Why this podcast?
Well, I’m 99.9% sure that this podcast has never been featured on this blog. It has, however, been lurking in my podcast library for quite some time so I decided to give it some air!
The Dallas Birth Guide is, as the name suggests, aimed at families in Dallas, Texas but as it is an online resource everyone can benefit from its content. The Dallas Birth Guide’s goal is to –
”Educate, empower, and support growing families through informed decisions and support in birthing their way!”
There is a mix of information from care providers and birth workers as well as stories from new parents.
Sounds good to me!
This episode features doula Rebekah Lewis and explores her journey to birth work. The part I will focus on here though is how epidurals can be empowering and how they and TENS units can be used in labour.
I should point out that this post is a bit of a mix of info from the episode and some of my own input as well.
I love that Rebekah underlines that even though the majority of people can birth without interventions, that doesn’t mean that will be the right choice for everyone.
A doula’s role is to offer evidence-based information and to respect and support the client’s own choices.
Can an epidural really be part of an empowering birth experience?
There are, as with everything, both risks and benefits associated with an epidural* and if you are going to use one it will likely pay to use it strategically, but an epidural doesn’t have to mean that you’re flat on your back in bed, totally unable to move.
When is a good time to get an epidural?
An epidural can slow things down so whether you are planning to get one or decide at some point during labour that you want one, it’s best to try and wait until you are well into active labour before getting an epidural administered.
Work with your doula and try a whole range of other positions and comfort measures first if you can.
An epidural can also make it tricky to feel how and when to push so asking for it to be turned down or off when you get to that point might be good too.
When is an epidural a good option?
The short answer is, whenever you decide that’s what you want but situations where an epidural can be useful include:
If you are exhausted
Sometimes, especially during a very long labour, an epidural can allow you to rest or even sleep while your body re-charges and continues to do its work.
If you are suffering
This sounds a bit full-on but as a doula, I always talk to my clients about the difference between pain and suffering.
Pain is a physical sensation and, in the case of labour and birth, is not usually warning us of danger. Rather, it is a sign that things are progressing. That all is as it should be.
Suffering, however, is mental and emotional. If you begin to experience the sensations of labour as suffering and trying new comfort measures and non-medical forms of pain-relief isn’t helping, it might be time to think about an epidural.
You can’t relax and allow your body to open and release your baby if you are tense and frightened.
An epidural could help you let go of that tension, allowing your body to relax and open.
After the epidural is placed your doula will continue to work with you to create space in your pelvis for your baby to move down. Some epidurals allow you to walk around though you may have less sensation in your legs so having someone close by, just in case, is a smart idea.
If you are in bed resting after the epidural you will still need to work on creating space in your pelvis for your baby to descend. Peanut balls can be great for doing just that.
Your doula can place these in various ways under or between your ankles, knees or thighs to create that space and allow your baby to move down.
A rebozo is a long, traditional Mexican shawl and can be used in various ways during labour to help relax your body. It can also be used during the pushing stage to give you some leverage, think tug of war.
Your doula will encourage and help you to change positions regularly with or without an epidural. If you have more limited movement this might simply involve lying first on one side and then the other as well as changing the position of your legs and the peanut ball but it all helps.
TENS stands for, ready? Transcutaneous Electrical Nerve Stimulation. Pads are attached to your back which carry mild electrical pulses that stimulate your nerves.
The intensity level can be turned up or down and there will be a handheld control so that you can boost the charge when you feel a surge coming.
The feeling of the ‘zinging’ from the TENS unit distracts your brain from the sensation of the surge. It can be especially helpful for back labour.
TENS units tend to be used more in early labour but they can be kept on throughout (unless you want to be in the shower or bath!) and I believe there is something to be said for the ritual involved in clicking the button, it can give you an element of control.
To wrap up
This was a pretty short post but I felt it was an important topic to cover. Epidurals can sometimes be viewed as either completely necessary in order to get through labour or as totally evil and to be avoided at all costs.
As with all medical interventions epidurals come with both risks and benefits and it’s important to be aware of both so that you can make an informed choice.
Having said that, an epidural is absolutely a tool that, when used appropriately, can be very helpful.
TENS units seem to be becoming more common and knowing that there are non-medical pain relief options out there (of which a TENS unit is just one example) means that you have options when it comes to labour.
I’d love to hear from you if you had a positive, empowering experience with an epidural or if you used a TENS machine for your labour.
Until next time!
* Evidence Based Birth has two great (and short!) videos on the evidence surrounding epidurals for pain management and how epidurals can effect the second (pushing) stage of labour. This article from Dr. Sarah Buckley explores the hidden risks of epidurals.
Emily Wills is a doula based in Stockholm. She believes that birth can be a beautiful and empowering experience and started this blog as a way of sharing some really great podcasts. She is also a mother of three and an enthusiastic runner.