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#1 of 15 Old 12-05-2011, 01:28 PM - Thread Starter
 
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Hi Doulas!

 

(I hope I am posting this in the right place...)

 

I have some questions for you if you have a moment.  I'm expecting my first in April and have planned a homebirth at our apt in NYC  My due date is in mid-April.  Our midwife requires that we hire a doula and she prefers if we work with one of her "in-house" doulas, though we can find our own if we insist.  I am on the fence about having a doula in general mostly because even though I know it could be amazing with the right person, I have no idea how I will feel at the birth and part of me right now feels like I don't want too many people present.   (We are not having friends or family there to keep things as small and intimate as possible.)   We finally found a midwife we feel comfortable with and now I feel a bit stressed not knowing if I'll "click" with her doulas or if not, how to find one I do feel comfortable with.

 

I swear I am not high maintenance or demanding, it's just the reason I chose a homebirth to begin with was so I would feel extra-comfy in my surroundings and now the thought of adding another person to the mix of energy feels a little stressful.  I know I should just probably just calm down, have faith, and not worry so much. :)

 

I want to know how most doulas are in terms of going with the flow...say if I'm in labor and I feel like I need space to just chill with my husband is a doula cool with stepping back and giving us alone time?  Or on the flip side getting right in the mix if I need more direct support?  Will a doula try to "read" what a woman needs in the moment or just simply ask?  Should I be direct about comunicating these things in the moment and is it common for these needs to change throughout a labor?  If any of you doulas could help describe your role in a "typical" (if there is such a thing) labor I would really appreciate it.

 

One of the trickier things is that I'm working abroad right now and won't be returning to the US (other than a week in December) until March, right before the birth.  So any relationship I build with a doula would have to be via e-mail, phone, and maybe a visit in December and a few in March.

 

Thanks in advance super-doulas for your help sorting this out! 

 

Best,

A

 

 

 

 

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#2 of 15 Old 12-05-2011, 03:26 PM
 
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I'm a fairly new doula, but I did have a home birth without a doula, but with extended family present. Our midwife wanted us to have some sort of support person there in addition to my husband, and I thought it made a lot of sense~it can be good to have another person besides your husband who can support both of you so that he can be as involved as you both want him to be, but still have an extra pair of (experienced) hands. I had additional family support, and it was really valuable for us, but we kept our options open and were honest with our family members that we might not call them in labor if it didn't feel right.

 

I think if you find the right doula, she absolutely can be as hands off and unobtrusive as you wish, or sensitive to giving suggestions that might help you be more comfortable. She is also there to support your husband, not to replace or supplant him. Labor support can be physically and mentally exhausting, and your midwife's job is to monitor your baby and you, so she may not be able to step in and fill the support role if your husband needs to take a break.

 

Since you have a good rapport with your midwife, it seems likely to me that the doulas she works with have a similar philosophy. In your shoes, I would speak with a few of them via telephone--ask them the same questions you are posing here!--and see what you think. I didn't want to have a "stranger" at our first birth either, but a good doula should be able to form a quick, close relationship but still be able to hang back when you want her to.

 

Congratulations and best wishes for a wonderful rest of pregnancy and birth!


Stay-at-home mama married to my best friend of 10+ years. lovestory.gif  Aspiring midwife loving parenting our beautiful babyf.gif Julian, born 5/24/09. Expecting a second bean in late July 2012!joy.gif
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#3 of 15 Old 12-05-2011, 03:35 PM
 
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Doulas come in all shapes and sizes, and it is very likely that you could find one who is just the right mix of intuitive and perceptive to give you the sort of support you're looking for. It depends on personality, and also on good communication before the fact. 

I'm more puzzled by your midwife's requirement that you have a doula though. I mean, I am a doula, so obviously I think they're a good thing to have, but it is very, very odd that your midwife would require one. Why is this? I think you need to ask a few more questions! Does she not have backup and or a second at the births she attends? Is she using the doula as her second? (in which case, do her doulas hold current NRP certification?) Is she not willing to provide labour support herself? (some midwives don't do too much labour support, but I still don't see why such a midwife would force her clients to hire doulas) When does she typically arrive to a birth? It's great that you have midwifery care, it's awesome that you "click" with your midwife, and doulas are a good thing, BUT, your midwife also needs to be safe and ethical, and I would have my doubts in this situation. Things might be totally fine, but I think you owe it to yourself to ask a few more questions. 

Congrats on the babe! :D


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#4 of 15 Old 12-05-2011, 03:49 PM
 
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Quote:
Originally Posted by quantumleap View Post

Doulas come in all shapes and sizes, and it is very likely that you could find one who is just the right mix of intuitive and perceptive to give you the sort of support you're looking for. It depends on personality, and also on good communication before the fact. 

