Birth, Baby!

Welcome, this is Birth, Baby.

Your hosts are Ciarra Morgan and Samantha Kelly.

Ciarra is a Birth Dula, Hypnobirthing Educator, and Pediatric Sleep Consultant.

Samantha is a Birth Dula, Childbirth Educator, and Lactation Counselor.

Join us as we guide you through your options for your pregnancy, birth, and postpartum journey.

There are many options for pain management and labor.

Today, we'll talk about what the options are in all of the different birthing locations.

So excited to talk about this today.

Y'all, you have the benefit of two childbirth educators talking about this with you, and our problem is not going to be, do we have enough information for you?

It's going to be, are we giving you too much information in this supposed to be bite-sized podcast episode?

So we're just going to dive in and see what happens, and I hope you all enjoy with us today.

All right.

So for home birth, we're going to tell you that the first option for pain management is a doula, right?

Are we obligated to say that?

Absolutely we are.

But a doula can help you with things like positions that might be more comfortable, depending on what type of sensations you're feeling in labor, physical touch, double hip squeezes, lower counter pressure, things like that, and different exercises to do, depending on what you're feeling.

Also water.

So getting into a birthing pool or the tub, getting into the shower, having your partner or your doula or someone kind of use your shower head if it has one that detaches and go side to side on your lower back with hot water.

You could sit on a birth ball while you're doing that.

You can, early labor, sometimes your midwife might tell you to take a Unisom or a Benadryl if you are going into labor late in the evening and your waves are still pretty spaced apart, but it's making it just hard enough to sleep.

Sometimes they'll say to take that, we are not giving you medical advice to do that, but that might be something you hear, so don't be super surprised if you do hear it from your midwife.

Did I miss anything, Samantha?

Um, no, yeah, no, I don't think so.

So if you're starting like at the beginning stages of labor, obviously rest and sleep and ignoring it are going to be your best bets for, I mean, it is for pain management, because if you're sitting there paying attention to every single thing that happens, every, you know, oh, I felt a little cramp there, oh, you know, this is happening, it's tight, whatever.

That's going to be physically and mentally exhausting for you.

So that's why rest and sleep and, you know, taking a Unisom or a Benadryl with your providers, okay, is helpful.

And then, you know, moving from that movement and the yoga balls, there's actually a lot of research about those and how effective they are as forms of pain management.

Positioning in every stage of labor is going to be really helpful.

And honestly, it doesn't really matter where you are or what you're doing, positioning is going to be hugely beneficial for pain relief when you're laboring.

I also think it's important to know, and I don't think a whole lot of people realize this, is that the number one reason for changing your mind about pain management, no matter where you're having a baby, is maternal exhaustion.

So being exhausted is the number one reason that people choose an epidural or choose a transfer from a home birth or a birth center.

First time moms especially, that is usually what it is.

So if you can rest in early labor when it's just kind of annoying enough to stay awake, but not so intense that there's absolutely no way you can ignore it, them telling you to take a Unisom or a Benadryl may be the thing that helps you have enough energy at the end to push through.

Yeah, I mean, legitimately for, especially for home births and birth centers, the number one reason for transfers is maternal exhaustion.

So resting as much as possible.

When we have clients that are like, okay, walk me through what I'm going to do when I go into labor.

The very first thing I always say is, well, if you're able to ignore it, ignore it.

If it does not demand your attention, do not give it your attention.

And then the second thing is go take a nap.

I don't care what time of day it is.

I don't care if you woke up two hours ago, go take a nap.

If it is possible for you to be sleeping, I want you to be sleeping because there will come a point where sleep is no longer an option.

Laying down in bed and staying there for an extended period of time is not going to be an option.

Just physically, you're going to need to move.

You're going to want to move.

So yeah, absolutely.

It does make me laugh.

I think that people get sick of us telling them to go take a nap.

They're probably surprised too, even though we kind of warn you in our prenatal meetings that that's what we're going to do.

When someone has waves, they're really excited that they're getting waves because like, oh, something's happening.

