Hired Doulas and UC

[Blueone]

I have opted to hire a doula with this pregnancy because my hubby may be away in training before the baby comes.  I had wanted to go the homebirth route but we can't afford the only midwife in our area.  There aren't any birthing centers in our area either so it would be either going to the hospital that would be free due to our insurance, or going the UC route. 

I e-mailed the doula today to see if she would support that decision if I did it, but haven't heard back yet.  Does anyone know if a hired doula would support such a decision?

Also, any resources on UC would be really great.  I checked out the website and reserved a copy of Childbirth without Fear, but wouldn't mind more information.  Oh, and any info on being RH- would be wonderful.  I'm RH- and my DS was + when born.  I know it's not common to have issues, but the previous OB freaked me out a little.  I have a feeling that if I go through with this everything will be fine.  But I don't want to do it without the doula...

[LindyGirl]

I know four doulas, and they won't attend UCs for liability reasons. Because they're being paid, they could be viewed by the law as practicing medicine without a license, or could be held liable for your health or the baby's health should something go wrong. Even though you and I know a doula's role is different, a court, should something catastrophic happen, could misconstrue the arrangement because they are the only paid professional at the birth.

But you may find someone who is comfortable with a UC arrangement!

[womenswisdom]

If you are just looking for the non-medical labor support that the doula offers, perhaps a good friend would be willing to serve in that role. Being a doula at a homebirth or UC is mostly about keeping the mother comfortable and involves much less need for an experienced doula than a planned hospital birth.

[Blueone]

Originally Posted by womenswisdom 

If you are just looking for the non-medical labor support that the doula offers, perhaps a good friend would be willing to serve in that role. Being a doula at a homebirth or UC is mostly about keeping the mother comfortable and involves much less need for an experienced doula than a planned hospital birth.

Originally Posted by LindyGirl 

I know four doulas, and they won't attend UCs for liability reasons. Because they're being paid, they could be viewed by the law as practicing medicine without a license, or could be held liable for your health or the baby's health should something go wrong. Even though you and I know a doula's role is different, a court, should something catastrophic happen, could misconstrue the arrangement because they are the only paid professional at the birth.

But you may find someone who is comfortable with a UC arrangement!

I kind of figured this would be the case.  We're decently new to the area so I don't know of anyone who I would be comfortable with as support during the labor.  Maybe this doula will consent, I should know here soon.  Otherwise I guess I'll be working through my hospital anxiety here soon.

[Almi]

As far as the RH factor, in an normal, unhindered, untouched birth, the mother and baby's blood should not mix.  It is typically due to intervention that they do.  Just don't force anything, particularly the placenta.

By the way, I'm due May 2nd.  Hope you can find a doula that will support you!

[LindyGirl]

If you do decide to go the hospital, you might consider hiring a family practitioner or a hospital based CNM to deliver the baby instead of an OB. They tend to be more hands off, less surgery happy (because they don't get paid extra when a C/S is needed)... You could use a doula and stay home as long as possible.

[Blueone]

Originally Posted by LindyGirl 

If you do decide to go the hospital, you might consider hiring a family practitioner or a hospital based CNM to deliver the baby instead of an OB. They tend to be more hands off, less surgery happy (because they don't get paid extra when a C/S is needed)... You could use a doula and stay home as long as possible.

I do plan on staying home as long as possible and already had hired a doula before the anxiety kicked in over the whole hospital birth.  I'll look into a CNM though.  I have an OB and she seems great at the moment.  The only CNM practice in our town (I live in a very small town) is rated horribly and the CNM's were extremely negative and even called a friends friend fat during her pregnancy.  My friend got fired from it too when she decided to go a homebirth route.  I called them once and was so not impressed and I had a bad OB last time too.  But maybe I can find one at the hospital.  I plan on going in for a tour soon.

Everything I read about UC's has been so positive, I'd so love a delivery that calm.

[Tzipporah]

I'm a doula and though I would never announce it to my clientel--I have been there for an UC before. It was a friend who I knew could do it by herself, just just wanted a doula--someone to tell her she was doing a great job and help clean up afterwards.

I have all of my clients sign an agreement that expressly reads that I am NOT a stand in for a midwife, OB or emergency care. etc etc etc. I discuss this with my clients right off the bat.

Still, most people I wouldn't attend a UC for.

[stik]

Originally Posted by Almi 

As far as the RH factor, in an normal, unhindered, untouched birth, the mother and baby's blood should not mix.  It is typically due to intervention that they do.  Just don't force anything, particularly the placenta.

By the way, I'm due May 2nd.  Hope you can find a doula that will support you!

Historically, many, many women have had "normal, unhindered, untouched" births with no intervention and still wound up with Hemolytic Disease of the Newborn as a result of rh factor incompatibilities.  Historians, archaeologists, and demographers who work on basically anything up to the mid-20th century can explain how to spot some of these women (and their families) in cemeteries, and in various records.  If you have an older cemetery near you, you can probably go find one yourself.  Look for a mom with one child who lived into childhood, and more than one who died at birth (in colonial-era cemeteries, this is a tiny stone with one date) or shortly after (a tiny stone with two dates close together).  That's a historical case of HDN.  It's even easier to spot in birth records and family bibles, which are generally more likely to include pregnancy losses than cemeteries are.  

