Your doula's role is to assist you during birth, to comfort and support you. Giving birth to your baby is so much more than a medical procedure. It is an emotional, spiritual and physical journey. Having a doula with you can help smooth the crucial transition from pregnancy into parenthood. Both parents will benefit from the nurturing care a doula provides.  Epidurals do not always take all the pain away.  There are many reasons why an expectation of a "painless childbirth" may be an unrealisitc goal.  You may still require the use of other forms of comfort measures during early labor and beyond.  Although epidurals due reduce pain 90% of the time, few epidurals limit all pain.  Here are some barriers that may hinder your desired  "painless childbirth".

• Your labor may progress too quickly for you to receive an epidural.
• A pre-existing medical condition, low blood pressure, low hemoglobin levels, previous spinal injuries, or prior bad reactions to anesthesia may disallow epidural usage.
• Epidurals do not provide complete relief for back labor but will confine the mother to the bed and prevent her from doing many of the positions that relieve the pain of back labor.
• Often you must wait for the anesthesiologist to become available.
• You may need to wait while you receive 1-2 liters of I.V. fluid before the process of the epidural may begin.
• The procedure itself can take up to 30 minutes to perform,
• Once you have been given the epidural you may not have complete pain relief for another 20-30 minutes until the medication takes effect.
• Once you are close to complete dilation, the epidural may need to wear off to encourage pushing
• You may experience breakthrough pain
• Epidurals increase the likelihood of other painful interventions: IVs, urinary catheters, continuous fetal monitoring either externally or internally, frequent blood pressure monitoring, maternal fever requiring use of antibiotics & tests on baby (complete blood count, spinal taps), pitocin, forceps, vacuum extractors, episiotomy, and cesarean section.
• Sometimes the epidural gives only patchy pain relief, or doesn't give pain relief at all.
• Some women experience epidural induced pains after the birth: epidural/spinal headaches, postpartum backaches.