We're like, cool, go to sleep.

And I think for first time moms, not only is it most important for them to rest because they probably are going to have a longer labor, but I think it's harder for them to rest.

When you're a second timer, it's a lot easier to go back to sleep.

You're like, oh shoot, yeah, mm-hmm, okay.

I know what it's like to not sleep.

I am going to use this as an opportunity.

Don't threaten me with a good time.

Which is exactly why I think it is beneficial to have that conversation with your provider before you go into labor about, are you okay with me taking a Unisom or a Benadryl in early labor to help me sleep a little bit?

Guys, taking a Unisom is not going to make you sleep through labor.

When your body needs you to wake up, you're going to wake up, and that Unisom isn't going to do a whole lot.

I remember I had a first-time mom who had a pretty rapid labor, actually, but she went into labor, and with her midwife's permission, she took her Benadryl, and she went to sleep, and then the midwife ended up coming over earlier than I did, which doesn't happen too often.

But when I got there, mom was sleeping in bed, and the midwife was like, yeah, I think we're pretty far along.

And I was like, what?

She's so chill.

And this mom, she would sleep in between the waves, and then she would wake up and have a wave, and then she'd go right back to sleep.

And when the midwife finally did a cervical exam, she was like eight centimeters.

She got to sleep through-

Yeah, she got to sleep through so much of her labor.

And then when it was time to push, she was well rested and ready to do stuff.

And then afterwards she had a baby and she was rested and not like crazy tired enough that she could sit there and look at her baby and have a good time getting to know her new person.

It was so cool.

Her new person, I love that.

Yeah, so anyways, rest, sleep, with the provider's permission, taking some sort of sleep aid can be helpful.

Not some sort of sleep aid, really just Unisom or Benadryl.

I feel like this became a commercial for Unisom or Benadryl.

That was not where we were intending to go.

Not sponsored.

But Unisom or Benadryl, if you want to sponsor us, holler at us.

Yeah, no, for sure.

Okay, so Birth Center.

So everything we just said for a home birth also translates to a Birth Center.

There also may be an additional option of nitrous.

So nitrous oxide is available at some Birth Centers, not all of them.

You know, here in Austin, a few of them do.

I don't know all of them do.

I'm pretty sure not all of them do.

But that's something that you should probably talk about beforehand.

So nitrous oxide is, you just have to hold the mask on yourself when you're using it.

And there are very few risks to it.

I will say some people, it makes them feel a little bit anxious, although it's supposed to do the opposite, but isn't that true for everything?

There's always a possibility that it's going to do the opposite.

It's pretty safe for mom and baby.

It can make you a little bit dizzy sometimes.

Some people say they feel a little bit lightheaded.

So we do always want you to be kind of in the bed or leaning on the bed when you're using it.

In a birth center, they're fine with you leaning on the bed often, but not really the hospital, which we'll get to.

And the benefits are that it helps relax you just enough to take the edge off.

This is not going to let you nap.

This is not going to take away sensation.

It's just going to dull it a little bit, or hopefully will dull it a little bit.

And they usually say it takes at least three waves or contractions to be able to feel the kind of cumulative effect of the nitrous to make it so that, okay, now I think it's working.

So you have to hold it on your face for the full waves.

At the moment you feel it coming on, you put it to your face, you breathe through in and out of the mask for the full wave, and then you take it off in between waves.

And again, you do that for the next one.

And after about three of them, you should be able to kind of feel that little bit of an edge be taken off.

Now at the Birth Center, I believe a lot of them, not again, I can't say for all of them because there are so many in the United States, but we usually it's a 15 minute free trial or some sort of free trial.

And if you really like it, then you keep using it and they'll charge you for it.

Or if you don't like it, you don't have to keep using it.

And I just said free trial, but I am in a backup because I actually think there is a charge for the trial sometimes.

I think I have heard of that.

So just ask them and they'll tell you.

You may like it, you may not, but I will say the majority of people that have used it where I've been the doula have liked it.

Yeah, yeah, definitely.

