Need a doula?

[mslisa2u]

I am a first time pregnant mama planning a homebirth. I have two wonderful midwives - one is more laid back than the other. At my appt this morning, she asked us who we planned to have at the birth. My plan is to have it be very small and intimate. My husband, our two midwives and my sister who will be acting as our doula. My midwife stated, "You need a doula as well." I explained to her that my sister had taken a class on childbirth, was a huge proponent of homebirth, was reading "The Birth Partner" and is taking an introductory doula course. In addition to all of that, she is the most calming soul on the earth to me. Our midwife is concerned because my sister has not had a baby or attended a birth before and is not a certified doula. I expressed my concern about having too many people there. That idea overwhelms me and I don't see it as helpful. My midwife stressed that things will be different "when you are in labor and you won't feel that way." She talked about people taking turns being with me and that it could be a very long labor and I might need more people. She asked me to think about it and keep an open mind. I am doing that but also felt pushed into the idea.

What are your thoughts?

[rnra]

Here's my personal opinion:  You need someone to offer you emotional support during labor.  Most likely, that does not mean a doula.

For the majority of laboring women, the only person needed in addition to the people actually delivering the baby is the husband/father/partner.  If that person is not available, a mom/best friend/sister/aunt can be a good choice.  Whether or not that person has personally experienced childbirth is irrelevant.  What you are looking for is someone who you trust, who supports you, who will be your advocate, and who makes you feel calm and loved. 

I'm not against professional doulas.  They have their place.  There are definitely women out there who do not have anyone who can offer support to them while they are in labor.  For them, doulas can be a god send.  Some women are not close enough to anyone to have them offer emotional support during labor.  Some women have husbands/partners who are so squemish about the process of giving birth that they are not able to provide emotional support.  Doulas are great for those people who need one.  Most people do not.

Although I know many people would say otherwise, I feel like it is the minority (and not the majority) of women who need a doula.  If you have a good team to provide care to you and the baby (i.e. your midwives) and a good support system (your husband and sister), then why hire a doula?  I certainly wouldn't.  Let you husband and sister fulfill their roles in the childbirth process.  Don't hire a professional husband replacement (which is what many doulas end up being).

[womenswisdom]

I very much disagree with the tone of the previous post. A doula's job is to support you not just emotionally, but physically and with information. Most midwives do not and cannot fulfill the role of a doula and most husbands are not prepared to be the sole support person for a laboring woman who has a long labor or complications, especially a husband who has never even seen a birth before. Husbands have needs - they need to sleep and eat and take a break. If they are the sole support person, that is very difficult to do. A doula's job is not to replace the husband - at all. It's to support the laboring couple and to be a supplement, because it's hard for any one person to provide everything a laboring woman needs, especially if she has a long or difficult labor. There have been lots of studies, and a recent Cochrane meta-analysis, that show that the presence of doulas who are not employed by the hospital and are not related to the mother, result in lower incidences of several interventions and improve the birth experience.

Regarding the OP specifically, it sounds like your sister will probably be a good support system for you, along with your husband. She is doing more than most family members do to prepare to support you. My guess would be that your midwife is concerned that if you have a long or difficult labor, what you have is basically a " brand new" doula, who has never seen a birth before and who is also emotionally invested in you as a sister and might not be as effective as a professional doula would be. I have been at births where the mother had her husband and a friend or family member for support and could really have benefited from a doula, because they did not know how to support her when she had a long, posterior labor for example.

[aprilv]

At my first labor I had my mother and husband- they did the best they could but had no idea how to really help me.  They mostly felt awful I was in so much pain and had trouble handling that- I wish we had a doula to support us all!

For my second, we had a homebirth with a midwife and her assisant.  What a difference!  The midwife was so calm and knew just what to say and do to make everything seem better. 

If you can, I would say having an experienced person there will help.  Even if she's just supporting your support team to help you effectively!

