Tight Budget Homebirth, Should I get a Doula? - Mothering Forums

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#1 of 11 Old 05-16-2012, 12:34 PM - Thread Starter
 
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I'm doing my first homebirth in November with my first baby and not knowing what to expect at all, I was wondering what you guys think about whether or not I should get a doula. I'm on a tight budget because of our financial situation so I don't know whether a doula a really good thing to have since it is my first baby. What do you guys think? Should I just stick to my midwife and her assistant or is it a doula definitely worth investing in? Also, what do you think about having a less-experienced doula for half the cost vs. a very experienced doula charging double?  

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#2 of 11 Old 05-16-2012, 12:41 PM
 
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I wish that I had a doula for my first.  I ended up transferring to the hospital for pain reasons, not because there was anything medically wrong with me or the baby.  I was too far along for them to do anything for the pain in the hospital so I ended up with a natural vaginal birth in the hospital.  I truly believe that if I would have had a doula (i.e. someone's whose only job was to support me and help me have a homebirth) I wouldn't have transferred.  The transfer ended up costing us way more than the homebirth and we still had to pay the homebirth midwife because she was there.  You need to remember that the HBMW is there to make sure that you and the baby are medically ok.  It's not her job (or her assistant's job) to be your labor support person.  They will certainly help you through labor but it's not their main focus.  My husband and mother were also present at the birth and were pretty much useless as support.  I think that the $500 or whatever a doula costs in your area is money well spent.  I would prefer a doula who had some experience if it was my first birth but I think anyone whose job is to be there to support you and is a neutral third party would help you immensely.  It will save you money in the end if you can avoid a transfer that way. 


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#3 of 11 Old 05-17-2012, 07:15 AM
 
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Well, as a homebirth midwife, I certainly do everything a doula does plus so much more! I used to get insulted that someone would hire a doula as well as my homebirth team, but found out that many midwives do not practice as I do. now as I get older & have less mobility & endurance, I do appreciate having a doula or LMT at the birth w me. But  when I do, I consider them part of the team, & split my fee with them accordingly. I still do not expect the client to pay extra for what I  consider to be part of my job.
  On the other hand, every hospital birth, should have a doula!

So I guess my answer to you is to ask your midwife whether or not she considers the labor support of a doula as just another part of her job, or whether she expects, if you want that, you will be responsible for hiring her separately. 
 

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#4 of 11 Old 05-17-2012, 09:05 AM - Thread Starter
 
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Thanks for your replies! 

Quote:
Originally Posted by MarleneCPM View Post

Well, as a homebirth midwife, I certainly do everything a doula does plus so much more! I used to get insulted that someone would hire a doula as well as my homebirth team, but found out that many midwives do not practice as I do. now as I get older & have less mobility & endurance, I do appreciate having a doula or LMT at the birth w me. But  when I do, I consider them part of the team, & split my fee with them accordingly. I still do not expect the client to pay extra for what I  consider to be part of my job.
  On the other hand, every hospital birth, should have a doula!

So I guess my answer to you is to ask your midwife whether or not she considers the labor support of a doula as just another part of her job, or whether she expects, if you want that, you will be responsible for hiring her separately. 
 

MarleneCPM, that's really amazing that you do the job of the doula as well. From my understanding, the midwives in this area say that they are responsible for the health of the baby more than anything and that having a doula there would be more emotional and physical support for the mother. My midwife was telling me that for example, she lives quite far from me, so perhaps the doula might be able to come much early on in the birth whereas the midwife would be there when I was closer in labor to delivering the baby. Also, the doula would assist in things like massage, comforting the mother, making sure she's eating, helping out, etc. I certainly do wish more midwives acted as a doula as well, just doesn't seem like something midwives here do much anymore. Since the doula does have a different role than the midwife in my case, would you still recommend getting a separate doula or is it more of a luxury?

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#5 of 11 Old 05-17-2012, 02:17 PM
 
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Originally Posted by AndtheStars View Post

The transfer ended up costing us way more than the homebirth and we still had to pay the homebirth midwife because she was there.  You need to remember that the HBMW is there to make sure that you and the baby are medically ok.  It's not her job (or her assistant's job) to be your labor support person.  They will certainly help you through labor but it's not their main focus.  My husband and mother were also present at the birth and were pretty much useless as support. 

 

Wow, what a crummy experience for you! I am so sorry your midwife failed you in that way. I would not be paying our midwives the thousands of dollars it costs if I thought that they were only going to be looking out for me "medically". 