I mean, that's just like anything else.

Like sometimes it's going to work really well for one person and the next person, you know, it's not going to do a whole lot of anything.

Um, you know, nitrous is if you've ever, like been to the dentist or something like that, and they've had laughing gas, that's exactly what this is.

So it's not really, you know, like she said, it's not really taking away the pain.

It's kind of just taking away how much you care about it is what I hear about a lot.

And I should say also that the later you are in labor, like the further along you are, the more beneficial it is.

If you are four centimeters and wanting to use the nitrous, it's probably not the best sign that you're going to make it all of the way with nitrous.

But like seven centimeters and on, when I see people use it around then, then usually it's not just a stepping stone to another pain medication option.

It's usually that that gets them through.

I think that that's the only difference really between birth center and home birth.

Did I miss anything?

Yeah, no, I don't think so.

I think you mentioned the billing stuff.

And really the thing to keep in mind with billing with home births and birth centers is that they're charging you for the things that you are using rather than charging you for everything that is available to you, which is kind of the difference between like the hospital and the birth centers is the hospitals, most, I mean, there are certain things that they are charging at adding to your bill, but most of the time, whatever you use, everything that there is available to you and you can just do whatever you want.

But with birth centers and home births, they're going to charge you for the things that you use.

So that's just kind of a little bit of the difference with that.

And I think it's also really important to have kind of just an idea of what are your goals with pain management?

Are you wanting to experience no pain or little pain during your labor?

Or are you just wanting to have it to be, I know, as quote unquote, manageable pain during labor?

I think that we would probably say that most pain during labor is going to be manageable with the right tools, but that's what these are.

These are tools for managing that.

So it's important to know, when we're talking about nitrous oxide and we're talking about TENS machines and using hydrotherapy during labor, those things are not going to completely take away all of your pain.

They're just going to be tools that you use to make it more manageable and to make it more of a, I say it all the time, but more of a positive experience.

And these things can all do that.

And if you're having a home birth or a birth center, you know that there's going to be some discomfort if you are someone that experiences discomfort with labor.

You keep using the P word, Samantha.

All of my people are going to listen to this and go, Ciarra tells us not to use the P word.

But yes, any discomfort or sensation or whatever that you don't want to have, you're going to have some of those things and these things can help make those less uncomfortable or less strong, less intense.

But then if you're going to be, and there are some people that are like, well, I'm not going to go to a home birth or a birth center because I want pain management and labor and I don't want to feel things.

So let's move on to hospital birth.

And do you want to start us off, Sam, with talking about some of those?

Yeah, absolutely.

So at hospitals, some of it is going to be very dependent on the hospital.

We found that with most hospitals in the Austin area, nitrous is an option and it is becoming more popular across the country as well.

I think there's only three or four states at the last check that did not have nitrous available at any hospitals.

So nitrous is typically available.

Some form of hydrotherapy is typically available in the form of a shower.

Some places may have tubs that are available for laboring in.

And then of course, you know, everything else that we've talked about, physical touch, tens units, counter pressure, all those things are also available.

But then we can move into some more of the actual medication options for pain relief.

So when we are talking about medication options, when we're talking about anything in regards to labor, it's always important to note the risks and the benefits to things.

So we're going to very briefly talk about the risks and benefits of things as we're moving along through these options.

But the first one that we're going to talk about is IV pain medications.

So depending on the hospital that you're at, the anesthesiologist that you're working with, there are different medications that might be offered through the IV.

Typically, what we see used is fentanyl.

This is not the fentanyl that is being sold on street corners.

It's, you know, the actual legit, real tested stuff.

And it's not being used in the same amounts that or in the same way, and it doesn't affect the same.

Well, so many things we could say on this.

Yes.

Please do not freak when you hear the word fentanyl in this capacity.

Yes.

But if you are uncomfortable with it, of course, there are always other options that are available to you.

That's not to say that you shouldn't be, you know, can't be worried about it, but you don't necessarily need to be.

So when we're talking about IV pan medications, typically they are pushed, you know, of course, through your IV.

