doulas and midwives at homebirths?

[libbylu]

I just want to get some opinions about the differences between doulas and midwives, and how others have decided who to have at their homebirths.
I was just at a childbirth info-thing and talked to some doulas who had had homebirths themselves, and they really seemed to think that a midwife has a very defined role at a birth, and being a midwife requires so much focus that often the same person cannot play the role of doula and midwife at the same time. They said they wouldn't have called their midwife right away, but the doula came immediately. I know everyone practices differently, but is this typical for homebirth? We are expecting our second in minus two months, and with the first, I didn't hesistate to call the midwives as soon as labor started. I talked to them a ton, and it seemed like they almost spent the whole week at my house! (it was a long labor!)

There are a lot of different issues here, but at that birth, I had two midwives and a doula, and two other loving people to support me. The doula was rather new and inexperienced, but she did a lot of the hands-on labor support, with my dh, and the midwives were taking a more distant role, because I was connecting well with the doula and dh.

I felt that there were just too many people in the house, and want fewer this time; we are planning just for one midwife, dh, and one other close family member, no doula. Is it unreasonable to think that a midwife can do continuous labor support while being a good midwife? (our midwife is totally fine with this) I thought that this was the midwifery model of care; one-on-one support, with a real relationship backing up the experience and knowledge of the midwife. It almost seems like a doula in that case would only be necessary if the mother just wanted that much extra support and companionship; I know some people like a sort of house party at their birth? Or one would need a doula if the midwife practiced more like a doctor, and expected to only show up shortly before the birth?

Thanks for input!

[MamaSong]

I think it just depends on the midwife. My mw was very much in the background, she was a doula for many years and she definitely differentiates between her role as a mw vs. doula. I knew that ahead of time so I had a doula. I would just be very clear w/ your mw about what your expectations are of her during the birth. My mw strongly encourages you to have a doula, while I know others do not.
For my hb, it was just dh and doula and mw at the end. Very quiet.

[Yemaya1]

My midwives always provide a doula, free. My doula rested and prepared everything while my doula offered support.

I was appreciative.

[Missy Princess Eha]

Well, I am a student but I find that my preceptor and I along with the woman's family are able to give the mother plenty of support. We do however give the couple room to labor on their own. And if she has that "watched" feeling we give them some time alone and go for a quick bite to eat in early labor. But a doula wouldn't be unwelcomed at any of the homebirths we attend. I really think it just comes down to what you need. If your midwives and spouse fulfill that then I would not hire a doula. You know them and what they can bring to your birth in the way of support. Do what feels right. It sounds to me that you want a very quiet and intimate birth and too many helpers would interfere with the birth you have in your mind.

[ZeldasMom]

Originally Posted by libbylu

I felt that there were just too many people in the house, and want fewer this time; we are planning just for one midwife, dh, and one other close family member, no doula. Is it unreasonable to think that a midwife can do continuous labor support while being a good midwife? (our midwife is totally fine with this) I thought that this was the midwifery model of care; one-on-one support, with a real relationship backing up the experience and knowledge of the midwife. It almost seems like a doula in that case would only be necessary if the mother just wanted that much extra support and companionship; I know some people like a sort of house party at their birth? Or one would need a doula if the midwife practiced more like a doctor, and expected to only show up shortly before the birth?

You've got it right about what homebirth midwifery is about mama. Go with you gut and just have the midwife. Sounds like those doulas were trying to sell their services.

[happydoulamama]

When I think of my upcoming homebirth, I think of my friend who is a doula doing hip squeezes, back massages, setting up my music and aromatherapy, and helping guide me into the place I mentally need to be in. (my dh will be there, and if he wants to do those things he will, but based on my last birth I am not putting any weight onto him really helping) Anyway, I envision my midwife's major role as to give me confidence that an experienced provider is at my side, check on baby/my stats, give me suggestions if I need them, catch the baby, and help me avoid tears. I can't imagine her doing hip squeezes and everything else that my doula will be doing- I don't expect her to. Maybe I should? I've never thought about it before. I just have never seen her in that role and I wouldn't expect her to play both either.

Input? Do most midwives do massages, aromatherapy, hip squeezes, etc? Silly question I guess, but I've never really questioned it before.

