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Epidurals

When a woman is first administered an epidural…she needs her doula.

indexWhen a woman is first administered an epidural…she needs her doula. In fact, she and her partner need, and want, their doula* very, very, much!

 
In most cases when a doula is present, this woman has just given up her dream to have a natural birth. This is difficult for her. And that is not even mentioning the pain she is dealing with at the time. She hurts; she is upset; she is scared. She may even feel that imaagesshe has just been forced down a path she did not want. She knows that this is a turning point in her labor and takes her closer to the possibility to major surgery. And all of this has a huge impact on her partner.

 
It is obvious…they both need the woman they have come to know and trust over the past several months. They jwant the woman they have handpicked to be with them throughout this journey of childbirth. They want that one consistent and ever present woman. They want their doula.

 
And why shouldn’t their doula remain with them? Around these parts, the anesthesiologist do not mind. There is plenty of space in the room. And the doula knows to stay out of the way. She is beneficial because imageksshe knows how to calm the woman so that she is not moving about during this precise procedure. She knows how to keep a watchful eye on the partner. She offers a sense of peace and calm for this couple with whom she has spent so many hours, as no one else in the room can offer.

 
imagesThen there are those first delicate moments immediately following the administration of the drugs. The woman’s blood pressure may drop; the baby may not react well; etc. Again…this is the time to have the soothing presence of the doula. This is the very important time for both mother and partner to be assured by this woman they trust so much.

 


The doula knows that the medical team must do what they need to do at such an intense time and is prepared to remind this couple of what is occurring, as she has already reviewed the possibilities weeks ago. She is also prepared to remind the mother of her options, her choices, with all the pros and cons. She is able to explain to the couple what might be occurring, even while the mother and baby are being cared for by the medical team.

 
kWhen an epidural is administered, which is a turning point in a woman’s labor, the woman and her partner need and want their doula.

 
It is very simple…the doula gives them what no one else can.

 

*For the purpose of this article, when I refer to a doula I am referring to a certified doula, or one in the process of certification, who abides by a set Code of Ethics and Standard of Practice.

To Epidural or Not…

Are you planning on having an epidural? iStock_000008463436XSmallIf so, that is certainly your choice…but have you considered all of the effects, and not just for yourself, but for your baby, too? I mean really considered???

If you tell me yes to these questions, then I say go for it!

But what are you going to do until the anesthesiologist administers it? How are you going to handle your labor until that point? An epidural is usually not given until you are well into active labor, about 5 centimeters. Heck, these days you are often not even admitted to the hospital until you are about 5 centimeters.

And what if, as happens so often, you have “break through” pain? Do you know what you will do then?

And don’t forget about the 2nd stage…pushing.

My point…….an epidural does not take away the need for education, coping tools, and the need for a birth doula!

 

How much do you know about epidurals?

Dr Sarah J. Buckley MD has said in her article

                 “Epidurals: risks and concerns for mother and baby.”

Epidurals and spinals offer laboring women the most effective form of pain relief available, and women who have used these analgesics rate their satisfaction with pain relief as very high. However, satisfaction with pain relief does not equate with overall satisfaction with birth,5 and epidurals are associated with major disruptions to the processes of birth. These disruptions can interfere with a woman’s ultimate enjoyment of and satisfaction with her labor experience, and may also compromise the safety of birth for mother and baby.”

 

If you are considering the use of an epidural, you may first wish to read Dr. Buckley’s entire article. This can be found on her website, www.sarahbuckley.com

For more information on epidurals, see Chapter 7 in Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices (Sarah J Buckley MD, Celestial Arts, 2009).


Epidurals and Cesareans

I found this interview with Dr. Aaron Caughey, by Kate Fillion, enlightening as well as fascinating.  If you are considering using an epidural, I strongly encourage you to read this!!!


Here are a couple of excerpts from this interview:

Dr. Caughey says, “The epidural slows labour down. Many times, in the first stage, after an epidural you’ll see a decrease in the rate of contractions. In the second stage it’s blockading your nerves, so you have less motor strength and can’t push as hard.”

Q: Is there an incentive for a physician to order a C-section even if it’s the woman’s first pregnancy?

A: The physician doesn’t make that much more for a Caesarean delivery, about 10 per cent more in the U.S. For the physician, the main incentive is related to time and convenience. If I’m on call all weekend, and I’ve got somebody in labour who’s been six centimetres dilated for a couple of hours and it’s 5 p.m. on a Friday—well, if I do a C-section now, I might get to leave the hospital to see my family. If I give her two more hours, and she dilates further, that still doesn’t mean she’s ready to deliver. It could be midnight before she’s completely dilated, and then she could push for three or four hours, and at the end, I’m paid about the same as if I’d just done the C-section 12 hours earlier.


Dr. Aaron Caughey on labour and how epidurals changed childbirth…a must read!!!

http://www2.macleans.ca/2011/09/26/on-labour-how-epidurals-changed-childbirth-and-why-women-don%e2%80%99t-have-to-push-so-much/#.ToMZqTC_YnA.facebook