Dear Doulas; Mars, Lulu, Klaw, hertsandessex, jofeb04 your expertise is required if you wouldn't mind....

[3Ddonut]

As some of you may remember, I am going to act as a Doula for my friend in Jan. I was hoping to have completed a DoulaUK recognised course by then, but there is no way that I can by that time. I was hoping that whilst doing the course some of my questions and concerns would have been answered, so that's where you lot come in!

My main query is what happens when something goes wrong? baby in distress, emergency C section, extended labour etc? What is a doulas role there? how can we support Mum without being in the way? would we be allowed to accompany Mum to a c section?

Do you meet with your Mum's beforehand? (obv. you need to know their birthplan and such) but what type of things would you discuss with them? and is one visit enough or do you visit a few times?

and lastly, for now, my client is very concerned about lack of oxygen at the birth causing disabilities, (she's worked with kids that this has happened to) I've tried to settle her, look at the rate of incidence etc and that these days medicine has advanced but do you have any other suggestions???

Thankyou so much for taking the time to read this!!!! Wouldn't it be good if we could all get together???!!!

Is no-one around tonight then??!!!!

Hi 3Ddonut!

Well, my first two (VBAC) clients have ended up with CS, the first because of ruptured uterus, and the second was an elCS after scaremongering about baby's high HR.

At the first, she laboured well for a few hours at home and it was literally as soon as we got to the hospital that the shit hit the fan! It all happened so fast that although I tried to offer support with holding the CTG belts in place, then asking if a GA was the only way (yes) and if her dh could go with her (no).

I had been very conscious of not getting in the way and I do believe that I didn't in any way.

With the second I wasn't with her for the elCS but had spoken to her on the phone for more than an hour at a time twice on the day before, firstly when she was supposed to be going to hospital to query the FHR (they didn't even scan or do CTG!! FFS) and in the evening afterwards.

We both have expressed a regret that she felt she could not grab a few minutes to talk to me before the CS the next day. She is now grieving for the loss of her HWBAC but made the right decision to elCS as the cord was wrapped round baby's neck

I have also been at the home water birth of a fellow Doula, was upstairs with dc when she birthed but we piled downstairs immediately and I was able to help her dd understand stuff while dh was in charge of ds1, and mum sat on sofa with ds2 giving him his first feeds. I tended to try to shrink into background so that mum didn't feel swamped and the mw could finish up their paperwork and tidy away their things.

In the Birth Preferences of both clients they had expressed a wish that in the event of an unplanned CS that both their dh and I would be with them and it was 'agreed' by the HCPs, but it just didn't happen that way. Your friend could make sure that her Birth Preferences state that dh and you both are with her in a case of an unplanned CS or instrumental delivery.

I met both mums at least twice before hand and spoke to them on phone and by email endlessly. I am also there as much as they want postpartum (as I feel very protective of them) although the first lady is not ready to let me in yet .

I'm not sure about your friend's worries about oxygen deprivation, maybe someone more experienced would help there, but have to say that babies are remarkably resilient and their brains recover and compensate extremely well.

This is a fear that you need to work through with your friend before labour as she doesn't need this in the back of her mind when labouring. After all you "have nothing to fear except fear itself".

HTHs

Thankyou so much, that's really helpful, her dh isn't going to be there, just me and her Mum. We skirted around the issue of unplanned c section when we last spoke as she is so frightened of it, a lot of people have told her horror stories about labour, as all of her peers already have a couple of kids with her being in her mid thirties. I've been concentrating on trying to make her see that it doesn't have to be that way and that labour can be an enjoyable experience, she did say that she's looking forward to labour the other day! but now she's latched onto this oxygen deprivation issue we're going to get our heads together for a firm birth plan in Nov/Dec she's due mid-Jan, and after all of this, I hope that my work committments don't scupper my plans of being there! (although I work in the hospital where she's going to have baby so should be able to pop down for a bit)

Thanks again for your help and love the halloween name!!!!! Best one I've seen (are you in that competition?)

Hi, don't concentrate on a 'firm Birth Plan' as that can lead to pnd if things don't go to plan. She must realise that she needs to be flexible and so I tend to call it 'Birth Preferences' and go into the preferences for most eventualities. Dyswim?

That way she will have some 'control' over what is happening and this makes things so much easier to bear if the birth is not quite what she hoped for.

Make sure that her mum is very included in this so that she can be an advocate for her if need be (especially if you can't make it on the day)

Can you suggest she reads Ina May's Guide to Childbirth? Have you got a copy to lend her?

Yes, of course you're right about the birth plan, with my first I was obsessive about it and after the birth I realised how uneccesary they were, dh knew the plan and that was that. I don't have Ina May's guide to childbirth, it's on my list of books to buy next, I have read most of spiritual midwifery. I would prefer to have read it myself before recommending it to her, I think but I suppose we could read it at the same time. Thanks for your help.

JoFebo4 - Over here!!!!!!

Hiya 3D
The main thing to do is discuss with her the fears she has well before the birth. By discussing this with her will allow her to say all hear fears/problems/worries etc, and this may be in one of your meetings.

With any emergency procesure, the main thing is just being there for her.

HTH

Thanks JoFeb!!

Mars, did I see you on a cake thread down there???!!!!!

3D.... email me on lovelymarslady at aol dot com

Just seen this.

mars, you've got mail

so have you!

3D rushes off to read (and needs an excuse to stop MN'etting cause she's going to work in half an hour!!!)

thankyoooooooooo