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Long Laboring at home/Midwife hired as Doula???

post #1 of 13
Thread Starter 

I just cannot afford to have a homebirth but am becoming increasingly terrified of my local hospital and the birth experience that it may/will bring (including being told I will only have a 30% chance of being successful and continuous external fetal monitoring with no exceptions).  

 

I can spring the cost for a doula but my question is: Will some/most doulas feel comfortable laboring until the last minute (6-7cm if not longer)?  Or are there any midwives willing to act as a doula or montrice?

 

Any personal experiences with this or BP advice would be greatly appreciated.

 

I'm in the Metro Detroit area (just in case there are any references :)

 

Thank you so much.

post #2 of 13

Not sure if there are any particular ones in your area, but can tell you with my doula, she is a midwife in training, so for me that is a bit of an added bonus, in case labor becomes precipitous (unlikely, I think, for me).

 

If you find a doula, they are great to ask about the hospitals in your area, what their VBAC practices are, and which protocols can be bent or changed.

 

As much as I, in general, don't like CFM, it seems to be the best way to detect early rupture. You could see if they at least have a telemetry unit so you can be up and moving. With my first baby (that did end in a c-section) I could be up and moving once they put the internal monitor in. I am in favor of whatever allows me to be up and moving. I couldn't walk the halls, but I could get in and out of bed, rock in a chair, on a ball, etc. I was on Pitocin, so had to be monitored.

 

since doula's don't check your cervix, they will be going by your cues as to how far along you are. You would have to ask the doula about at what point she would think you would *need* to go.

 

Good luck! you may try posting in finding your tribe about finding a particular doula in your area that meets your needs.

post #3 of 13
Thread Starter 

Thank you akind1!

post #4 of 13

I'd be really wary of internal monitoring. You have to have your water broken, which puts you on their time clock, the cable is basically a highway for germs into your body and it literally screws into the baby's head (although a lot of drs tell/imply it's just an electrode, it is in fact a screw) which has caused some babies injury.

 

Maybe try posting on the Finding your Tribe for your area and see if anyone knows of someone who could help you.

post #5 of 13
Thread Starter 

Yes, i would like to avoid continuous monitoring altogether in favor of intermittent monitoring.  I think I will try posting in Finding your tribe.  Thank you Devaskyla!

post #6 of 13

Most (if not all) of the doulas I know advocate laboring at home as long as possible. Personally, my doula was a CPM as well, though not practicing as one, and I felt very confident that she would know when we should go. I know that there definitely ARE midwives or mw assistants who work as montrices as well. You just have to find them!

 

For cervix checks, you could learn to check yourself.  Or have your partner learn to do it.

 

As for monitoring, it really is up to your OB. Mine was 110% fine with intermittent monitoring without an epidural. She even put it in my chart in case the nurses gave me trouble. Again, having a supportive care provider is the one of the most important things you can do to improve your odds of VBAC!

post #7 of 13

I don't know your financial situation, but I would encourage you to talk to some midwives if you haven't already.  Many in my area will take some low income clients on for a reduced fee, because they genuinely care about women having the birth and prenatal care that's best for them.  I had a CPM as my monitrice due to my husband's reluctance to have an out-of-hospital birth.  Her doula/monitrice clients typically labor a long time at home, and she also said she would be okay with catching my baby if things got out of hand and we didn't make it to the hospital in time (which actually came pretty close to happening).  Monitrice fees are usually much higher than doula fees, but I would post in your Finding Your Tribe area to see if anyone can give you a recommendation for a sliding scale midwife and/or monitrice.  Good luck!

post #8 of 13

Hi there!

I'm in Metro Detroit, too, and am hopefully having a vbac in October.  Where are you planning on delivering?  I'm seeing midwives out of Henry Ford West Bloomfield, which is a hike for me, but I believe the very best vbac hospital in the area, no question.  Any chance you could deliver there? 

 

I brought up declining efm, and the midwife was not particularly phased. She said she'd be recommending it because it's hospital policy, but is fine to give me a form to waive it and continue with intermittent monitoring. 

 

I also have hired a doula who is almost done with her homebirth midwife training. She is comfortable staying home with me as long as things are going well.  There are several midwives in the area who are monitrices or homebirth midwives.  Check out Courtenay Grabowski (here as courtenay_e) and the doula we chose, Bonnie Miller, Kristen Lacy - all doulas we interviewed who have vbac experience and who have the ability to monitor you.

