Your doula's  role is to assist you during birth. With or without pain medication, you are giving birth, and your doula will be there to comfort and support you.

Giving birth to your baby is much more than a medical procedure. It is a physical as well as emotional journey, and having a doula with you can help smooth the crucial transition from pregnancy into parenthood. Both parents will benefit from the nurturing care a doula provides.

It is best to get an epidural once active labor is well established (usually after 5 cm dilation) you might need a doula to cope with contraction waves to get to that point. Often an epidural can slow down or stop contraction all together, and pitocin is introduced to the cocktail to bring them back. Waiting longer to get an epidural can help reduce the amount of drugs going into your body and potentially changing the outcome of your birthing experience.

Epidurals do not usually take all the pain away. You will still be required to use some other forms of comfort measures at times. Although good to excellent pain relief is obtained in 90% of epidurals, few epidurals take away all the pain.

The administration of an epidural requires you to sit without moving for several minutes, and generally through a few contractions. Having a doula, who is both familiar to you and experienced with the procedure, can help you remain calm and relaxed during the placement of the catheter. This can help the anesthesiologist achieve a good placement faster, allowing you to have the comfort of an epidural faster.

After the epidural has taken effect, you will be greatly limited in your ability to move. An expert doula can help preventing one of the most common complications of an epidural (a cesarean birth) by making sure mom’s position in bed is often changed facilitating the baby’s descent into the pelvis.

As much as I don’t like horror stories here is an article you should read about epidural and consequences, having a doula with you will bring an extra pair of eyes monitoring what is been given to you and how.

A common problem with epidurals is the mother’s inability to push effectively. A doula can assist you by offering several alternative positions for the pushing phase. Above all having someone who understands what is going on with you emotionally can be very comforting. Often partners rest once you get your epidural misinterpreting your apparent comfort with the absence of anxiety or fear of the incumbent delivery, a doula is there to keep you present through this miraculous rite of passage and support you emotionally throughout.