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

[pupuce]

This must be the day ...
The independent and the BBC are featuring the role of women's birth partners.... it makes for interesting reading... maybe some of you will find it ebatable of course

I am biaised I know

ebatable? You can buy doulas on an online auction site?

I found it really interesting, sent it to dh (because I've been pushing "what a great idea it would be to have a doula this time around" to him since I've found out I'm pregnant). He immediately said the answer was obviously he should disappear to the pub as soon as I go into labour... sigh.

Saw this today pupuce, though to of you.

Had my best friend and my mum with me.

Personnally I think if you can take mum, sis or best (girl)friend... you should ! And if that isn't possible and Dh/Dp isn't exactly sure of how we will feel (or knows!) or if the mother is particularely keen on a specifc outcome (usually but not exclusively) a "natural" birth,.... then doulas are a "new" option.
There are a few mumnsetters who have had doulas and I am aware of at least 2 who are booked to have one in their upcoming labour...
So we are yet to hear more "real" accounts of what they thought !!!

Pity there aren't any in Switzerland - you don't fancy busman's holiday Pupuce?

Where are you in CH?

We've discussed this elsewhere, but could I just note that the journos involved have really misreported this story.

The story is about the benefits of Doulas - undisputed - they're good news, for mother and father alike.

BUT - they've written it up as a 'get rid of the dad' story - in the indie, the journo claims that no on has bothered to find out whether having dads in the labour room benefit women.

The answer is yes - having your partner in the delivery room is likely to mean less intervention, less pain experienced and a more positive birth experience than if he is not there.

These stupid journalists have written it up as if there's a choice - either the dad or a doula. It's crap - you can have both, and you'd benefit from either/both. Doulas are very keen themselves to get fathers involved in supporting mums, and they put fathers at ease.

We're very irritated by this journalism, and the Independent will be printing a response letter from us by Thursday. We're also trying to get Women's Hour to set up a debate.

But please don't take the headlines seriously - kicking dads out of the delivery room will NOT decrease your chances of a caesarean, it will INCREASE it. The best scenario is to have your partner and a doula.

I've said enough now.

Near Basel

My BIL lives in Nyon (near Geneva) and I discovered that there is a doula in Nyon... amazingly !

When are you due

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.

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

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.

SueW - I think the idea behind a doula is not just the labour though.... a lot of my work is about supporting a woman during her pregnancy and postnatally. Even if you had a fab midwife in hospital you still don't know her when you turn up! She is a complete stranger and is likely to be unaware of some of your concerns/fears (birth plan or not). She does labour day in/day out. And I hasten to add I know some fab midwives in hospital (Mears being one of them).

Or are you suggesting that our AN midwife followed us in the labour ward and then postnatally - like what independent midwives do ?
If so - I agree but that's a LONG way away in a strapped for cash NHS!

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.

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!

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?

Thank you for the heads-up Tinker - I did listen to it - thanks to you !

Monkey - I am inquiring for you. The costof a doula varies quite a bit from country to country and in the UK from doula to doula. A very rough idea would be between £250 and 500 - it may be lower or higher - I have NO clue for CH. You usually get a few antenatal visits/calls at your house - your labour for however long and 2 postnatal visits.

Nyon is between Geneva and Lausanne. But I wasn't thinking of her.

thanks pupuce

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.

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.

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.)

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.

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.)