Can a doula conduct fetal monitoring?

[Ambivalent Dreams]

If I am forced to have yet another hospital birth (due to financial reasons), I want to stay home as long as possible before going in.  But, I would like to have someone with me at home who can monitor the baby periodically.  Is this something a doula can do, or would I need to hire a midwife.

[pokeyAC]

The answer is no.  Doulas are for emotional and physical support only.  They do not provide medical support including monitoring or checking dilation.  It is outside the scope of practice.  A monitrice may provide this service, but they are often trained as midwives and working as doulas.  They would probably be more expensive than a doula. 

[eabbmom]

A monitrice is somewhere between a midwife and doula but I am not sure how many actually practice. As a doula I would not because it could be construed as practicing medicine without a license. What makes you nervous about not being able to hear the heart beat?

[Ambivalent Dreams]

Thanks.  I thought they could not, but I had never heard of a monitrice, so that's good information.

eabbmom, you ask a good question.  Both of my previous births began with my water breaking and progressed very slowly.  With DC #1 I was 1 cm dilated when my water broke at 39 weeks and some days.  The water was clear.  With DC#2 I was 1/2 cm dilated when my broke at 41 + 6.  There was meconium in the water.  I labored with him for about 30 hours after that.  I went to the hospital almost straight away because I was concerned about the amount of meconium staining.  His heartbeat was slow through most of my labor and he only really perked up when the OB scratched the top of his head with a finger.  He was born limp and blue.  If my labor starts with my water breaking for the 3rd time, I'd like to have someone check to make sure the cord is not prolapsed and check to make sure the baby is not in distress without having to rush off to the hospital.  Because, as we know, once you get to the hospital you are on a time-clock and your movement is restricted (which did nothing to help speed up my labor, of course.)

[eabbmom]

You can go to triage, have them check you out and leave. You have the right to informed refusal. I definitely understand your concern. My first labor was sixty hours, if I had been at the hospital I could have easily had a surgical birth. You have the right to refuse interventions, ask for more time and be respected. How many hospitals do you have to choose from?

[oliversmommy329]

What about purchasing your own fetal doppler and checking the heartbeat yourself? I have a Sonoline B that is very good. I believe I paid around 60 USD for it.

[womenswisdom]

The issue I would be concerned about with checking the heartrate yourself or having a doula (who is untrained in interpretation) is that it isn't always the count that matters, it's what the heartrate is doing throughout and after a contraction. You could have heartrates within the normal limits, but if there is a concerning pattern (like 160 to 120 and back to 160 coinciding with particular points of a contraction) it doesn't mean that everything is okay. You can be falsely reassured that things are okay when maybe they aren't.

[phathui5]

Do you have a CPM in your area that you could ask to do labor monitoring at home before you go to the hospital?

[Ambivalent Dreams]

Thanks, everyone. I am in Houston and have found there are at least 2 monitrices here! I'm going to check on that and also keep researching every option to see if I can somehow have baby #3 at a birth center.