The doula question

[ohthegoats]

I am dithering about whether to hire a doula or not. I've met a nice one who I'd like to have there if I go ahead with the idea, and I need to let her know asap, but I'm dithering. Sorry - this is long winded.

I'm consultant led, and haven't ever met a local midwife - I don't know anyone by name for example. I've never met the same midwife twice as part of my consultant visits either, on one visit I saw 4 midwives for about 2 minutes each for different things, and for each one had to re-explain my medical issues.

I am factor V leiden (a clotting disorder), and on heparin injections and aspirin. I'm also 40. As far as I understand, my birth preferences are limited by these things, but CS is worth avoiding since the heparin would have to be managed, and personal preference would lead me towards avoiding induction since it seems so often to result in interventions. I'll be on the main labour ward, so limited access to birthing pools, and no likelihood of a known midwife in attendance, with a higher than average chance of induction on a given date, and consequently epidural and other interventions. I have a fear of being trapped, so want to be able to move during labour, and not confined to a bed. Obviously I want to get things going on my own as much as is possible, and also to stay at home for as long as I can to avoid any early stage intervention.

I'm not sure that my partner 'gets' this. Maybe no men do, they don't have to do it! But he seems to think everything will be 'fine', and whilst suggests he understands my fears and preferences, he keeps saying 'just take the drugs and be done with'. This is a man who didn't know that you bleed for a few weeks after childbirth, and can't work out why sex wouldn't be straight back in the equation.

I just feel that I'd like some additional support. But the support is going to cost me £800. She will provide antenatal visits, be on call for the birth, and be there until I'm feeding (if the circumstances allow) after birth. If I need to go to theatre, and partner doesn't feel he can do it, then she'll come with me for that. I expect I'll be panicking if that happens, I'd like a soothing presence! She also does one post natal visit if you want - can help with stuff or just socially.

Can someone please give me some opinions as to whether their doula was a positive or negative addition to the whole childbirth thing, I need some help to persuade me one way or the other. Part of me thinks it would be brilliant, part of me thinks 'it's just one or two horrible days, you'll get through it and over it... '

I would go for it if you can afford it.

I didn't for DC1 and wish I had. It was long, so long DH needed to rest/nap, when I was then alone. MW's came and went. I would have loved the additional back up.

I had them for no.2 and no.3

I don't think it's 'a day or two' either actually. If you feel out of control, or panicked, or that things happened a certain way because you weren't strong enough to question/push for them, that can have a long emotional effect. The exact same birth can be a positive experience with the right support.

Also, if your partner doesn't 'get it', someone hwo does and who will make a big fuss of you might help him get perspective. The one on one antenatal would probably be useful for him too.

I have not yet given birth (fx its imminent!) but I have hired a Doula. For me, at the moment, its been a really positive experience. She has met with me three times so far (for a couple of hours at a time), and generally just chatted through stuff, provided me with various resources to research on questions / options and has spent time with myself and my DH to go through stuff as well.

Continuity of care and having a person in the room who is calm and objective I think is important. She is very experienced and I am confident will be a calming voice of reason should we need it - both for myself and my husband who is new to this all as well.

Its not for everyone, but when you say part of me thinks 'it's just one or two horrible days, you'll get through it and over it... for me, although a few horrible days, it could have such a long lasting affect on myself, my relationship or even my bonding with our child that I want to do everything that I can to make it as positive as I can. I know that a Doula wont guarantee a perfect birth, but I think will facilitate me being able to confident that what ever the way the birth goes that I wasn't forced or pushed or out of control.

I would recommend hiring a doula. She was invaluable at home with me in early stages, DH slept and she stayed with me, she read my breathing and contractions really well and pepped me up when I went to hospital and was sent away again as well as liaising with the midwives for me. Later when it all went pear shaped (DS in distress) she kept me and DH very calm on way to theatre and in recovery got DS to the breast when I was stills bit out of it.
DH was very supportive in an emotional sense but was useless with more practical stuff and knowing how to help me. Whilst it was not the birth I had hoped for I am very glad she was there at a very difficult time.
I think from what you say of your DH a doula would be really useful.

If you can afford it, absolutely yes. I had one for dc1 and have one for dc2 due any day. It's just a lovely supportive relationship that extends well after The Birth.

Good luck with your pregnancy and birth, it sounds complicated so I hope everything goes to plan

Totally agree, yes if you can afford it.
Doulas rock!

I would also recommend using a doula, especially if your partner doesn't really get what goes on in pregnancy and childbirth. I had a doula for my 38-hour labour (induced at 42 weeks) and she was brilliant- just so calming and there with me the whole time - not like the midwives who only popped in every hour or so. I slept for only 1 hour in the entire labour so was a bit of a zombie by the end but she helped me get baby to latch on etc.

My husband was able to go and a good nights sleep so once baby was born he was ready to jump into action.

If the cost is difficult for you then look at a student doula who would be a lot less - about 250-350. My doula was a student - though a 40-something mum of 4 - so someone with real life experience.
We also had her come round post Natalia and that was brill. I was in bits so she showed my husband how to do skin to skin, bathe baby, put him in car seat properly, cooked us dinner when we had been back at hospital all day.
Really worth it especially if you don't have your own mum around to help.