I'm more puzzled by your midwife's requirement that you have a doula though. I mean, I am a doula, so obviously I think they're a good thing to have, but it is very, very odd that your midwife would require one. Why is this? I think you need to ask a few more questions! Does she not have backup and or a second at the births she attends? Is she using the doula as her second? (in which case, do her doulas hold current NRP certification?) Is she not willing to provide labour support herself? (some midwives don't do too much labour support, but I still don't see why such a midwife would force her clients to hire doulas) When does she typically arrive to a birth? It's great that you have midwifery care, it's awesome that you "click" with your midwife, and doulas are a good thing, BUT, your midwife also needs to be safe and ethical, and I would have my doubts in this situation. Things might be totally fine, but I think you owe it to yourself to ask a few more questions. 

Congrats on the babe! :D


I agree with this as well, and a similar thought occurred to me--does your midwife bring her own assistant? Is the doula requirement a blanket requirement for all of her clients, or is she pushing it because of your specific situation? "Standard" doula training programs don't really prepare us to be a midwife's assistant, though obviously there are many excellent doulas out there who are qualified to fulfill that role as well; I, for example, do not have current CPR certification or NRP certification. I would definitely be concerned if the doula requirement implies that the midwife doesn't have skilled backup of her own.

 

Talking to doulas who have worked with her may also help you solidify your feelings about your midwife, if you're still at all uncertain. Having an outside observer at your birth can also be valuable for you to process the experience, and most doulas do have a postpartum visit as part of their care package with clients.


Stay-at-home mama married to my best friend of 10+ years. lovestory.gif  Aspiring midwife loving parenting our beautiful babyf.gif Julian, born 5/24/09. Expecting a second bean in late July 2012!joy.gif
  h20homebirth.giffemalesling.GIF  intactlact.gif  namaste.gif

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#5 of 15 Old 12-05-2011, 04:17 PM
 
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I have been a doula for 5 years and have started attending births with a hb mw about a year ago, so I think I have a view of the situation from both perspectives. I wouldn't assume that the midwife is wanting the OP to have a doula for any reason other than support. As a student, I have seen the benefit of having an experienced labor support person at a birth, especially with a first-time mom. I have had to step in to do labor support when I really was there to learn or to assist because the mom really needed a doula there and didn't have one. I can understand why a mw might require a client to have a doula if she doesn't do labor support, which many don't. A midwife's job is to monitor your health and your baby's health and respond to complications should they occur. If you are really in need of labor support that your husband turns out to be unable to provide alone, she will feel she needs to step in and do that. Believe me, you don't want your midwife to have been up doing counterpressure and massage for 12 hours when it comes time for her to manage an emergency situation.

To the OP: those are all questions you should ask potential doulas, but imo, a good doula will step in (or not) only as needed and respect that some mamas really don't need her there for anything other than fetching water, heating up towels, etc. Usually doulas are pretty good at reading nonverbal cues, but if you want something or don't like something she's doing, you should definitely speak up. I agree that the mw probably has a list of doulas who are compatible with her philosophy of birth and who are experienced with home birth. Maybe start there and speak to a few of those doulas and then branch out if you don't find someone you are comfortable with.

Fledgling midwife on hiatus, Wife to B, mama to C (c/s ribboncesarean.gif 12/04) and S hbac.gif (12/07), angel3.gif m/c (3/12) and expecting another bean 6/13 stork-suprise.gif.

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#6 of 15 Old 12-06-2011, 09:30 AM
 
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Quote:
Originally Posted by quantumleap View Post

Doulas come in all shapes and sizes, and it is very likely that you could find one who is just the right mix of intuitive and perceptive to give you the sort of support you're looking for. It depends on personality, and also on good communication before the fact.



exactly... if i'm not needed, i'm not in the room... i'm not there to intrude or replace a partner... i'm there to support you how you want to be supported, whatever that may look like...

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#7 of 15 Old 12-10-2011, 06:56 AM
 
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I would be more inclined to hire an independent doula rather than one who works for the midwife. You want a doula to work for YOU and your needs-not follow someone else's agenda-not that your midwife has one of course!

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#8 of 15 Old 12-11-2011, 03:00 PM - Thread Starter
 
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Thanks everyone!  These are REALLY great insights and suggestions.  Particularly has me thinking about going the route of hiring my own doula rather than using the midwife's doula.  I contacted one of the doulas my midwife works with though and have a consultation set up with her for the week I'm back in town.  I've expressed these thoughts to her via email so she understands where I'm coming from.  I'll just have to wait and see how our meeting goes.

 

To address some of the other questions...my midwife doesn't bring an assistant to the birth, but she does have a "backup" midwife who would attend if she was with another birthing woman when I go into labor.  Is it unprofessional for her to not have an assistant?  I wasn't aware it was necessary, though it does sound like it would make it easier for her.  @QuantumLeap, what is NRP certification?

