Tell me why I need a doula for a home birth

[whitneyg]

I had a hospital birth for my first and will be at home for my second.  If I will have a midwife and two assistants at the birth already, what is the additional benefit of a doula as well? I had a doula for the first birth and found her very necessary as we were in the hospital and otherwise alone most of the time.  I am looking for a way to save on costs as I will have to pay for the birth out of pocket since it is a home VBAC (Washington MW malpractice law requires this).  

Thanks!

cross-posted in VBAC.

[TiredX2]

What is the purpose of the assistants?  To me, a midwife with two assistants sounds like *plenty* already.  I'm interested in the responses, though.

[whitneyg]

One is an assistant MW who is training as an apprentice.  The other is a MW and naturopathic student who is attending births and doing some prenatal care as a part of her school program.

[TiredX2]

Originally Posted by whitneyg 

One is an assistant MW who is training as an apprentice.  The other is a MW and naturopathic student who is attending births and doing some prenatal care as a part of her school program.

I meant more... have you talked to them about what roles they plan to fill during the birth?  It looks like you have another child--- do you have plans for her during the birth?  Personally, I had DP, DD, a midwife & her "assistant" (still in school) at the birth of DS and didn't feel the need for a doula.

[travelmumma]

Hi Mumma, 

I just wanted to put my hand up and let you know why I  am having a doula.

1- I want my DH to be prepared for our home birth by knowing about stages of labour etc, and a few local doulas offer more advice and info on the "what its going to look and feel like" than the midwives do

2- I want a physical back up for when my Husband/midwife needs a nap/break/food etc

3- I want to know that someone else will have a voice for me. An educated voice in case of transfer. A voice who is still legally allowed to practise, rather than my midwife who would not be able to if we transferred to a hospital.

4- I want someone supporting me who has experience in both the birthing process and with survivors of childhood sexual abuse, in case I am triggered etc.

I thnk thats about it.... But thats just me.. Its mostly about wanting to feel educated (this is our first so you may not feel that way) and supported, while knowing my husband will have a back up and a source of info for him too

[dovemama]

I am not having a doula, but this is my 2nd birth. If it was my first I would definitely want one at home. It seems doulas are good for support in pre-labor since midwives don't come around until things get really going. In fact, my midwives required first timers to have a doula as well. 

[cristeen]

This is my 3rd, and the first time I'm planning on having a doula.  I really needed one last time and didn't have one.

I suppose for you it might in part be useful to know why you had a c-section, how helpful/knowledgeable your DH is about normal birth, how long your labor was, etc. 

For me, I was in labor with DS for 5 days.  My MW and her apprentice showed up on day 4 and were here for about 22 hours.  By the time they got here, I had already had to call in reinforcements just so my DH could go take a nap.  Neither my DH nor my back-up help is the slightest bit knowledgeable about birth, so they had no suggestions on things to do, positions to try, ways to help labor progress.  We were all dead exhausted after 4 days in labor, and none of us was thinking clearly.  A doula would have been able to make suggestions, spell my DH sooner, possibly helped things get moving, etc.  We also ran into a lot of problems pp, which a pp doula could have helped prevent.  For those reasons I will be hiring both a labor and a pp doula. 

You may not need one.  Or you may.  Only you can assess that.  Just keep in mind that most MWs will not attend early labor.  Nor are they there to be your labor support person.  They are there to attend your birth, and there is a distinct difference when you get right down to it.  But it is very much something I would suggest discussing with your MW. 

[cryswilkins]

This is my third baby, first at home, and second birth with a Doula. As much as I love my DH he is not always the best support when I am in labor.  He just gets overwhealmed and doesn't like to see me in pain.  I am more having a doula for him that for me.  Last time she really helped direct him in what to do, and that in turn helped me.  I think that its good for him, he actually asked if we would be using our doula again.

[Turquesa]

If you see a doula as somebody to advocate for your wishes, it may still be worth hiring one, since it sounds like you're going for an HBAC, and it would be nice to have her on board for advocacy in the event of a transfer. 

I've had a doula with my first two and will again with my third.  To date, I've never given birth in a hospital and hope that this coming baby doesn't necessitate a hospital transfer.

My concept of a doula's role has shifted somewhat over the years.  At first I was just scared sick of feeling so helpless during labor that I couldn't defend myself or my wishes against people in conflict with them.  Now, I just crave the emotional support that it takes to get me through those scary unpredictabilities of labor.  If you see a doula as providing that role, then yes, I would still consider one even for a home birth. 

