Doula Chats: Epidural Alternatives

June 28, 2022


In my previous post having to do with epidurals, I gave a few different suggestions on how to prepare to birth without one. To take it a step further, here is a list of discomfort measures that may be available to you instead of the epidural.

Hydrotherapy - I see this method at nearly every birth I attend. Whether the mother spends time in the shower or in the tub, the unique ability of water to provide comfort is undeniable.

Counter-pressure - This method is amazing for mothers because it helps to create more space in the pelvis, relieving pressure. I wrote an instagram post a little while back with more information on how this method works that you can read here.

Gate Control Theory - This complex theory addresses how sensations of pain are transmitted to the spinal cord which, basically, acts as the gateway to the brain. The idea is to use distractions to stop the passage of those pain signals because there are other sensations to focus on as well, like the feeling of pressing a comb into your hand or using a tens unit to generate small, electric shocks.

Nitrous Oxide - Listen to Evidence Based Birth Episode 15 or read the transcribed version here to learn more.

Hypnosis - The two major branches of Hypnosis for discomfort management in regards to birthing are Hypnobabies and Hypnobirthing. Hypnobabies is an intensive regimen of practicing, rehearsing, and re-training your brain so that you can fully focus on your labor and eliminate any feelings of pain. Hypnobirthing also helps to retrain your brain to think only positive thoughts surrounding birth, but does not include specific cue words that induce hypnosis and is not quite as intensive as Hypnobabies. Both are wonderful options and I often encourage my clients to take a Hypnobirthing course if they do not feel that they can commit to the strict requirements of Hypnobabies.

Acupressure - Acupressure is an ancient form of Chinese medicine that focuses on specific points on the body that correlate with desired results elsewhere in the body. By applying pressure to the LI4 point (the space -dorsum - between the thumb and the pointer finger of the hand) studies have shown a decrease in labor discomfort.

Massage - Watch this video from Evidence Based Birth or read the transcribed version here to learn more.

Aromatherapy - Some of my favorite oils to use during labor are peppermint, lavender, citrus (orange), and lemon. I have also heard wonderful things about Clary Sage.

Conscious/Controlled Breathing - Conscious and Controlled Breathing is wonderful way of centering yourself in the present moment. Letting go of distractions and feeling sensations as they come, then pass. I often encourage my clients to think of breathing deeply and giving their breath to their baby.

Positioning - Birthing babies is all about positioning. The more space your baby has to progress in the proper direction, the smoother your birthing time will be. Noticing where your baby is located (high, mid, low) will help you to know which positions will benefit you most and create more space so that baby can progress, as well as relieve some of the pressure for you.

Affirmations - The mind is a powerful tool. Thinking positive, calming thoughts that uplift and encourage you will help your mind be able to let go of stress, which will lead to less tension, and a more peaceful and painless birth.

Music - I have heard worship music, rap, and everything in-between! Whatever makes you feel inspired. There are some doulas, like my friend Jacquelyn Smith, with specific training in the psychology of music and use it to create playlists for mothers in each phase of labor. I have not experienced this yet myself, but it sounds intriguing.


As we wrap up this section on Epidurals and their alternatives, the most important thing to remember is that the more relaxed, happier, fearless, and calmer you are, the better you will progress. For some, this may look like having an epidural, and for others it may be reliance on some of the alternatives. Whatever your choice is, always remember to consider the Benefits, Risks, Alternatives, and your own Intuition. You will know what is right for you and your baby.

*See* ya next week!


*Susan Joy is a Doula and Birth Documenter serving the families of Mesa, Gilbert, Chandler, Scottsdale, Queen Creek, San Tan, and other cities in the East Valley. The information presented here is not medical advice. All medical decisions should be made after discussion with your medical provider.*

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