A Deep Dive into Epidurals and How Your Doula Can Help

Today’s Epidural Landscape

Over the past ten years, nearly every demographic across the US has shown an increase in the use of an epidural. In fact, the CDC reports that as of 2024, nearly 75% of all singleton vaginal births were assisted with the use of an epidural. It’s one of the most common interventions used in birthing! 

What you might not expect is that Here at Heart Tones Birth Services, we saw that same percentage mirrored in our clients through all of 2025! That’s right, about 75% of our clients last year chose to get an epidural at some point during labor. Many people assume that doulas mainly support unmedicated births, but we’re highly experienced in helping our clients labor with an epidural. That could include helping you understand the pros and cons of epidurals, talking through the best time to get one during labor, and assisting you with movement and positions to help labor progress after you get an epidural. 

To understand how your doula can help you labor with an epidural, it’s important to understand the epidural itself. 

What Is an Epidural, Really? 

Most people have heard of the use of an epidural for pain management. What you may not know is how it works, what options are available, and the other benefits it can have for birthing parents and baby alike. 

What most people think of when they hear “epidural” is the Labor epidural analgesia (LEA). This entails an anesthetic administered through the use of a catheter. Essentially, a small tube is placed by an anesthesiologist between the bones in your spine near the spinal nerve to prevent pain signals from going back to the brain. The tube stays in place so that the medication can be continuously administered throughout your labor. 

However, there may be times in labor when it makes sense to get a Combined Spinal-Epidural (CSE) which offers quicker pain relief than a traditional epidural. A CSE is also sometimes called a “Walking Epidural” because it can often allow for more leg mobility and sensation. However, the term “walking epidural” is misleading. No matter what type of epidural you get, you will remain in the hospital bed from that point on through labor, so there’s never a time you’d be walking around with an epidural. Your doula will have all sorts of recommendations for movements and positions you can get into in the bed to promote labor progress. 

What Are The Risks of an Epidural?

Realistically, there are always risks with any medical procedure and intervention. 

The three most common risks include:

1. Hypotension: This is the formal term used when your blood pressure drops. Your medical team will always counteract this risk by giving you IV fluids before and during the epidural, which can help stabilize your blood pressure.
2. Incomplete Pain Relief: Sometimes the epidural medication doesn’t adequately relieve all pain, and there may be a portion of your body that still feels painful. Your doula will help provide relief by helping you move into different positions. If you’re still experiencing pain, your doula can help you advocate for the anesthesiologist to come back and double check the epidural placement and dosage.
3. An “Epidural Headache”: This side effect is rare, but some people experience intense headaches in the days after an epidural. If you are experiencing these symptoms, always let your medical provider know so they can offer suggestions and make sure it’s improving over time.

Epidurals aren’t a one size fits all intervention. It’s important to talk to your birthing team about your options and what might work best for you, your body, and your birthing plan. 

How Can My Doula Help If I Choose an Epidural? 

An expert doula knows how to support your physical and emotional health through labor and delivery–while helping you maneuver through the expected and unexpected realities of birth. 

Emotional Support for First Timers and Not-So-First Timers 

You don’t know what you don’t know. As a first time parent, it can be hard to advocate for yourself and your needs when you don’t know what to expect. Making choices when things don’t go according to your birth plan can make an already stressful time even harder. 

Heart Tones Birth Services doulas have the advantage of having supported many different birth scenarios–from unmedicated, to induction, epidurals, cesareans, and every choice along the way. This type of experience across a multitude of births means they are prepared to help you advocate for your needs, even as circumstances change in real time. 

And even if it isn’t your first rodeo, no two births are alike. If you’ve had an epidural before, your experience may be entirely different this time around. Doulas help you understand what your body is experiencing during your epidural and advocate for your needs.

This kind of reassurance can help you remain calm and collected throughout the beauty and trial of birth. 

Physical Support with an Epidural

Doulas are there to support birthing parents every step of the way. From the placement of the epidural to assisting movement, a Heart Tones  doula will provide you with support and reassurance the whole way. 

An epidural will mean you’ll be in the bed during labor, but the good news is that limited mobility doesn’t mean you have to be stationary. There are a variety of assistive devices and positions that can help progress your labor safely and efficiently. 

Doulas can help with side to side rotation, peanut ball placement, assisting with throne position, and even the use of a squat bar or hands and knees position if your situation permits it.  

Your doula and partner can work together to support your birthing experience with an epidural. Helping empower your support system with knowledge to support you better is one of the things doulas do best! 

Talk with Your Doula About Your Options

The decision to use an epidural or not is deeply personal. If you aren’t sure, consider talking with your birthing team about the potential benefits, risks, and side effects of the epidural in your situation. 

Be sure to talk to your doula during your initial consultation about your desires concerning medication and epidurals. Once you have selected your doula, they can help you refine your birth plan and put contingencies and back-up plans in place.