 

She only asks first-time moms to have a doula.  I didn't ask why, I just assumed it was because there are more unknowns the first time around and maybe she finds that a woman having a doula there frees her up to focus on the safety of mom & baby, rather than tending to all aspects of emotional/labor support. 

 

Thanks again for so much food for thought!

 

xo

A

 

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#9 of 15 Old 12-11-2011, 03:01 PM - Thread Starter
 
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Oh, one more thing...if any of you have suggestions for doulas you know of/have worked with in the NYC area, could you PM me?

 

Thanks again!


A

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#10 of 15 Old 12-12-2011, 10:19 AM
 
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eeep! She NEEDS a second midwife. The second doesn't attend the whole birth, usually, but the idea is that if you're bleeding out and your baby is born and has trouble getting going, who is she going to care for? You? The baby? You both need immediate help, and she's only got one set of hands. There are lots of solo practice midwives, and the chances that something are going to go wrong are low, and then lower again that both you and your babe are going to need help at the same time, but you need to go in to these things with your eyes open. I've lived in some places where the "second" is simply a lay person, like a doula, who gets some additional first aid training (NRP= neonatal resuscitation and advanced CPR) because the midwife has a solo practice and there simply aren't any other midwives around to act as the second. I'm guessing she uses the doula as her second, even if not officially. 

 

I've planned both of my own births without the traditional two midwife set up. There weren't any midwives available, so we weighed risks and preferences and chose to stay home without midwifery care. It's not that I think birth is dangerous. I'm supportive of UC'ing. I just think that, when most women hire a midwife, they're hiring her for support and also for peace of mind in that they're trusting their midwife to deal with any unexpected emergencies that might pop up (even though, chances are, there won't be any). If your midwife is, in fact, NOT prepared to deal with unlikely emergencies (ie: mother and baby needing help simultaneously), then you need to be aware of that and make your decisions accordingly (either you're comfortable with that set up or you're not!).  


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#11 of 15 Old 12-12-2011, 12:33 PM
 
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I don't know how I feel about this…I think having just the midwife there is totally fine--but maybe that's just because I trust birth so much. But I'm not as familiar with this because around this area most midwives have apprentices that attend births with them for extra hands and training. I personally wouldn't worry too much, but I would be sure that you have a doula you feel comfortable with. A doula "jumping in" when you need her and stepping away for you to have alone time with your DH is what doulas (should be) all about. I hope you're able to find someone you're comfortable with. I personally work on a combination of 'reading' mom and asking her directly what her wishes are. I would recommend you set up some sort of 'signal' with your doula that will let her know what you want to be alone and then simply call her over or have your DH let her know when you'd like her help again. 

Best of luck with your homebirth!

 


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#12 of 15 Old 12-14-2011, 07:01 AM
 
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It might be helpful to ask your midwife to help you get in touch with 2-3 recent clients of hers who have had a doula at their homebirth, to find out what their experiences were. That may give you a better understanding of whether the doula is in this situation more of a midwife's assistant; or really there to focus on your physical/ emotional comfort to free up the midwife.


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Homebirth Midwife, Birth Doula, Postnatal Doula, Night Doula, and Doula Trainer

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#13 of 15 Old 01-14-2012, 12:12 PM
 
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You have some very good questions.  All those concerns depend a lot on the doula, her experience level and her general respect for the couple.  It usually is not hard to find a doula who really wants to be supportive and is extremely intuitive about the couple's needs.  But, as others have pointed out - doulas are not trained to help out in an emergency.  You could find a good monitrice - they are rare, but could be valuable in this situation.  As to the feeling of a doula being one too many - a lot of women feel like that, but having been a doula at many home births I can tell you, the doula's job is NOT the same as the midwife.  Your midwife is very likely to sleep while you're in early labor - even in active labor...a doula is pretty much like a 3rd arm to you and your husband.  She litterally labors with you and takes a huge load of pressure off your husband - men tend to have a much easier time being emotionally available to their wife and new child when there is a doula there to support and encourage his involvement.  I've worked with couples that really only needed me there to help the dad get going as labor support - and I've been at births where that was the expectation and the dad really needed my help the whole time.  The whole family is better off with a good doula.  Just be sure you really connect with her and she is willing to take the time with you to establish a bond and a comfort level before you're in labor.  I think your midwife is smart to insist on a doula for first time moms - it is such an important time to have the best support and so many moms regret not having good support that first birth.


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#14 of 15 Old 01-14-2012, 12:15 PM
 
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OH - and I have had to work as the midwife's assistant more than once - if your doula is willing to follow instructions from the midwife she will likely enjoy the experience.


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#15 of 15 Old 01-14-2012, 12:17 PM
 
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one more thing...

I heard about a couple that hired a doula for a hospital birth - and had her sit outside the room in the hall - mom would come out every hour or so and ask doula a question...go back to labor with just hubby...being flexible is all part of the job!!!


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