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let's talk about doulas

post #1 of 25
Thread Starter 

Hi everyone!  This is my third pregnancy and I am considering hiring a doula.  For those of you have used one before, did it help?  Worth the money?

 

I will be having a hospital birth (like my previous two).  My first birth was filled with interventions (still vaginal though and a healthy baby), my second was less intervention-y, but not the labor of my dreams.  I guess I have poor confidence in regards to birthing.  I educate myself and feel prepared when I arrive at the hospital - but I never stick to my guns when the doctor comes around.  I would love to have a birth where I can labor while standing, no epidural, no artificial rupturing of membranes, etc.  I don't mind having a saline lock and I don't mind external monitoring. The previous two times after arriving to the hospital (at 5cm & 7cm), I became scared of the pain, and (sadly) didn't want to be perceived as a "bad patient."  I didn't talk to my OB last time about how I really wanted the birth to go - he's a very "in and out" type of doctor, not the greatest bedside manner.  I plan to talk to him this time.  I also had family in the deliver room the past two times - this time I will not - I realized that I felt like I had to be stoic in the face of pain and that caused my resolve to crumble.  

 

So, do you think a doula would help things?

post #2 of 25

same question :) ooc

post #3 of 25
Yes and no. The reality is that the environment for what you are looking for is wrong. It's like being committed to Bermuda shorts and then traveling to Alaska In January. Ain't gonna happen. What about a birth center or...gasp...a home birth? smile.gif
post #4 of 25
A doula cannot advocate for you, FYI. She can only remind you to advocate for yourself. And again, in the throes of birthing, that is not a simple matter to do. It's better having a doula than not, but ultimately, she cannot protect you, if that is what you are after....or take care of problems for you.
post #5 of 25
I don't feel like suggesting a homebirth is necessarily helpful. She said she's having a hospital birth, so probably best to make suggestions within those parameters, no?

I am planning to have a doula this time, although for different reasons than you're interested in. My husband does not want to be at the birth, I support him in that, and I will need someone to be my birth support. I also had a hospital birth last time and will this time. I didn't feel like I had too many interventions or need someone to advocate for me so much as I need someone to come up with ways to help me manage, push on my back, and hold my water.

If you've given birth twice before, I think you probably have a better idea than anyone else what a doula could do for you.
post #6 of 25
Thread Starter 

I should have clarified - I live in Alabama where, unfortunately, it is illegal for midwives to attend home-births.  Midwives are treated horribly (as are traditional nurse practitioners) in this state..currently less than a dozen CNM's practice in Alabama.  So sad. Midwives aren't even hired by the hospitals. 

 

Thanks for the replies!

post #7 of 25
I personally have not used a doula but know a few doulas and in your situation I would say one would be extremely helpful. They are there to support you and your husband and help give you a voice. I am the same way with doctors! I go in strong but always want to be a good patient. Generally doulas will meet with you and come to some of your prenatal appointments as well. From what I hear they are really worth the money. If I end up having to have a hospital birth I will defintely get a doula. I am planning a home birth but you never know.
i do however think I will be getting a postpartum doula to help with everything after the baby is born. I told my husband that is what I wanted for my "having a baby gift" smile.gif

It is awesome that you are thinking about this now. If you meet with a few doulas they will be able to give you a better idea if what they can do and it will give you time to pick someone who matches you! Good luck and keep us updated on what happens smile.gif
post #8 of 25

I don't perceive doulas as being able to stand up to the hospital for you, but maybe I'm wrong.  I always thought that they were there to support you during labor.  You could always meet with one in your area to see what they will do for you. 

 

It is hard to stand up for yourself when you are having to deal with something as difficult and emotional as birth.  Can you find a different doctor that you are more comfortable talking about what you want before the birth?  Do you have to have an OB?  In our area, even regular family practice doctors can attend births, as OBs are often more prone to interventions and are used to dealing with high risk births.  My OB was on vacation when I gave birth last time, and they had a regular family practice doctor on call, who attended my son's birth.  

 

One thing that helps prevent interventions is laboring as much as possible at home.  I know driving in the car isn't fun when you are having intense pain, but the farther along you are with birth, the less time they have to do anything to you. 

post #9 of 25
fishywishy, I think you are really on the right track here. You have an idea of how you hope this third birth can go, and you are thinking that some extra labor support could help you feel more supported. I actually think that's a great use of a doula. Very true that a doula doesn't do advocating or "speaking up" for you, and you are totally right that the time to have the talk with your doc about your hopes for the birth is now, way before you're in labor. It's great when you can also have a doctor who is supportive of a low intervention birth... do you have any idea if this one is?

I'm saying this as someone who was a doula for 5 years, but mainly as someone also expecting my third - I didn't use a doula with #1 but I did with #2, and it was a big difference. Just in terms of how comfortable having a woman I knew and trusted next to me and who trusted the birth process -- and who was specifically there to help cater to my every whim, lol lol.gif I can say that because we had been doulas together for years and I had very specific expectations! orngbiggrin.gif Seriously though the doulas job is to support you, the nurses and doctor have other jobs, and your husband should just get to be there as your partner and experience the birth himself. Dads can have a much better time at a birth with a doula too! The 1st birth was stressful on my DH. The second time he could relax, and still did a lot to help me.