Sometimes they can be offered in a in an intramuscular shot as well.

Those, the way that IV pan medications work is just the same way that any narcotics would work any other time.

So they are going to kind of move through your body.

They do cross the placenta barrier, so they do get into baby's blood as well.

And they work differently for different people.

So typically, what we see happen is you get an hour or two of pretty solid relief with the first dose of IV pain medication.

It might make you kind of sleepy, kind of loopy.

I had a mom recently get some IV pain medication for a procedure, and she was like, oh my gosh, I haven't felt like this since Margarita's before I got pregnant.

I was like, yeah, girl, get it.

I will say, though, that everyone, because everyone's body processes things so differently, like I'm a lightweight, I can't even drink because I will feel drunk after one drink.

However, my body processes things really quickly, too.

So for me, I got fentanyl in an IV when my daughter was born.

I was trying to not get an epidural, and I really, really, really didn't want my epidural.

And I finally had 11 hours.

I was like, all right, give me something to take the edge off.

I just need a nap.

I'm so tired.

Because my labor started at 315 in the morning.

And so when they gave it to me, nobody told me that it crossed the placenta, and that really upset me afterwards.

So I do.

I'm glad that we're telling you that.

I hope that you hear that.

Not because that maybe will make you make a different choice.

I'm not trying to say that.

It's just, I think it's important that everyone knows that going into it.

But it only took away the edge for maybe 30 minutes for me.

And I never, I could definitely still feel it wasn't a numbing.

It is not like having an epidural for a short time.

It is just like feeling a little bit loopy and tired.

And you can still feel waves or contractions.

So I didn't get to sleep.

I felt very misguided.

Yeah.

And the other thing to know is, you know, it lasts for however long.

Some people, you get five minutes of relief.

Other people get a solid two, three hours of relief.

And then it starts to wear off.

And after it wears off, each consecutive dose that you get, so if you get one dose, you get a few hours of sleep, and then you're like, OK, I need another one.

That next dose is probably only going to work about half as well as the first dose did.

So the effects are going to wane with those consecutive doses.

So that's really important to know.

So with IV pain medications, when I see them being helpful is exactly like what Ciarra said.

If you need a nap, if you need just a little bit of relief for a while before you're ready to jump back in and get back to work with it, that's, I think, when IV pain medications can really come in clutch.

If you are looking for continued pain relief throughout labor, then I think that you're going to want to start thinking about our next topic of discussion, which is the epidural.

Yeah, and real quick about the IV pain meds.

They, a lot of places, will not give you, a lot of hospitals will not give you the IV pain meds if you are eight centimeters or above, because it does make the baby sleepy.

If mom is sleepy, baby is sleepy from medication, and it can deal, you know, have problems with respiratory function, afterbirth, breastfeeding issues, everything.

So baby comes out tired.

So they will likely say that you have to have a cervical exam first.

I did have a mom that wanted IV pain meds and did not want a cervical exam.

And she was like, they always said I could refuse cervical exams.

And they're like, well, you can.

We're not going to give you IV pain meds if you refuse it.

So she had to make that choice.

So you don't usually have to have a cervical check before having an epidural.

You will have to for having IV pain meds.

Yeah, absolutely.

Absolutely.

So epidural, let's talk about the epidural.

So epidural is kind of widely considered as the gold standard in pain management options during labor.

Do you want to tell us a little bit about why, Ciarra?

Well, put me on the spot, why don't you?

Just kidding.

Because it is supposed to, if everything goes right, completely cover you.

You know, it's supposed to completely cover the pain.

And when I say that, it's just from kind of the waist down.

It's not going to make your chest or your arms, you know, not be able to work.

I had somebody worry that they weren't going to.

We actually had one mom get an epidural, and she was just super still.

And I was like, you know, she asked me to hand her a drink or something, or give her a drink, and she was just stiff as a board.

And I did it, and I didn't mean to sound rude, but I was like, your arms do work.

Because I realized that she was thinking that her arms didn't work.

And she lifted them.

