Someone recently asked me if I would be willing to support a laboring mom who intended to get an epidural. A great question! I’ve thought about it a lot since, trying to clarify the answer for myself.

The short answer is yes, of course, my job is to support the mom is pursuing whatever kind of birth she wants. But there’s a long answer to this question, too. Here’s how it breaks down.

Epidurals can be useful tools. Especially in long labors when the mother is exhausted, it can be a saving grace to get an epidural because of the way it often allows the mom to rest. A few hours of sleep, or near-sleep, can make a huge difference later when it comes time to push. I’ve been to at least one birth that I believe ended vaginally because of an epidural. That mom might well have been too worn out to push if she hadn’t rested during active labor. (She pushed for three hours.)

However, when a mother—particularly a first-timer—tells me prenatally that she’s planning to get an epidural, I can’t help but think “Oh, that’s a shame.” It’s a shame because I think she’s missing an opportunity to discover her own strength. It’s a shame because she’s likely buying a message from outside—from her mom, her friends, or society generally—that tells her it’s too hard, or not worthwhile, to labor without drugs.

It’s not that I want people to suffer pointlessly, but I believe (and I know from experience) that the pain of birth does have a point. Physiologically and psychologically, it is there for a reason. I also know that it is not always experienced in a negative way. And that making it through those intense sensations with your own breath, imagery, movement, and so forth is an awesomely empowering experience. What a great way for a woman to begin a transforming new chapter in her life.

So, prenatally, my job is to listen to women as they tell me about their hopes and plans. And whether they are planning on an epidural or not, my job is also to make sure they know all the facts. If you think you don’t want one, you should know why. (For one thing, if you change your mind during labor, that’s the wrong time to start learning about the risks and benefits of epidurals.) If you think you do want one, you should be clear about the tradeoffs for yourself and your baby.

Once my clients are informed and have decided on a plan, I will support and honor their wishes. And I know there’s a lot I can do to make birth better for my clients, even those who want an epidural or have already gotten one. More about those risks and benefits another time!