[MamaTaraX]

Depends on the midwife. Some midwives only have a more "clinical" role (checking FHTs, VE's, perineal massage/compresses,etc etc etc). Some take on the role of emotional and physical support both. I have doula'd at homebirths. I've arrived before the midwives and stayed after. (this is no different than hospital births really, I am always there before the doctor and well after). I think that it's also up tot he woman to decide what roles she wants played at herbirth. My midwife and doula played complimentary roles at my homebirth. They both sang with me and talked to me, both touched me and calmed me. Both were there doing things for the moment of birth, the midwife checked for a cord then move out of the way so I could catch, the doula held the flashlight and spoke softly.
baby cryin' more to come..

Namaste, Tara

[courtenay_e]

Originally Posted by ZeldasMom

You've got it right about what homebirth midwifery is about mama. Go with you gut and just have the midwife. Sounds like those doulas were trying to sell their services.

I disagree with this. I'm a doula, and love it when the opportunity arises to attend a homebirth. This gives the doula the chance to do her best work...without fighting hospital staff every step of the way.

I really know homebirth midwives who do well in the dual role, and I also know well homebirth midwives who would stall a womans labor if left to themselves to provide continuous support. IT ALL DEPENDS ON TWO FACTORS: First, what kind of support do you need? If you need the kind of support a doula gives you, and your midwife is not that kind of attendant, get the doula and lose somebody else...or at the very very least, give a copy of "The Birth Partner" to your close friend who will be providing labor support. Second, what kind of midwife do you have? I had a homebirth midwife who was very clinical. If I was the kind of laboring woman who needed support, I would very badly have needed a doula. I had my mom there, in that role, but she did more of the physical stuff (changing cool rags, making the water the right temp) than the emotional support...which is fine. But if my mom hadn't been there, that physical stuff wouldn't have been taken care of. But, again, it just came down to what kind of midwife I had. I suppose there are more hands-on-support types...but if you're someone in need of support, be sure that you have it there, behind whatever nameplate they may wear...have them there.

I don't think that the doulas were working too hard at "selling their services" (or any harder than they would be with any other potential client). I think that they were being responsible by suggesting that you may still need the additional support.

[grace's voice]

If your mw offers birth support, that's awesome. Mine does not, she purly oversees the medical side of things and that is how I like it, I feel safer that way. I had a doula for my first homebirth and couldn't have done it with out her (or, rather, it wouldn't have been as great as it was). It was only her 3rd birth, but she was awesome. I'm having a doula for my upcoming homebirth as well. I don't want a ton of people at the birth, but its turned out that there will be the 2 mws, the doula, and my sister (to watch over my dd, though she's told us her feelings won't be hurt if we decide not to call her).

[alegna]

It depends on the midwife and what you want. I'm not a big one for female support, so I didn't really want that from my midwife, and I didn't use a doula. My dh was just the support I needed.

-Angela

[rere]

At my daughter's birth there was a midwife and her apprentice.Most of my labour was just me and my husband so a doula would have been completely wasted.If my midwife didn't have an apprentice at the time that I completely loved and was happy to have care for us and learn from our experiance I would have been fine with just the midwfe if she was comfortable with that.I'm not a big let's have a party to watch my vagina kind of girl though.

[ZeldasMom]

Originally Posted by MamaTaraX

Depends on the midwife. Some midwives only have a more "clinical" role (checking FHTs, VE's, perineal massage/compresses,etc etc etc). Some take on the role of emotional and physical support both. I have doula'd at homebirths. I've arrived before the midwives and stayed after. (this is no different than hospital births really, I am always there before the doctor and well after). I think that it's also up tot he woman to decide what roles she wants played at herbirth. My midwife and doula played complimentary roles at my homebirth. They both sang with me and talked to me, both touched me and calmed me. Both were there doing things for the moment of birth, the midwife checked for a cord then move out of the way so I could catch, the doula held the flashlight and spoke softly.
baby cryin' more to come..

Namaste, Tara

I was basing my comments on what the OP said about her situation and previous experience. I am all for doulas--I have used one myself and am trained as a doula. I do think some people in the birth community unintentioinally act in a disempowering way toward mamas-to-be though when they get too into telling women what they need rather than listening and supporting the woman in her way of birthing.