Monday, July 24, 2017

Wanting vs needing pain meds in labor

Deciding on how to manage the sensations of labor is probably the most discussed topic surrounding childbirth. Do you want an epidural? Do you want a natural birth? Do you need a childbirth class? Which one should you take? Do you need a few classes? Should you give birth in the hospital, birth center, or at home? How you plan to manage the sensations of labor determines where you give birth. You can't get an epidural at home!


I work with clients who have a variety of goals and needs for their births. Just how no two people are alike, no two births are alike. That is the beauty and wonder of birth. Most clients who seek my services desire to have a natural childbirth. While there are different definitions of what constitutes "natural," most people who approach me want two things:

1. To avoid a Cesarean
2. To avoid pain meds

Many of my clients use pain meds in labor, so I want to share some thoughts about this.

Sometimes a person might NEED pain meds in labor. Some examples might include:

1. Needing a surgical birth
2. An inability to cope with the sensations of labor despite trying a multitude of comfort measures
3. A persistent cervical lip and a cervix that starts to swell despite doing all the tricks in the book
4. Exhaustion (i.e. hasn't slept days and labor has been taking a really long time)
5. Client says so

Let me say a note about #5.

I am a professional believer in you, you are capable-er, you are a badass-er, the bomb dot com-er, you are strong enough-er, I know you can do this-er, these doubts are part of the process-er, you've got this-er, let's try something else-er. I am an encourager and confidence instiller. I am a believer in your strength despite what others in the room, yes, even sometimes YOU, think. When they doubt, when even YOU begin to doubt, I believe. I never stop believing.

But I have a confession to make. It is very difficult for me to turn that off. I will encourage. I will suggest other things. But I will never say that I think you need pain meds. I will never suggest it. You probably asked me not to mention pain meds anyway. You hired me to be the one person to never ask you, "Are you suuuuure you don't want an epidural?" And I truly believe deep down to the core of my being that you don't need one.

That is, until you tell me you do.

Here's my promise to you, amazing clients. I will never ever ever stand between you and receiving pain meds if that is what you want. I might have a few tricks up my sleeve to help you get back in your groove if you hit a wall, but if you say you're done, I believe you. I support you. And I do NOT judge you. Please know that. And I am not disappointed in you. I am not disappointed in myself either. I would not put that burden on you. I understand that your choices are not a reflection of me or my skill as a doula. They're your very own unique and wonderful choices. They belong to you.

Sometimes a person might WANT pain meds in labor. Here are a few examples:

1. Natural birth is not appealing. Like, at all.
2. Goals change
3. More painful than expected
4. Sleep deprivation
5. Client says so

I don't know about you, but it is hard for me to say that I want something. I feel selfish, and I struggle about my wants and needs. I have a feeling many others might understand. But let me say this.

Wanting pain meds in labor is a good enough reason to have them. 

It is ok to have them even if you don't need them. It really is ok. Just like you don't have to justify or explain your reasons for wanting a natural birth to anyone, you do not need to justify your reasons for wanting pain meds to me or anyone else. I trust you to know what is best for you. I want you to have a satisfying birth experience, however that looks for you.

I've been around long enough to see that instincts are a wonderful thing. Even if those instincts say, "I need to go to the hospital now even though it is still really early and we planned to labor at home as long as possible" or "I think I should be induced even though we were planning a home birth" or "I think I would like an epidural even though I appear to be coping well and took all the birth classes and read all the books and hired a doula."

So if you decide in labor that you need or even want pain meds as part of your experience, I promise to support you. I promise to remain by your side. I promise not to judge. I promise not to question your choice. I promise to continue providing the same unwavering and compassionate support as always.

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