epidurals_and

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

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.