ETA: But in your case, it will depend on your personal relationship with your midwife and the two apprentices.  Do you trust either or both of the apprentices to look out for your birth wishes AND provide any emotional support that you may be seeking?  Are they trained in any pain relief measures, such as counter-pressure massage, in case that's something you want?  If they meet the expectations that you may otherwise have in a doula, then hiring a doula might be overkill. 

If you're in the Seattle-area, especially, I definitely understand your cost concerns; doula's ain't cheap out that way.   Could you try a low-to-no-cost student doula?  DONA or ALACE may be able to help you find one where you live. 

Good luck! 

[motherhendoula]

I have three children and never had a doula - and i deeply regret that!  My first was in a birth ctr and i had no idea what a doula was, my second was a home birth and my MW  and her asst both showed up WAY early in labor and provided lots of great support - that was 14 years ago. 

So when DS was born 8/10  i had another HB and waivered on whether or not i wanted a doula.  I too - had major financial restrictions and was trying to save every last cent - so ultimately, i didnt hire one.  (i also thought i could handle anything labor had to throw at me HA!)  my labor was very short and very intense and i basically got in the tub, grabbed the sides and screamed NO! at every contrx.  My DH was a basket case ...a doula would have been able to direct me so i wasnt so out of control freaked out in pain....and she would have been able to quell DH's fears.  (in the interest of saving $$ i also opted against taking a CBE class! another big mistake)  

in the natural childbirth -friendly Pacific NW you might be able to find a doula in training that you like - they typically do not charge as much. 

The bottom  line is that once you have spent the $$ - you wont regret it....you will either have an easy short birth, and just be so grateful for that teh $$ wont bother you!  OR you will have a tough tough labor and this doula will WORK for her pay!  and you will look back and say 'im so glad we hired a doula - what would we have done in hour 30 without her???'   

i vote YES for the labor doula!

[purplerose]

nak. i accidentally ended up with a doula at my last homebirth and i am so glad! she was my midwife's apprentice who is also  a doula, and the midwife was out of town over an hour away so she had the apprentice come until she could get here. i ended up on my back leaning against dh with the midwife between my legs, and the doula just about on top of me having me push against her arms to help me push. i don't know how i'd have done it without that help, i was so scared. her hands were bruised for a week! my story is on the traumatic homebirth thread. i never expected to actually need anyone, as i'd had a uc with my previous baby.

[bethandanna]

i think it depends on what your MW sees her role being.  our mw was/is amazing but not a birth support person; she acted as the medical professional in the situation.  our doula was amazing and arrived at our house just before we were in active labor.  She was a great constant support and reassurance.  Also, during active labor and transition, it was our doula who was pushing our my partner's back, helping her up the stairs, helping me support her squat as she pushed, etc.  having a doula present, allowed our MW to focus on the labor at hand and do all the medical monitor we needed (my partner had a pesky cervical lip so we needed all the help we could to get baby E under the lip and out) 

our MW did have an assistant (a MW student studying under her)  the assistant worked mainly to monitor vitals, keep the chart and take in the whole situation.

Now, since we had a doula present, I'm not sure how our MW would have assisted throughout labor.  our MW is a huge advocate for doulas b/c the extra support is awesome

Postpartum, it was great to have the MW and doula we could look to for PP and BF support...everyone has their own experiences, opinions, and recommendations.

in my opinions, get the doula!  it's totally worth it.

[thegoodearth]

It looks like I'm in the minority - I did not have a doula at my first HB and I'm not planning on having one at my second birth this June (also a planned HB). DUring my first birth I really didn't need or want a lot of interaction with anyone and I imagine I'll feel the same way this next time around (though I could be wrong). When I needed emotional support my MW  stepped in and provided me the encouragement I needed during transition - but other than that I really just wanted physical support, i.e., rubbing my back, putting a washcloth on my head, etc which my husband provided. My labor was relatively quick I think at about 9 hours. But I imagine that during a long labor having extra support would be pretty helpful.

But I did have a postpartum doula which was AMAZING!!! I really needed the support in the transition in becoming a mother for the first time and I was pretty much alone as my DH was gone most of the time for the first 3 months of DS's life. In my situation I would definitely pick having a postpartum doula again as I found what came after the birth much more difficult than the birth itself. 

[julietea8]

In addition to two midwives and one apprentice, my partner and good friend were present. They read "The Birth Partner" and we're wonderful. We interviewed a lot of doulas and realized, though they were all competent and lovely, we had enough people scheduled. I'm so glad we made this choice because I wanted to be alone for most I the labor. The less I had to talk to others the more present I could be in my process and with my pain.

Blessings for your birth.

