide to Birthing Your Way describes in detail how to write your own user-friendly birth vision.) Hiring a local doula can really help, too. Doulas know what your local options are. That really opens up your choices. Your doula’s goal should be that your birth is culturally compatible with you! It is your birth, after all.
midwife, doula, mom and baby!
The word “doula” is an ancient Greek word meaning “servant.” And that’s what the doula does for you. She’s your servant when you’re going through the most challenging time in your life—the birth of your child.
No matter how many children you’ve had, it’s a new adventure every time. Here are some of the things a doula does for you while you’re in labor:
- She gives you emotional support throughout the entire labor. She doesn’t leave when the shift changes.
- She explains the medical procedures, so you know what the doctors are trying to do to you.
- She gives you massages and other kinds of drug-free pain relief.
- She helps you have the kind of birth you want. Since she’s the servant, her job is to put you in control.
- She gives you suggestions for positions that will make the labor easier and quicker.
- If you have a partner, she helps support the partner, too. Her job is to make the labor easier for both of you—to help the partner help you.
- She can keep a written record of the birth.
- She can take pictures of the birth.
- After the birth, she can help you get a good start with breastfeeding.