I would be careful to ensure that she is fully alongside your choices about intervention/CS etc. So supports you and does not railroad you when vulnerable.
Your DH also needs to be on-side with her if he is present as you do not want them arguing at the delivery
If the above works then good use of the money

OK, thanks. On reflection I decided to go for it. I think that if I have a dreadful time of things, for whatever reason, then I'll regret not spending what in reality is 'just' £800 over the lifetime of a mother/child relationship.

I had a doula and I can't recommend it enough. £800 seems like a lot of money - well let's face it it is a lot of money - but it's the best money I've ever spent. Up until my doula arrived my birth was absolute hell I was left almost completely alone as the unit was very busy. I had completely lost control and was just alternately screaming and sobbing. XH was next to useless. But as soon as my doula walked in the room it was transformative she had calmed me down in a few moments and from that point onwards I coped fine. The physical sensations can't have been any different but having someone there to support me who had positive energy and was reassuring made an incredible difference. She also did massage and aromatherapy which to my surprise I really responded to. After the birth she took a lot of photos for us and even went and topped up the meter for the car! My only regret is that I didn't call her out straight away and I endured the first few hours of labour without her. I didn't want to call her for a false alarm but that was stupid; if I did it again I'd get straight on the phone to her from the first twinge! Good luck OP whatever you decide to do.

Just remember they have no medical training and you should not follow their advice above the doctor's.

Yes Rosh - that was what was worrying my boyfriend I think. But I've explained to him that it's more about helping me/us have the confidence to stand my ground when I'm feeling a bit pushed into something, or to understand when something is feeling 'pushy' compared to 'necessary'.

Make sure your boyfriend understands that they aren't there to replace or assist the medical side, so the fact that they aren't trained isn't an issue.

I usually describe it that, years ago, many women would have had their mother, or another relative who had seen/had a lot of births with them. It's that role. Someone a bit experienced, but ultimately there as emotional and practical support, not medical.

Also, a good doula won't attempt medical advise. What they might do is, for example, if you are being pushed towards having your waters broken, say "Goats, you said that that was something you wanted to avoid. Do you want to talk a bit more about the pros and cons and what happens if we wait a bit before you decide?"

I think a doula is brilliant given modern hospital care.
Looking back my priority for birth was to have my sister therefrom beginning to end, when she was there I felt fine, as long as she was there. She is also a mw which helps. But it's that continuity, IMO, that is so precious, it's actually priceless. I think giving birth to a child is like trying to win Wimbledon, it's an act of faith and self belief to get through that level of discomfort and surrender to it in order for labour to progress. When you have your coach with you : I think their touch and confidence in you is what makes labour possible for many of us. Obviously only in births where there aren't massive issues which need proper intervention.
A great mw can do this but her shift will end and she may need to go just as she's about to help you get through a stage. I mean midwife means with wife I think? The key word is WITH!!!!
So my sister got me through my first birth and I was fine except when she left me to call dh... Who was not indispensable, bless him. Good for him to be there though.
So big sis could not make it for birth number 2 so I got a trainee doula. Now she was lovely but during the birth she had some very stinky hair product on that made me want to
Projectile vomit her directly into space for ever.
BUT when I needed stitches she held my hand so I could relax and cope with the discomfort. That was priceless.
But for the birth, she smelt so strong I threw her out of the room. Doula basics: women in labour don't need you to smell like a coconut lime explosion.
But women in labour need a coach because the system might take yr mw away just when you need her.
So some kind of lovely bland smelling warm loving relative, mate is great . If you have the funds a doula is fantastic alternative as long as you feel really in sympathy with each other.

I remember in the period leading up to the birth thinking what exactly is the Doula actually going to do? Just sit there? It was only when I was actually in labour the time realised what a difference it made just having someone there with me in the room. The midwife was coming in about every 40 minutes to take the baby's heartbeat and write it in my notes. She was very perfunctory about it; she didn't touch me apart from with the doppler; she was just in and out - but what a difference it made for the few moments she was there I begged her to stay for a bit longer but she said she couldn't.

XH was freaking out and panicking as much as I was btw so he was no help and not for want of trying; he needed calming and reassuring too! He also says it was the best money we ever spent.

It's the physical contact isn't it? A hand held by someone who believes in you, fabulous.
I had nothing for birth number 2. Vile mw, doula too hair product smelly to help so I gave birth sort of on my own, really lonely work!

Well, since I made the call I feel more relaxed. So it is already worth some of the money!

For me the biggest thing is about consistency of person, for both me and the boyfriend. Since I posted this question, I've had another appointment at the consultancy unit, seen another 3 different midwives from last time, and a different consultant. The only consistency is the receptionist on the front desk!!

I'm glad boyfriend will have someone to keep him calm (he might not need it, but I don't want to risk him being panicked, because that will just panic me too), and she's really nice. All good. Feels like the right thing to do.

Glad you've made the decision. I had a doula for all 3 of my births and both I and my DH found it fantastic. It takes more than one person to support a birthing mother IMHO.

One part that was great for me was that after the birth, DH held the newborn DC, and the doula fussed over me, getting me my tea and toast the way I wanted it, helping me to the shower, and with DC3 supporting me through a frankly very unpleasant manual afterbirth removal.