 

PM if you have any more questions. Good luck, and I think you've got the right idea! 

post #9 of 13
Thread Starter 
Quote:
Originally Posted by merebella View Post

Hi there!

I'm in Metro Detroit, too, and am hopefully having a vbac in October.  Where are you planning on delivering?  I'm seeing midwives out of Henry Ford West Bloomfield, which is a hike for me, but I believe the very best vbac hospital in the area, no question.  Any chance you could deliver there? 

 

I brought up declining efm, and the midwife was not particularly phased. She said she'd be recommending it because it's hospital policy, but is fine to give me a form to waive it and continue with intermittent monitoring. 

 

I also have hired a doula who is almost done with her homebirth midwife training. She is comfortable staying home with me as long as things are going well.  There are several midwives in the area who are monitrices or homebirth midwives.  Check out Courtenay Grabowski (here as courtenay_e) and the doula we chose, Bonnie Miller, Kristen Lacy - all doulas we interviewed who have vbac experience and who have the ability to monitor you.

 

PM if you have any more questions. Good luck, and I think you've got the right idea! 


Thank you so much, this was very helpful.  I'm currently on the path of St. Joe's in Ypsi with a Dr. Fleming (As far as I've heard he has very high VBAC success rates) and I like that St. Joe's has some of my requests already in policy which I found delightfully rare.  It's a trek for me to to deliver there too but as I'm sure you can understand, I feel like my best success will be in a supportive environment.  Thanks for the recommendations, tomorrow I am beginning my phone calls for doulas-two we already had on our list but I think we may be adding one more :)  Good luck to you too, I look forward to hearing more about your experience.  I think I see a PM in your futureredface.gif  Sending you prayers and love in October ~

 

post #10 of 13

When looking for a doula, if you are wanting one to labor with you at home as long as possible, definitely let them know that during the interview and you'll be able to see what their feelings are on the subject.

 

I have a client right now I believe is in very early labor - a VBA2C - and she hopes to labor at home as long as possible.  I'll be joining her later this afternoon hopefully and will labor with her at home until she's ready to go to the hospital.  We both feel this will give her the best shot at her desires for this birth.

 

I've labored at home with women until they've felt pushy (literally 2 blocks from hospital) and we went to the hospital, up to L&D, and had a baby 20 minutes later.

 

A knowledgeable doula will know when it is time to go most often and will avoid an "accidental homebirth".  There are cues we looks for as to when you are in various stages of labor.

post #11 of 13
Thread Starter 

 

Quote:
I have a client right now I believe is in very early labor - a VBA2C - and she hopes to labor at home as long as possible.  I'll be joining her later this afternoon hopefully and will labor with her at home until she's ready to go to the hospital.  We both feel this will give her the best shot at her desires for this birth.

Cinderella08, how'd it go?

post #12 of 13

I had a LESS than  30% chance of success and was successful.  Lots of acupuncture, walking, low dairy/sugar diet at the end, and chiropracty to keep positioning in check helped with all of it.  But I also knew my body better and had a great birth team who listened to me and what I wanted/needed to BE successful.

I also had CFM once things really got going.  It was no biggie.  I was moving around tons and my team knew better than to tell me to be still or be in any kind of position.  As long as we were all on the same page about that, it was really just a minor nuisance of some cords and tangling every now and then.

You can do it!  I do feel a doula or the right nurse at the hospital(which you can request a new one in case yours isn't a good match...mine was a 3 time homebirther herself!) makes or brakes this experience.  That, and a good, simple birth plan that they are able to help follow.

Good luck!

post #13 of 13

Oh, I should also say the CFM was my thing that I was willing to be flexible on which I thinked helped us all out a lot.  It showed the Dr.s and nurses that I was willing to play their game and, in the end, it helped them play mine and got me out of the hospital faster.  I think its important to have a card like this to play, esp if your birth plan says something like mine did which was "NO CFM!"  If they see you are willing to be flexible when they want you to be about something, they are oftentimes much more willing to work with you on other things that might be more important to you.  Also, its important for them to understand WHY you want no CFM.  When they heard my issue was mainly due to really wanting to be mobile, they worked super hard to make sure we both got what we needed.

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