In today's independent - how to raise your chances of "natural birth"

I'm upset about it professionally laydees - we've worked for 4 years to change the perception of midwifery and health professionals about fathers to see them as potential sources of support and the opportunity to enable fathers to be to be more supportive - after all, they are with the woman for the entire process, and those dads who are engaged with positively are much more supportive and more effective in the labour room.

I'm upset at lazy journalism that casts the issue as a doula vs fathers issue (doulas good, therefore fathers bad), and I'm upset that a professor of midwifery, advising the media, doesn't know her subject.

It sets our work back, and we're busy and underfunded enough without having to deal with this kind of pap.

Look, I'm not in tears or anything! And as to whether I was any use in the labour ward, you'd have to ask my wife - she had an emergency caesar because of a placental abruption and rapidly rising blood pressure, but I don't think that was my fault!

Tinker! JJ, did you know I always check your smileys in case there's a link there?

It must be a wonderful job pupuce. I find it quite difficult to trust other women and building close friendships takes alot of time so doulas aren't really for me but I imagine for well-off, confident women doulas would be great. Being a doula isn't for everybody I imagine, to have that personality to make women feel comfortable and confident in your abilities must be quite a useful and necessary part of your vocation. Don't get me wrong pupuce I think doulas are not only useful but necessary to enable women to have the kind of birth that they would really prefer. Anything that encouarages natural birth is a good thing. Just probably not for me thats all.

Blimey, if a bloke could get 'SERIOUSLY upset' by a newspaper headline, don't think he'd be much use at a birth anyway

Theres not alot I can add to whats already been written but I have to agree on the important role women have to play in supporting others in labour. However, it depends on the individual. In my first labour I asked my mum to be there incase my dh decided that he didn't want to be there. In the end I sent my mum out as she was in such a state you would have thought I was on my death bed. My dh then helped me through the last stages. With my second birth I insisted that only my dh would attend but when it all started my dh proved to be a waste of space and irritated not only me but the midwifes and his mum who then decided to stay with me throughout the birth. This enabled me to have the birth I wanted, just through her support, reasurrance and encouragement. I can't imagine how a doula (a stranger) could of helped me through labour but if you don't have any female support then I think a doula would be a fantastic alternative.

Monkey -- a nosey question, but I had a quick ring around: what hospital are you using? You can email me, if you'd rather.

Tom yeah, I think fathers should be considered as support also and more education on pregnancy should be available and geared toward them. But you have to realize that most women (well, I did, at least) need someone throughout the pregnancy also. Preparation for the birth takes around 9 months... (Please don't take that the wrong way I agree with you! Just adding a bit more.)

Some points..

• I agree with SueW - the rise in use of Doulas is, for me, a symptom of an under-resourced maternity service - the woman's advocate? That's the midwife's job! From ante to post natal. Maternity services are thoroughly undervalued, underfunded and undeveloped in this country, despite beingn the only national service to interact with almost ALL parents at a critical stage in their lives. Women should not have to pay for a Doula, they should be getting a high quality service from their midwives. If the service was properly funded, and wages were better, I imagine most of the women working as doulas would go into midwifery.

• Yes - Michael Odent asked the question (although he only talks about fathers who have had little or no support and preparation for a support role, and then decides they're no good at it). Other research has found father's presence helpful: A number of studies as early as the1970s established that women report less pain, receive less medication and feel more positive if fathers are present. (See for example, Henneborn, & (1975); and Anderson & Stanley (1976) cited in in Lamb (1997a); a more recent reference is in Tarkka(2000)). The journalist (we have spoken to him) asked a "Professor" about this, who told him that no one had asked about fathers - I won't name this professor, but she obviously doesn't know her subject. We have contacted her to correct this.

• Interesting issue about women's/men's choice - I support the position that the women's choice in birth is paramount (balanced by medical imperatives in emergencies), but the pressure on fathers to attend the birth, from the culture and their partners, has raised another issue - if he doesn't want to be there, but his partner wants him to, whose choice is paramount? Some men don't want to be there, some do.

• The irresponsibility of the article in the Inde was the headline, which effectively suggested that women should get a doula and leave their partners outside. This is irresponsible, and could cause anxiety among women and their partners. It could SERIOUSLY upset some men who want to be at the birth of their children. It is also innaccurate - as the research shows that if the father is present, birth outcomes tend to be better.

• The issue of preparation and support for the role of birth partner is important - fathers get very little, unless they pay for NCT classes etc - if you are not told what roles you could play, and how you could help, and are then thrust into a hospital and are watching your partner in alot of pain, it's hardly surprising that alot of men are useless. But, even men who don't actively support their partners are reported to be helpful merely by their presence, by most women (by no means all though). 96% of all fathers attend the birth, and I think we're a seriously underrated and underused potential resource to women, and with a little thought, men could be prepared better and could become more helpful.

• If anyone is preparing for birth and wants some information specifically for their partner on how they can support them through the birth, then send them to our website (www.fathersdirect.com) and tell em to go to the NEW DADS section. If they still have unanswered questions, send them to the forum to ask other dads some questions.

Returning to the discussion: for me, it was important to have an advocate during the pregnancy and birth. This meant continuity of care and someone who was willing to make me a partner in the process and stand up for me when needed. Luckily both times that person was my OB and my husband was supportive as well.

