doppler use during hb

[doulawoman]

Does anyone have any thoughts or research on doppler use in general and during homebirth in particular?

I found out this week that the midwives in the clinic I am going to generally use the doppler every 15 minutes during active labour. This really surprised me...the other women I have known have been in other areas of the country true or othercountries and their midwives use it infrequently, ever 1/2 hour at most unless something was amiss or they were concerned. They said they could use the fetoscope instead but from what I understand that can be more annoying as you often have to lay back so they can hear better and not easy/possible during a water birth.

So my question is twofold 1.) what do you feel/think about risks or even annoyance/interference to baby during labour with doppler esp. every 15 mins? 2.) does that seem excessive to you? The midwives are pretty good but have many regulations governing them that ae quite strict and they are also a new practice in a conservative community so this probably influences the practice.

As a side question, how many of your partners were able to catch the baby in an uncomplicated birth? they said it should be no problem but it would be "four handed" (theirs+hubby's) for the head at least... this doesn't bother me too much but I wonder if it's necessary?

[treehugginhippie]

Every 15 mins seems excessive IMO...I don't remember how often my hb mw said she likes to check but it wasn't that often for sure. I don't mind the doppler during labor because we used the fetoscope (doppler is even stronger than u/s from what I've read so I really try to avoid it) throughout the entire pregnancy (well, except for 9 seconds once) so since I avoided the doppler until that point, I was ok w/ it for the birth.

The "four handed" thing...I guess it would depend on how comfortable the mw was?? I think most in my area are ok w/ you or your partner catching the baby by yourself w/ them right there. Not sure what the extra set of hands does that makes it a "safer" delivery ???

[Sijae]

The 4 handed catch is completely unnecessary. I'd ask them why they want it and get a detailed response. It makes me wonder if they are of the school of thought that they need to be touching the baby and perieneum during the birth of the head in order to "control" delivery which is considered by some to help prevent tearing. It doesn't actually help anything (and looks pretty darn uncomfortable and annoying on film) so if you do or don't want them touching you like this you should have a discussion. You can ask them to give a very detailed description of exactly how and why they want to use their hands during the birth of the head. Maybe they will have some videos of births that include their style of delivery.

No-one should be deciding who gets to have their hands on baby or your vulva but you. It really makes me mad when I hear about midwives trying to dictate what a woman can do with her own baby. If your dh wants to catch baby who are they to say nay? It's rather condescending isn't it?

Some states mandate frequency of checking the FHT during labor. That said you could talk to them about signing a waiver and refusing these frequent checks. You should find out if they check that often based solely on the law or if they actually feel the need to hear it. We usually check FHT every 30 minutes unless mom doesn't want us to which is not unusual. Even at 30 minutes it feels intrusive to me and I'm not the one in labor.

As for the use of the doppler, it is a personal judgement of how you feel about the use of ultrasound technology.

I'm a UC birther at heart and am a very hands-off apprentice working with a very hands-off evidence-based midwife. So take it as you will

Laura

[ErinsJuneBug]

My midwives said they were going to use the doppler every 15 minutes in active labor - but i dont remember it being that much. Maybe it was, but i wasnt aware of it. When they were checking i was moving all over the place and they told me to just keep doing what i was doing and that they would follow me. It wasnt bothersome to me at all and it felt like the perfect amount of checks.

As for the birth, you should absolutly be able to deliver the baby by yourself. We had a 4 handed delivery - but it was me and dh's hands with our midwives looking on.

Keep looking around, you can find someone who honors your wishes.

[ShwarmaQueen]

I think I remember my MW saying that monitoring is like every 20 min, but nothing about a 4 handed catch. She UCd all her babies so I hope she would believe it's not necessary!

Are you a VBAC? I read that MWs like to monitor these moms more closely and frequently due to the signs of UR, such as low HR.

[doulawoman]

Hi,

Thanks for your responses so far! No, I am not a VBAC..it's my first baby and so far I'm totally healthy and so is babe.

The midwives are very new... and the only other ones are quite far so I don't have many choices that way.

As to the four handed delivery, I also did not see why that was necessary and I like the advice of asking what it is about and possibly if they have videos with their delivery style!

The waiver for the frequent checks is good idea...I'm sure past a certain point I won't mind it as much whether fetoscope or doppler but I know myself well enough to know that that frequently would annoy me.

[CalmCenter]

I so understand where you are at. On first meeting our midwife, when I said that I would want dh to catch the baby, she immediately replied that she would have a hard time "keeping her hands out of there." I was pretty put off by this statement, but without many options we went with her anyways.

Now at 28 weeks, I am learning a lot about the actual delivery and I have brought up several points with her that are important to me. When she heard that I care a lot about how things go, ie doppler use, water birth, husband catching the baby if possible and so on, she said that we can sign a waiver and we can have the say on anything.

I am finding out that it really is an act of empowerment to choose the birth you truly want.

Be strong and say what you want. If you need to sign a waiver for releasing the midwives from responsibility, think about if you are willing to do this and if so, it is totally up to you how the birth goes! It's you and your families birth. And you as the birthing mother should set the tone for how it happens.

Good luck! Believe in yourself and your intuition to best birth your baby.