She was very excited that she could still use them.

Oh, my goodness.

So I know.

But what we want to happen is that it's covering your body from the waist down and gives you a sensation of numbness.

That's what we want to happen.

Does that always happen?

No.

So I do think it's important for even people that are saying that they want an epidural to know that because that would be really upsetting if you anticipated having full coverage and then maybe have a breakthrough spot in a part of your stomach, or only one side is getting numb and then they're having to roll you from side to side to try to even it out and have gravity help.

So that's important to know.

And there are those one-off situations where an epidural does not work for someone, and you don't know until you're in that situation if that's you.

I've only had that happen once.

Yeah, there's certain medical conditions that can cause your body not to react in the same way to pain medication.

Like Ehlers Danlos is one of those things.

People with EDS often find that pain medications, like epidurals, are not going to work quite as well for their body.

People with red hair, for whatever reason, and this is the same with IV pain medications, too, but it just doesn't seem to work as well.

And that I have seen that happen a number of times, where we need a much higher dose of medication in order for it to kind of touch.

And I have Ehlers Danlos, and we've had clients with Ehlers Danlos, and I had a good coverage with my epidural with my first, and I've had all of our, actually, Ehlers Danlos clients have coverage, but our redheads have struggled.

Yeah, it's pretty wild.

I don't know what there is.

I'd love to know the reasons behind that.

But in any case, so with epidural, talking about the dosages and things, you get a continuous flow of that medication.

So it goes into that epidural space in your back.

There's no sharp needles that are sitting back there.

It's simply a catheter that is inserted through a needle, and then the needle is taken away and the catheter is taped there.

And you're getting a continuous flow of medication through that until they turn off the epidural pump.

And then you also get the little extra juice button to give yourself a little extra hit of medication if you are having a hot spot or if it is wearing off in different areas or whatever is going on.

We can hit that button and get a little bit of extra juice.

And that tends to be pretty helpful.

Like she said, you can have hot spots, you can have epidurals that don't work very well.

We had a mom with twins once, and one of the twins somehow kept just bumping against her back and moving the epidural out of the space.

And so it took forever for us to get that epidural in and working.

And I think actually it unfortunately never fully covered things with that one.

And so there are certain cases where it doesn't work.

And so it is important to be aware of that.

If you're one of those people, it's like, I don't want to ever feel a contraction.

I don't want to feel any pain.

I don't want to have any of that.

It's important to note that one, that's not going to happen.

You are going to feel things.

You are more than likely going to have some waves before you get your epidural.

And you are going to feel...

We could do a whole episode about why you should.

Yes, absolutely we could.

And someday we probably will.

But it's important to know that you still need...

If you are planning on an epidural for your labor, you still need to practice and have other plans for pain management.

You need to know positioning.

You need to know comfort measures.

You need to know some of these other options.

Because it may not work well for you.

You may not be able to get one when you want it.

Or you may just need more.

So having all of those options, knowing what's out there is really important.

And then with...

Oh, sorry.

I was going to say not to scare anyone, but we've also had situations where someone wants an epidural, but the hospital is so busy that they can't get to them right now.

And then it was, oh, you're next?

And then like, oh, sorry, he had to rush back to an emergency C-section.

Oh, sorry, he had to go fix someone else's.

And it's like we were an hour and a half, two hours of her already having the bolus of medication, which by the way, they do need to give you a bolus of medication.

I'm sorry, of not medication, a bolus of fluids.

Yeah, IV fluids before you get an epidural.

And the reason for that is it can really drop your blood pressure getting an epidural.

So the something, another piece of important information would be if you're going to get an epidural, it can lower your blood pressure, but your body does not consider your uterus to be a vital organ, even in pregnancy, which is kind of crazy to think about.

You're like, what do you mean?

It's not a vital organ.

It's keeping someone alive in there, but it's not considered that by your body.

So if your blood pressure is lowering after getting an epidural and they are monitoring your blood pressure, but they also have to monitor your baby's heart rate because if your blood pressure is going down, your body is going to start filtering the blood and oxygen that it's pushing toward your uterus.