Since your insurance covers OB care, you can use it to get rhogam.  There is a blood test that can tell you if you are already sensitized - if so, there is treatment, and you'll be glad you have insurance.  If not, you can get rhogam in late pregnancy or shortly after birth.  You don't have to give birth in a hospital to get rhogam.  Needing rhogam should not interfere with UC.  It's routinely offered to women who miscarry, so emergency departments have it.  OBs give it to pregnant women, so they stock it in their offices.  

[Blueone]

That's good to hear about the shot.  I talked with my doula though and she said she'd loose her license if she did this.  But there is apparently one other midwife in the area, but you give birth in a trailer not your actual house.  I don't know...but I'll call.  Otherwise I'll just labor at home with her long enough so that when I get there all I have to do is push.  I think I can do that.

[tri31]

Blueone- thanks for posting this thread, I live in NY, too. I find myself looking into UC as well. I live in the Southern Tier, I am curious about the midwife (with the birthing trailer), if it is information you can share, I'm looking for options? If not I totally understand. I hope everything falls into place for a you. 

[Blueone]

Originally Posted by tri31 

Blueone- thanks for posting this thread, I live in NY, too. I find myself looking into UC as well. I live in the Southern Tier, I am curious about the midwife (with the birthing trailer), if it is information you can share, I'm looking for options? If not I totally understand. I hope everything falls into place for a you. 

I don't have any info on her at the moment other than her first name.  Once I do though, I will PM you with the phone number and all!  I'd consider a UC more if I knew for sure my husband were going to be there.  But since the army is so slow I on info regarding his training I don't know if he will be and I won't do that if it were just me and DS.  I hope he is though.  He didn't get to be there at DS's birth.

[tylersmomma]

what area r u ladies in here in NY im in Morrisville area and we have a MW here that does homebirths

[Blueone]

Originally Posted by tylersmomma 

what area r u ladies in here in NY im in Morrisville area and we have a MW here that does homebirths

I live in Watertown.  I've contacted Meredith at the CNY Midwifery, but I couldn't afford her. 

[lia_joy]

Originally Posted by Blueone 

That's good to hear about the shot.  I talked with my doula though and she said she'd loose her license if she did this.  But there is apparently one other midwife in the area, but you give birth in a trailer not your actual house.  I don't know...but I'll call.  Otherwise I'll just labor at home with her long enough so that when I get there all I have to do is push.  I think I can do that.

If you do want to continue to look for a doula that's willing to attend a UC, keep in mind that where one is certified makes a difference.  I am a doula certified through CBI. I chose that certification specifically because they don't discourage attending UCs. It is left up to the individual doula to decide.  We've discussed it in the email group and always get mixed responses -- Some doulas are uncomfortable about UC in general or the possible liability and others (myself included) say they'd be comfortable as long as they feel they're a good match with the family & that the doula's scope of practice is very clearly understood.... So, just because the doula you talked to would lose her certification, it doesn't mean it's impossible to find another one... If that's what you want, keep looking.

[Blueone]

Originally Posted by lia_joy 

If you do want to continue to look for a doula that's willing to attend a UC, keep in mind that where one is certified makes a difference.  I am a doula certified through CBI. I chose that certification specifically because they don't discourage attending UCs. It is left up to the individual doula to decide.  We've discussed it in the email group and always get mixed responses -- Some doulas are uncomfortable about UC in general or the possible liability and others (myself included) say they'd be comfortable as long as they feel they're a good match with the family & that the doula's scope of practice is very clearly understood.... So, just because the doula you talked to would lose her certification, it doesn't mean it's impossible to find another one... If that's what you want, keep looking.

Thanks!

[PaganMom92]

When I couldn't find a homebirth midwife in my area (CPM's are illegal in NC but they practice under the radar up in Asheville regularly, unfortunately I'm 6 hrs east) and the closest birth center is 3 hrs away I opted to just try and find a doula to go to the hospital with me. I had found one who is on maternity leave and gave me the contact info of her 'under-cover' midwife and I thought I'd hit the jackpot when it turned out we couldn't afford it, even working a payment schedule and her letting us pay half by delivery and work off the other half within a year (only $2,000 total), because I had found her so late in the game. Now I am without midwife-attended homebirth options, I haven't heard yet from the doula whether or not she would be able to make it to a hospital birth (she just delivered baby #3 and her hubby's deployed) and I've been considering a, what I would call 'partially unassisted birth' at home. A friend of mine is a paramedic and they're trained to deliver babies at home, and I would be confident with her and she'd only be as hands-on as i wanted her to be or if there was a complication. I don't know if the doula I was talking to would come attend as well as support. I'd have to ask. I believe that unassisted can be a good way to go, but I believe that women were meant to birth among women. I hear people all the time saying that unassisted is ok because 'we've been doing it since the dawn of time' but that's really an incorrect statement. We've always had other women, or at least almost always, whether a midwife and a group of family/friends/tribe women or just those women. Even back then midwives were very hands-off. It kind of makes me sad that all these women are having unassisted births with no support systems. Not just trained doulas, but women standing as doulas in the sense of the word, the meaning and context behind the term. That's just my personal opinion. There should be made a distinction between completely unassisted births and medically-unassisted births. Doulas (certified or otherwise) are NOT medical professionals. But I think there is a major need for them, or a 'stand-in' doula, or group of women-'doulas' that unassisted birthing women should take advantage of. ESP those without significant others there during the birth.