[BrokenFish]

I am in a really similar position.  I birthed in the hospital last time, planning a homebirth this time.  I went around and around with myself on whether or not to hire a Doula.  My midwife, her assistant and my (super supportive) partner will be there.  We really don't have the money to spend on a doula, and even those in training were out of our price range. Also I'm reluctant to have another person I don't know well there during the birth.  In the end I thought and thought about it, and the birth team just didn't seem like enough.  I wanted someone who could run out to the store, or make phone calls, or give my partner a break, or walk the dog, or even just sit in another room waiting for something to do.  I would totally not feel comfortable asking my midwife or her assistant to cook dinner, or walk the dog.  I though a lot about what qualities I needed in that person.  I didn't really need someone who knew a whole lot about birth, or options, or pain coping techniques.  I feel comfortable that my partner and I have enough of that knowledge with the support of our midwife.  But what I did need was someone who was able to be completely present for me, whether that meant holding my hand, rubbing my back, lifting me off the toilet, cooking a meal for everyone, or being told to leave me the ---- alone.  I realized (and it took me several weeks to come to this realization) that my Aunt was that person.  She's completely take charge, and will fill a need if she see's it, but also has fantastic sense for when to back off, and wait.  She's completely supportive of the natural process of birth, and couldn't be more thrilled to be present at the birth, even if it ends up meaning that she watches TV in the other room and doesn't end up doing a thing.  She also read "The Birth Partner" and came to a couple of my midwife appointments. It felt like the right choice for us.  If you have someone like that in your life, maybe they can act as an extra support, without necessarily being a "doula".

[Vegan Princess]

I am going to hire a doula for my homebirth, even though there will be a midwife, 2nd midwife and apprentice as well. We don't have family in the area and I need someone to be able to support my 3 yr old. I have friends who could take her to their houses, but I'd like her to stay home and be able to be present for the birth, if she feels comfortable. That is my main reason for hiring a doula. But after reading up on the women I am considering and learning that they can provide accupressure, massage, etc. (in addition to having nanny and preschool experience). I think it will be nice to have them around and let DH and the doula take turns attending to DD during the earlier stages of labor and let the doula help me while DD is with DH. I didn't really feel like I needed DH to do much last time, so he didn't do much. But it would be lovely if someone were proactive this time. My last birth was at a birth center and we got there 1.5 hours before the birth - so we were home laboring alone for the first part. I suppose the midwives will come sooner in my labor this time, but still. I am hiring a low cost/new doula to cut costs. That said, if I didn't need someone to attend to DD, I probably wouldn't be hiring the extra support person on top of the 3 already coming.

Cindy

[crimsonandclover]

I did not have a homebirth, but my DS was delivered by midwives and I had a doula present, AND I am a doula!  I think the difference in support in a birth is that the midwife's concern is to deliver your baby, but the doula's job is to focus on YOU.  There are times during my birth when my midwives were intently checking me, or checking the baby's heartrate, and I really needed that time to check in with my doula and have her focus on me and my needs, not just the concern of getting the baby out. (Not to mention, the massage was pretty great during transition!)  A doula will get you water, leave the room if you want her to, assist you in breathing exercises to center you, etc., while a midwife may not have the time.  For me, it was nice to have one person I could constantly check in with and who remained calm while everyone else was busy.

[dex_millie]

You seem like you have alot of people there already. I do think it depends on your personal needs. Some people like that extra person who will be there only for them.

I personally had all of my 3 kids at home with no doula. Just my husband and midwife was there for the first. And then for the last two we had midwife, DH, one assistant and the child(ren). Between all three adults they brought me what I wanted if I needed anything. I am also not one for the whole hold hands and stuff. The midwife and assistant also will remind me to "breathe" the baby out if they see I may start to push to hard.

It is doable without one. I think it just depends on what you think you need to have a better homebirth.

[Mami_Feliz]

I'm having my third homebirth and this will be the first with a doula. I had too many people present at my first and I realised later that it really inhibited me and slowed things down (there was midwife, DH and two friends, who didn't know much about birth).

For my second I only wanted my midwife, and in fact I laboured by myself in the bedroom and she would just check on me. I loved being by myself! I think this is how I need to labour.

However, this time, the midwife has an apprentice doula working with her and asked if I'd be happy to have her there. I met her and she is so lovely I felt that she could only add to the birth. The doula made it clear that if I need my space and don't want anyone, then no problem at all. She's also happy to make teas, help with the kids etc. Plus, my midwife finds it really helpful to have her there and I figure that anything that makes life easier for the midwife is a good thing.