It's going to start filtering it to your vital organs that it considers vital.

And your baby will be the first thing to notice a difference in that blood flow.

So their heart rate may start going down significantly.

We've had that happen a couple of times.

It was pretty significant.

And they can give you medications to help bring your blood pressure up artificially.

But that's why they're monitoring you very, very, very closely.

So after you get an epidural, I think they take your blood pressure every five minutes and they have continuous monitoring of baby.

Any pain medication you guys get is going to make it so that they're going to monitor you 24-7.

So if you are doing intermittent monitoring, that's kind of out the window at this point because it's necessary.

It is needed because these things, you know, they are interventions.

And so with interventions, there are risks and they need to add in that extra piece of safety equipment.

But yeah, so don't mean I don't want you to like freak out, but I do want you to know that those are things that can happen so that if they do, you're understanding what's happening in the moment.

Yeah, absolutely.

We talk about a couple of different things in childbirth education.

We talk about the cascade of interventions, which would just be the things that could happen because of another intervention, and things like that would be that potential cascade that could come from an epidural.

We also talk about how interventions come in packages.

So when you are agreeing to one thing, you are also agreeing to other things.

So with the epidural, the package, because I think the epidural probably has the most significant and noticeable package.

So when we're talking about that, we're talking about, you're going to have a blood pressure monitor that's on you at going off about every, it's normally, I think, every five minutes right after you have the epidural.

And then they kind of start spicing it out as your blood pressure regulates.

You're also going to have a catheter.

Yeah, exactly.

Yeah, you're also going to have a catheter because you can't get out of bed and go pee anymore.

I've heard about walking epidurals.

I know they're available in some countries, and I've even heard they could be available in some hospitals in the United States, but not around where we are, and they're not very common.

So expect to, when you have the epidural, to be in the bed for the remainder of your labor.

So you're going to have a catheter to make sure your bladder stays empty.

You are going to have IV pain medication, or not IV pain medications, IV fluids, to help with that blood pressure issue.

And they're going to have monitors, of course, on you and your baby, because they want to know how your contractions are handling this new kind of sedentary labor, how your baby is handling all of the medications as well.

So all of those things are going to be part of that package that comes with an epidural.

So it's important to be aware of that when you are agreeing, yes, I'm ready for the epidural.

Okay, that also means you are ready for a blood pressure monitor, IVs, monitors and catheter.

I think a lot of people are surprised about the catheter.

I get a lot of surprise books about that.

I'm glad you remembered to say that because I have had a few moms that are like, what do you mean they're going to be putting a catheter in?

I was like, well, friend, we can't get up and go pee anymore.

Also, can I get a catheter?

This sounds very convenient.

But you also have to sign paperwork before getting, I think the IV pain meds do.

But I know when you do nitrous, you have to sign something.

And I know when you get an epidural, you have to sign something.

And when you get an epidural, they will also make you sign something saying that you consent to a C-section.

Even though that's not necessarily what you're doing, you know, that's not the plan, and that your consent to having blood products will be on there sometimes.

Sometimes that stuff is on the main hospital admission information when you're coming into.

And then if you do end up in a cesarean for some reason and you already had an epidural, they will just try to strengthen that epidural, bolus the epidural to make it even stronger so you basically cannot move from your waist down for the cesarean.

Or if that doesn't work, I've also seen them have to do a spinal, so kind of abandon ship on the epidural and do a spinal, and then also if you have not had an epidural yet, and let's say you're coming in for a planned cesarean, or if you are in labor unmedicated and something happens and you automatically or quickly need a cesarean, they will do a spinal.

So there's a difference between an epidural and a spinal.

It's the space that it goes into.

A spinal works more quickly, and it covers and then goes away more quickly, whereas an epidural, and by the way, nothing is left in your back with a spinal.

It's just basically a shot of medication into your spinal space.

And then the epidural has a tube that stays there to continue that feed of fluid or of medication into your back like Samantha was saying.

