On a doula board I frequent, a doula asked the question of what the doula should say to the mom if she requests pain medication, if the doula should talk her out of it or 'let' her get it (her words, my emphasis), and what the doula does after the mother gets the epidural. Here's my response:
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I touch on this with my clients prenatally:

* What are your wishes for pain management?
* (For ALL moms, even moms who are going unmedicated)- What are your pain relief preferences if all non-medical options are not working for you?
* (I give a handout about epidurals risks/benefits adapted (with permission) from Tracy at B*E*S*T doulas, you can find it on her site) (Note: I do not use this as a contract because I do not expect my clients to 'answer' to me for any part of their labor/birth - rather I use it as a tool to help them have an opportunity to explore risks/benefits before they are in labor, and as a tool to help us discuss how WE will strategize if she requests pain medication, - that's it. No signatures involved.)
* I explain how sometimes moms will ask for an epidural before they truly want one, just because it is soothing to *ask* for it, or because it symbolizes a measure of time (she knows she can get one at 4, if she can 'have one' now, she knows she's at least 4cm). Bearing that in mind, what strategies can we use so that if you ask for pain relief, I will know you truly want it and don't go running for a nurse before you're ready?

* secret code- pick a word that will signal that she's 'serious'
* ask me to try another contraction before deciding
* try a position change first
* have a vaginal exam first

I also let them know that what they want at the peak of the contraction might not be the same thing they want in between, and that if they are asking for the epidural/medication during the contraction, I will help them get through that moment and let THEM raise the issue again in between. If mom asks me between contractions, I immediately call the nurse for her or tell dad to (or whatever).

If mom is clearly suffering and says she wants medication, I do not hesitate with all the other stuff; I will call the nurse immediately.

We are not in our client's bodies at the time they are making these decisions, and therefore can not POSSIBLY know what she 'needs'.

One thing to think through beyond her getting the epidural is what YOUR job becomes after she has medication.

Very typically after a mom has medication...

* the curtains get opened, lights go on
* TV comes on
* phone starts ringing or getting used
* mom 'comes back' to herself
* support people ease back to couches, chairs
* everyone sleeps
* support people take break outside of the room to eat/make calls/bathroom/etc

Think about what this does to a labor that is underway... we know that during sex, we need quiet, privacy, dim lighting, intimacy.... we wouldn't try to have sex with lights on, TV on, people coming in and out, etc (unless you're in to that LOL). As the doula, I always communicate with my client after her epidural about keeping the 'labor space' intact. Keep the lights low, rest with your partner in bed with you, touch each other's skin. Keep the phone off, keep the TV off- and I remain in close contact with her, touching her (although not as much, she isn't in the same need). I talk about how using the pain relief to her benefit for positioning and whatnot is important, so we try MANY different positions in the bed. Hands & knees, knee chest, sitting up as in a giant birth chair. Break down the foot of the bed (ask the nurse to do it, obviously) and have her hang her knees down while you or her partner sits behind her and supports her. Let everyone sleep if there is the opportunity- you're all working hard and need your rest! After sleep, keep the labor space intact as much as you can. Mom might be more interested in checking in with her family and watching TV- you have to follow her lead, but your input will be meaningful to her, too.

Also, be clear in your intention when you are attending a mom with an epidural: do you feel it is your job to talk her out of it? How do you feel inside when she gets it, disappointed? Frustrated? Angry? Like she's given up? Relieved? Accepting? Open? Trusting of her? Something else? Be honest because the only person you have to answer that question to is yourself- but it is important that your support of her is seamless, no matter what you are feeling.

After a client gets an epidural, I immediately celebrate all the ground she's gained so far, and her wise decision to get some rest before the rest of the hard work she has ahead of her comes. It is good to get rest, she will need it for pushing and when she meets her baby. It also gives dad permission to sleep, too, and he doesn't have the benefit of all the labor hormones to keep him going- he needs to rest, too. Sometimes the couple is reluctant, and I remind them that they are going to be parents today- sleep will be a luxury for a while! Get it while they can. :) Then I talk to her about the importance of fetal positioning, and how epidurals/laying in bed can affect it, and what we can do about it. I pass on the info and then follow her lead- some moms aren't interested in doing any OFP in the bed, but most moms are open to it. I also take dad/partner aside and talk to them about how the vibe changes in the room after the epidural and what we can do to keep us in a labor mindset, too.

I encourage you to do some deeper processing about your opinions with pain medication, and medication + doulas, and be open to the experiences that are offered to you- they are for YOU as much as they are the mothers you attend!