[gmaemaymama84]

I've never had a doula, but I need a voice of reason while I'm in labor to help me remember that I am strong, that I can do it, to help me stay positive, to answer my questions, etc.  Your midwife should be able to do some of that, your sister can do another part of that, and your husband too, assuming he is prepared to be supportive.  The fact of the matter is, you are the one who has to do this.  I say, what do you want?  Do you want a doula?  Do you think it would help?  If not, that is fine.  I think the fewer people involved, the better.  But that's me.  Trust your own instincts.  

[cristeen]

My first birth was a horrendous hospital birth that was wrought with all sorts of emotional baggage.  My DH and BFF did the best they could to support me through it, but there was only so much they could do.

My second birth was a beautiful HB, with a 5 day labor.  By day 3 I had to call my BFF to come over just so my DH could take a nap.  They traded off and on until DS was born.  While they were emotional support, they did not have the knowledge I needed to cope with 5 days of labor, and my MW was very hands-off (and was only there for the last day). 

This time around, I'll be hiring a doula.  My DH will be here, my BFF will come down if she's not working, but I'm not going to rely on them this time to get me through it.  I need someone with some knowledge and who is not invested in me emotionally.  I will be hiring a student doula though, one with very little experience, but who has taken a class.  I cannot afford to pay full price for a certified doula on top of the cost of the MW. 

Like a pp said - your sister may work just fine, but then again she may not.  She is emotionally invested in your outcome, and if she is not going to be able to distance herself from your pain, she is not going to be very useful to you.  During neither birth was my DH able to distance himself from my pain.  He really struggled with seeing me in that kind of pain, and that really limited his usefulness to me.  During my 2nd birth my BFF did really well right up until the end, and she went home when I hit transition because she couldn't handle it any longer (I don't blame her for knowing her limits, but she only missed the birth by an hour). 

Ultimately you're going to have to make the decision for yourself.  But I'd really sit down and have a heart-to-heart with your sister about what she thinks she's going to be able to manage.  Is she going to be able to distance herself from your pain? is she going to be able to be objective?  is she going to be able to spell your DH so that he can sleep if necessary?  is she going to be able to be away from home for 3 days, by your side, if necessary?  Discuss possible complications, discuss positioning, discuss comfort measures... what does she know, what is she learning, what is she comfortable with, where are her limitations?  And then go from there. 

But it sounds to me like your MW is warning you where their boundaries are, and I highly suggest you listen and make arrangements accordingly.  I had no idea that with 5 days of labor my MW wasn't going to show up until the last day.  I had no idea that they weren't going to make suggestions for different positions or other ways of coping.  That's what I expected from my MW, and I've since learned those are the roles that a doula fills. 

HTH

[always hope]

I am planning an HBAC and am starting to think through specifics. I am in New Zealand and midwifery care is normal practise and free but I did have some trouble finding a midwife. However I am really happy with who I have now. With my first birth in hospital my midwife was more interested in taking notes than in supporting me practically. My DH was also lovely but not that helpful. So this time I plan to have another support person who will either be someone who has experienced their own homebirths or a doula. I will need someone who is at my beck and call who can be there before the midwife needs to be and is solely there to provide practical support and reassurance. I think with our general lack of knowledge of birth because most of use have not seen one before our own labour, we need more support than if birth was a normal part of our culture from a young age.

[CaraShrum]

I would encourage you to research and interview a few doulas. See if they are for you. I personally think MOST women CAN greatly benefit from having a  doula in attendance. Their experience and knowledge can be invaluable. As for my own experiences with doulas, I hired a doula for my first birth. We attempted a natural hospital birth but before the doula arrived they were ushering me to the O.R. for a c-section. My second birth was at home with a Midwife, her assistant (who was a doula), my fiance, my sister, my best friend, and my Mom and we wished we would have hired a doula in addition to all the other support we had. Mostly because for the majority of my labor it was just my fiance and the midwife, and I was very high maintenance due to the intensity of the contractions. I am currently preparing for my 3rd child, second home birth and again our Midwife's assistant is a doula and we will also have an additional student doula attending plus my fiance, sister, BF, and Mom. I think we should be covered this time. Do your research and make the best choice for you.