 

 

Thanks for your input Marlene! Good to know.  I completely agree Sufimama on touching bases with your midwife about this. 


 

 

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#6 of 11 Old 05-18-2012, 11:31 PM
 
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I really think it depends on the midwife.  I got recommendations and did interviews for ours and specifically chose one who is more doula-like in addition to ensuring safety.  In our area, there are a range of midwives from some who are much closer to a typical medical model to some, like mine, who are just as good at keeping you safe but really enjoy the support aspect.  Honestly, in a hospital the safety part would be done by nurses and at the last minute a doctor who would mostly ignore you anyway.  I imagine it's a lot more work and more exhausting for midwives to do both but still possible.  

 

The other thing to check on is whether or not your midwife would accompany you to the hospital if you were transferred.  Mine also works as a monitrice (which is kind of a highly trained and expensive doula) and would continue in that role upon transfer at no extra charge.  Some doulas have a sort of doula insurance program where you pay a small amount as a deposit and if you decide you need them you can call and pay the full price and get their care.  Until we found our current midwife, that was my plan in case of transfer.

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#7 of 11 Old 05-19-2012, 06:12 AM
 
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I thought the fishy pool was adequate and deep enough, but not as nice as a legit birth pool by a mile. If it meant no water birth I'd snatch the fishy pool up real quick. I haven't found the support of a MW/HB OB/their assistants to be in line with that of a doula at all. I mean, there's encouragement, but their role is not the same as that kind of focused support.  


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#8 of 11 Old 05-20-2012, 06:56 PM
 
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can you have your friend be your doula?  my friend acted as mine and it was really nice (and free :) )
 


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#9 of 11 Old 05-22-2012, 01:34 PM
 
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My experience is similar to the pps...  around here (and I confirmed this with several MWs this pregnancy), the MWs duties do not include early labor support.  I wound up with a very protracted labor with my DS and no doula.  After 3 days in labor I called my BFF to come lend a hand so that my DH could get some rest (he refused to lie down and leave me alone to labor).  My MWs didn't come (to stay) until the 4th day of labor, and baby was born on the 5th day.  While I'm very much not planning on another 5 day labor this time around, I made sure to hire a doula who could be support for a protracted labor, JIC.  Because after such a long labor last time, my brain was mush on thinking of other things to try, my DH was mostly useless in that matter, and my BFF had no experience with birth.

 

I was less concerned with the doula's experience.  Yes, some experience please, I don't want to be the very first birth, but I did hire a student doula.  I was sure to discuss the problems we had last time and to discuss the possibilities of a protracted labor with her (one of the doulas I interviewed made it clear that she would have to go home after attending 1 day - she wouldn't be able to stay longer than that because of family/work obligations).  Ultimately I think someone who is passionate about birth and has a few under their belt and has done lots of reading is going to be sufficient for my needs.  And since my doula raided my birth library as soon as she learned I had one, I'm good with my choice. 

 

Ultimately though, I really think you need to talk to your MW about what her role is, so you can figure out whether one is needed. 

 

Oh, and also you need to differentiate between a labor doula and a pp doula.  For a labor doula, I'm less concerned about experience than I am with a pp doula - just because BFing support is so important.  Again, something to clarify with your MW - how much BFing support can you expect from her. 


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#10 of 11 Old 05-22-2012, 02:39 PM
 
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Interesting all the different experience with HB midwives. I think that emotional support of the mother should be part of the Hombirth Midwifery Model of Care. I kind of thought that's part of the whole deal. Honestly, if my MW told me she isn't there to support me during labor for all that that means, I think I'd find a different midwife. I've had two homebirths (my first ended in transfer/non-medicated vaginal birth) and I can't see there being room for a doula at either birth. What we could have used at my last birth was some extra hands after the birth. Even with a MW, an assistant, my DH, sister-in-law and mother to help, we still could have used a couple more people for support cleaning, breaking down the tub, preparing food, caring for DC. I can see wanting a doula for early labor, and especially if I had a really long labor like the PP. In that case I think a new or student doula would be fine. But, still, I kind of think of doulas as labor support for the hospital setting. If I didn't have the money I would skip it. 


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#11 of 11 Old 05-22-2012, 04:09 PM - Thread Starter
 
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Thanks everyone for all your replies! I went ahead and interviewed the student doula and feel confident that she'll do whatever she can to do the best job she can. She's also flexible about fee because of our tight budget so hopefully that works out perfectly!

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