So the spinal, they can't like give you more of the spinal while you're in cesarean.

So those are the differences between those two.

I just think that's important to know in case you end up in a cesarean.

Yeah, yeah, absolutely.

And it is also important to know that when you get your epidural can also matter.

Getting epidurals earlier in labor before what we would consider active labor, which is about six centimeters of dilation, increases your risk of cesarean.

And we don't really know what happens when you get epidurals after six centimeters.

At the very least, there's no research to show that it does not increase your risk of cesarean.

So, you know, take that or leave it.

You know, we can use that information however we want to use it, but do be aware that getting an epidural does increase your risk of other interventions, which would increase the risk of cesarean.

So if having, you know, avoiding a cesarean is your number one goal for labor, then having other plans for managing your labor instead of having an epidural as Plan A is probably going to be beneficial for you.

And with that, I'll also say on the flip side of that, there are times when getting an epidural could actually save a vaginal birth and lower our risk of cesarean, depending on what we're experiencing during the moment.

So that's another reason that it's really important to have a doula with you that understands kind of both sides of things, because there are times when I recommend an epidural if people are asking what should I do, because something is going on in their labor.

I'm like, all right, well, this baby needs to come down and out, and baby's getting tired and mom's very tired.

And if something doesn't change, doctor's kind of threatening, cesarean may become necessary.

So maybe we should do that now.

You get some rest.

This maternal exhaustion settles down.

So there are situations in which an epidural is a great tool, but it does in and of itself sometimes increase the risk of cesarean.

Absolutely.

I think that's just why this is probably a podcast for a whole other time, but that is why it's important to have birth plans and to have an idea of what you want, why you want those things, not just because my sister said to or my doula said to or whatever.

I'm scared of needles, so I don't want to get an epidural.

Those are all valid reasons.

I feel personally attacked, Samantha.

Sorry.

I totally didn't want an epidural because I hated needles.

That is a reason, but it cannot be your only reason for not wanting an epidural.

You need to know when you're going to pivot.

You need to know on your birth plan.

These are the reasons we pivot away from this.

These are the reasons we may need to pivot away from this.

That has to be a discussion with your care providers, with your doula, with your partner, before you're ever in that birthing room.

One of my favorite birthing affirmations is I'm prepared to meet whatever path my birth takes, because every birth is going to go differently.

You know, we can plan to the tee what we want to happen, and it's not going to go that way, y'all.

It's just not how it works.

Babies are going to come, how babies are going to want to come.

Our bodies are going to do things that we don't anticipate, and that's okay.

We can have our plan and we can be prepared to be flexible and to pivot.

And it's also really important for partners to be flexible with these things, too.

And, you know, your doulas as well.

It's important for you to know that your birthing team is there to support you in whatever you need, and what you need is not necessarily what they think is the very best plan.

It's what you need and what you feel is best for you.

So making sure that the team surrounding you is supportive of you and you pivoting and helping you to pivot when you need to, all of those things are going to be really important.

You know, we do hear stories about people that are like, oh, well, you know, my doula said that, you know, that they were going to support me in my unmedicated birth.

And when my birth wasn't unmedicated anymore, then they weren't really there.

And that hurts my heart.

I just saw somebody say that, that they, somebody was asking, oh, do you recommend having a doula for labor?

And someone was like, well, no, I thought I should have one.

But then I told her that I wanted an unmedicated birth, and I ended up with an epidural.

So I shouldn't have even gotten a doula in the first place.

And I was like, oh my gosh, there are so many conversations that should have been had so that she understood sometimes an epidural can be a tool.

So I really hope that this episode helps you guys understand what those pain management options are and helps you know what ones you might be comfortable with.

Maybe some of them are an absolute no for you, but I do recommend just taking a softer line with those things than such a hard line.

And I'm sure we'll be back with more information next week.

Have a great week, y'all.

Thank you for joining us on Birth, Baby!

Be sure to tune in next week as we chat with Andrea about her birth story.

Thanks again to Longing for Orpheus for our music.

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See you next week!