Prenatally:
determine what options are available to her and what the right choices are for this mom
explain any tests or procedures being suggested by the doctor, and explore alternatives
if the mom wants to
determine the type of care the mom is looking for and help her decide if she has a
caregiver appropriate for her needs
discuss any fears or concerns about birth and parenting
explain hospital procedures, what is "optional" and what is deemed to be "policy"
help the mom identify what sort of support she wants
prepare a birth plan together
help the mom to formulate questions to ask her caregiver if she wants to discuss any
issues
help the mom understand where she needs to consider options e.g.what happens if her
doc is not on call?
look at ways that she can improve her health if she has any issues with illness or diet
and help support her through that
provide her with a sense of normality and faith that her body is growing her baby
beautifully
answer questions and provide reassurance to partners
if this is a second or subsequent baby, debrief through previous births to better
understand what happened during them and which aspects mom and dad want to have
the same and which they want to have different, then identify what steps they can take
to change them this birth
explain the potential risks with an epidural and how to minimize these as much as
possible (same with any other intervention such as induction, cesarean etc)

In Labor:
come to the mom's home and support her in early labor
answer any questions about what is happening at different stages of labor
accompany her to the hospital and help her through the registration process
provide company for the mom so her partner can leave if he needs a break or rest
run for drinks and snacks for the mother and the partner
take notes of the labor and birth, providing the mother with a written record/memory
support her through labor until she reaches active labor, as it reduces the risks to mom
and baby if she has the epidural after 4cm dilated
support her and help her manage her labor while she is waiting for the anesthetist in
case she has to wait e.g.he is not in the hospital or is busy in surgery.
support her if the epidural does not work e.g.only works on one side or is patchy, or
needs to be reinserted
support her if she wants to have the epidural turned down for second stage to reduce
the risks to her and the baby and feeling begins to come back again
physically support her if she wants to be able to move around
massage her, particularly her feet and legs, if she has uncontrollable shaking (common
with an epidural)
take photographs of the labor and birth
discuss alternatives if her labor slows (common with an epidural) and the staff are
suggesting intervention to speed it up

After birth:
help with breastfeeding
make sure the mother and partner get something to eat
help mother shower and get settled into a clean bed
talk through the birth together and answer any questions mom has about how it went
provide emotional support if mom is finding it difficult to cope or is overwhelmed by
having a new baby
Mother's Advocate Doula Services
Epidurals
and Doulas
Mary E. Smits, CD (CBI)
Interventions may be
chosen because a
woman wants them, or
because medical needs
show that they are
warranted.

Having interventions
does not make a woman
a bad mother or a weak
person. Having a drug
free birth does not show
that a woman is
stronger or braver.

Whether a woman
chooses an epidural, or
she chooses a drug free
birth, it is paramount
that the choices she
makes be hers, not
her caregivers.

To impose a set
of random protocols
on her that limit her
choices, prevent her
from being fully informed,
do not benefit her
and her baby, and
remove the control
of her determining
her own birth, is
unjustifiable in a world
where we value
the right to autonomy
and freedom of choice.
I'm considering an epidural, should I have a doula?
A doula does so much more than just help with pain relief.
If you choose an epidural, your doula's role only changes slightly.

Examples of how a doula supports the mother who chooses pain medication.
Notice: the photos on this site are used by me with permission from my clients,
please out of respect, do not copy or reproduce any of these photos.  Thank You.  Mary E. Smits
Disclaimer
The information contained on this website is of a general nature and is
designed for educational purposes only. The information is not meant to
replace the recommendations or advice of your midwife or doctor.
Please consult your midwife or doctor regarding your health care.
I deem every woman's birth experience invaluable; therefore I feel services should be obtainable by all
women desiring a doula's support.  If you are concerned about affording my services, adjustments are
available to lower income families based on a sliding scale.