I don't think the male vs female thing matters -- everyone should have reliable support medically and emotionally during pregnancy. There should be many options (doulas, midwives, doctors and husbands) available as there are many different types of women around. Ie, what works for one doesn't necessarily work for another. (I would have hated having a doula, but that is just me and my issues.... I can appreciate that doulas are wonderful support for many women in pregnancy.)

Monkey, have you seen The New Stork Times ? The woman who runs it is a former midwife and there is info on childbirth in Switzerland. I can't link the appropriate pages (darn frames), but you might try emailing Andrea Bader-Rusch (the editor and "a lovely woman" or so two people have told me) or some of the midwives on there who are closer to you. They might have suggestions for people in the Basel area. I can email them, if you'd like, also. (Figure that your plea might be a little more persuasive, though )

If that doesn't work, I've heard that our local Kantonsspital has doulas. I'm guessing that they are German speaking, but if you'd like, I can try ringing them and asking if they know any English speaking (or is German speaking ok?) doulas around Basel. My German isn't great (especially on the telephone), so I might mess that one up. I do need the practice speaking though.

Hope all goes well.

I am no totally sure about the findings of the research but I do agree that men are not always the best birth partner. I have thought that for a long time, especially when you have a partner in the corner watching the telly. My own DH and I have said that, if we did it all again, he would not be there. He found it distressing to watch me in labour because it was a different me. I was not distressed by labour at all (enjoyed it actually) but I paid him no attention. I was very confident in my own abilities and didn't feel I needed anyone particularly other than to help with the delivery.
Continuous support is vital in labour though. I do believe though that I have the ability to support women in labour as a midwife. I think though that my philosophy is that of a Doula to some extent. For me the ideal would be midwives who care for women like doulas. Unfortunately that standard of care doesn't always exist and I do accept that midwives cannot always commit to looking after a woman through her entire labour, whilst a doula can.

thanks pupuce

This is going to be discussed on Jeremy Vine show this lunchtime.

Tom -just re-read that Indie article. I didn't interpret it the way you have atll. He actually writes 'And rather than undermining the role of husbands and partners, they (doulas) may turn out to support them to'. Wonder if you're going to be on St Jeremy's show?

Yes, pupuce, I am suggesting that the midwife should be constant from the first antenatal appointment to the postnatal discharge.

This isn't really such a lot to ask. In my case, I only used hospital midwives. There were six in a team and I met all of them during my pregnancy. As it happened, all of them were involved in my labour and postnatal care in hospital too. I was discharged into another area so different midwives took over (but it was 140 miles away so would have been unrealistic to expect otherwise LOL).

I think it is very sad that many women locally come to know their community midwives very well and then have to go to hospital and have another midwife take over their care. IMO, those who are 'allowed' to opt for a home birth seem to be extremely positive about their experience of NHS care - from a birth story I am publishing in our NCT newsletter this quarter from a mum who had a home waterbirth:

'I would like to take this opportunity to thank the midwives involved for all their encouragement and support (I'm amazed they were available on the NHS).'

Wouldn't it be lovely if every woman have that as her standard service, not be amazed?!

I'm not advocating home water births for all, I just wish every woman could find someone (be it midwife or obstetrician, according to the family's needs) who would guide them through this life-changing experience, listen to them, help them reach decisions without judging them and discuss their options with them.

I'd better stop now! I could go on forever!

33 weeks today, so mid November, although no. 2 arrived 10 days early, so maybe 5 or 6 weeks (not that I'm counting or anything).

After months of umming & ahhing I think I've come down to the (hideously scary) decision of another VBAC. Now I just want to be practical and see if there is any damage limitation steps I can take.

How much roughly do doulas cost? Dunno Nyon, but Geneva is 3 hrs away, so would this be practicle?

JJ and pupuce, thanks for your help, I am interested, but not 100% definite, does thank make sence. Actually, my husband was absolutely fantastic at both births. He didn't really know what was going on (neither did I) but was/is wonderful, and am not sure how he'd react if I suddenly announced I wanted some woman to come in with me too.

I was irritated at the start by the Independent's assertion that 'but nobody has thought to ask whether their [fathers'] presence is helpful' since it is now four years since Michel Odent posed the question Is The Participation Of The Father At Birth Dangerous?

What I think is important about a birth partner is that they want to be there, male or female. In hindsight, having my husband in the labour/birth room was one of the worst decisions we ever made. He had maintained since the beginning of my pregnancy that he didn't want to be there but we allowed ourselves to be swayed by the media, the culture of the time and our friends and family that this was an important experience we should both share. Perhaps if it had been a 7 hour labour and not a 30 hour marathon ending in a c-section, it would have been easier for him. He wasn't at the birth anyway as he really wasn't prepared to come to theatre.

I still don't think that women should need to pay to have a doula there, regardless of whether their husband is around or not. There should be sufficient midwives properly trained in woman-centred care and normal birth who can help the woman and whichever birth partner she chooses to get through.

Oh dear, not "do you want me too" but "do you want me to" -- still bad grammar wise, but much better innuendo wise.

Monkey, I have a few people I could ask about this. Do you want me too? If so, contact me through the "contact another talker" link. Or, y'know, just post "Yes" and then remind me frequently. Do you read Mothering Matters? (I don't, but it might have some ideas...).

Oh, and if any mumsnetters would like their partner to be prepared for the birth, so they can be informed and supportive, I can help.

Near Basel