Updated: Sep 15, 2021
A doula is there to support you no matter what path you choose your labor to take. A big portion of a doulas job is to make sure you feel educated and well equipped to make these decisions for yourself. The reality is that sometimes an epidural really is the best choice for you to make in labor. I've supported labors where the laboring person has accepted the epidural for a variety of reasons: a long relentless induction period, pure exhaustion, and/or a stall in labor progress.
What I have found in this line of work is that there are some misconceptions about the epidural. Today, it's not necessarily administered to take all of your pain away, the anesthesiologists goal is to take about 75-80% of your pain away. This is good, why? Because you will be able to feel when to push, but some moms just don't want any of that pain so they don't expect it. Even though you get the epidural you will likely feel the "ring of fire" too, but all of this helps prevent the risk of tearing.
To receive an epidural, you will have to remain still, even through contractions. It may take them a while to get it placed. I have been a part of a labor where it was super quick and the anesthesiologist was phenomenal (it actually made me expect this from all anesthesiologists). Well, 15 hours later I experienced another mom receive an epidural and her experience was not as delightful. It took over 20 minutes for it to get placed and I was not allowed to help support her during placement. I had to help keep her mom calm in the hallway as we heard screams of pain coming from the room. Once it is placed, it takes about 20-30 minutes for it to take effect. Once the drugs have taken their course you may find yourself feeling very itchy, it's normal but not always very pleasant. It may also be a bit alarming not to be able to feel your lower extremities. You will also receive a catheter either for the remainder of your labor or intermittently to empty your bladder.
All of the benefits surrounding the epidural really circle around the fact that you get rest and the ability to relax which should help you progress and dilate. In a hospital setting, you may find they push this option a lot or say things like "if it were my labor, it is what I would do." Don't fall for that, be solid on your plan until something legitimate changes your mind. In fact, none of your care should be prompted by statements of someone of authority saying "if it were me... if it were my... if it were my family..."
The list of risks is obviously a bit longer than the benefits.
1. there is a small risk of infection at the injection site
2. although very rare, you could get a spinal headache
3. getting the epidural could actually slow down or stop your labor, resulting in a c-section
4. you could spike a fever which the OBs will indicate as a sign as infection and may result in a c-section, even if it was a result of the epidural.
5. it is a challenge to switch positions after the epidural has been administered, you will likely switch sides on the bed every 30 minutes with a peanut ball between your legs or one leg in a stirrup
6. there is an increased use of vacuums and forceps in delivery
7. birthing people who get the epidural often have a harder time breast/chestfeeding in the first few days after birth (this doesn't mean you can't breast/chestfeed, but knowing this helps you combat the problem by hand expressing milk in the beginning and offering it to baby through a syringe or bottle).
The truth? Everyone reaches a point in labor where they want the epidural. The job of a doula is to get you to focus, understand your power, and push forward. We uphold and remind you of your birth preferences. Sometimes, giving yourself an hour to make the decision can help you get through the rest of your birth experience. The reality is, the best way for you to make a choice for yourself is to educate yourself about all of the benefits, risks, and alternatives.