Good luck, hope you find someone great! And have the talk with your doctor either way. smile.gif
post #10 of 25
It's good to tell the OB, but honestly, s/he could probably care less if you yell or are quiet, have an epidural or not, etc. if you are to stoic/embarrassed or whatever to yell and get loud and od what you need to do, s/he isn't going to make you more confident. The nurses might but again, their job is to get the anesthesiologist if you ask for it, not to convince you that you don't need to ask for it. a doula can do that, I think. I think the biggest right step you are making tho is kicking out the spectators, because it sounds like you were trying to create the right scene for them, and thus for sure you were not in the bubble of labor, but instead trying to live in the sane normal outside world while your body desperately needed you to focus on nothing but laboring. A doula will help create androgens that bubble, and can slip between the two worlds for you (full disclosure: this is based on me observing many many births, I can't really speak from my own experience, which was not anything like a typical labor).
post #11 of 25

Yes.  A doula would help you.  I would suggest having your OB and doula meet together and go over your birth plan together if possible.  A doula would really help with laboring and advocating for you and the baby.

 

For the best hospital experience I suggest turning the lights off and only having a lamp on instead.  I also suggest requesting that they check only close to the end (it really interferes with birthing and labor and makes a more invasive situation) and only intermittent monitoring.  The doula will help you with all of this as well as finding different laboring positions to get the labor moving in the right way

post #12 of 25

Fishywishy, I hope you can talk about this plan with your OB.  It sounds like you know what you want this time and are planning for it.  I think a doula can't stand up for you but they can remind you to stick to your plan and stand up for yourself.  They can also help with ideas for positions or things to do, like walk or get a drink of water.  This time I do plan to go over my "hospital in case" plan with DH, my sister, and my friend who had 6 CS's.  One or other of the latter will hopefully agree to be my doula.  The friend is my first choice because she knows more about hospitals, but my sister is the most bulldoggiest personality you ever met so she's a very close second place.    If we end up at the hospital, one of the three should be able to remind me of my plan and DH can actually ask /order nurses to do certain things.  A doula can also ask questions and get you some extra facts so your choices are clearer.  It really depends on who you hire and how you plan to use them.  I think if you want to have more of a say, you need to plan with the doula how that will play out.

 

I get that way in labor too, btw.  Just before transition I get really passive and pushovery.  Last time that all disappeared once I began to push.  We will see if that is a trend.  

post #13 of 25

I know this is old, but I do think a doula could be a help to you. I'd suggest meeting a few if you can, and you will know if someone feels like a good fit.  One of the things I think a doula is great for, in the hospital especially, is consistency. She's someone you know, she's calm, and she's there the whole time with no shift changing and other commitments.  She's also likely to be familiar with the hospital and can do things like grab you ice, water/juice, a hot cloth, those little things that your husband probably wouldn't think of and that a nurse may not be available for all the time. She can stay with you while your husband gets a break, and remind you of any non medical comfort measures you wanted to try.

post #14 of 25

I completely agree with @weliveintheforest about doulas.  

 

While doulas cannot speak for you to doctors and nurses and hospital midwives, they can help give you the back-up and courage to do it for yourself or for your husband/partner to do it.  She can also be a liaison between you and family that may be anxiously waiting at the hospital.  And the consistency of care is crucial too.  You and your doula should build an arsenal of calming techniques before the birth, and she will have many more to suggest during labor.  She will be there to help both you and your partner as much as possible.

 

I also want to say one thing about nurses, and something that has been mentioned on this thread.  I know there are many nurses out there who think a medicated, pain-free birth is the way to go, but I have also seen plenty of nurses who are very caring and try very hard to adhere to birth plans that don't involve these medications.  I have seen nurses who have acted as doulas and reminded patients that an epidural is not what they wanted and helped as much as they could to make the patient comfortable during labor.  I think it is a bit unfair to make a blanket statement that a nurse's only job is to call the anesthesiologist. :) 

post #15 of 25

how would one go about finding a doula in their area?

post #16 of 25

ask a hb mw about it, really, its the easiest way to learn your options.

post #17 of 25
Finding a doula can be easy using the internet as well. You can Google search "doula (your city, state)". That brings up results most of the time. You can also go to DONA International website and search your area.
http://www.dona.org/mothers/find_a_doula.php

These are two very good places to start. You can also attend a local La Leche League meeting and ask other moms about doulas in the area. LLL doesn't endorse any particular hospitals, care providers, birth centers, or labor assistants, but you can talk about specifics after the meeting usually.

I hope this helps!
post #18 of 25

I found some that service my area.  Next question - is there a list of questions to interview them with somewhere?  what should I be looking for?

post #19 of 25

I would ask them if they will be comfortable playing referee, asking questions of the nurses about treatment etc.  Or if they are more quiet, hands on during birth.  Do they talk alot? Or not?  Or do they have some things that they typically do or don't do during a birth.  Finally I'd want to go over what I expect them to do if there is an emergency and I want to have time to think, how would we handle that?  How could they hep DH and I get time to think? Ask them how they typically interact with the hospital staff (this is what I'd be hiring one for, but if its massage and encouragement you want, ask how that would likely go down). 

post #20 of 25

I have been thinking of hiring a doula. We are having a waterbirth in a hospital. Our doctor is very open about no interventions and allowing me to labor and deliver however I feel like. Our doctor does not use a regular labor and delivery room in the hospital that way we have more freedom but I can still get an epidural if wanted. I am afraid that I will become weak and ask for that epidural.  

So I was thinking a doula could help me a lot with pain management, suggesting different positions for laboring, helping DH with counter pressure and massage during a contraction. DH and I are planning on taking classes and also learning about hypnobirthing but I am afraid we will forget everything we have learned. Only problem we are tight on cash and DH kinda doesn't want to pay for a doula or see the point to one. :( Any tips on changing his mind?

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