Doulas and midwives

[Hoonette]

Has anyone ever experienced problems with doulas and midwives working together? I'm thinking particularly about midwife-led birthing units where the midwives actually provide all the services offered by a doula.

I'm thinking of hiring a doula for my second birth as insurance in case I get transferred to the unit from hell (that is, the consultant-led unit). But I've been warned that the midwives on the birthing unit, where I am booked in to labour, might not look on this favourably.

I've just realised that sounds really harsh. Let me try and explain myself a bit better.

The birthing unit is really excellent and I agree with my friend (who works on this unit) that I wouldn't need a doula if I laboured there. So I would totally understand if the midwives felt a bit agrieved if I turned up with a doula - it look as if I didn't trust them to do their job properly.

However, I don't trust anyone on the consultant unit.

So my dilemma is: do I hire a doula, and risk annoying my midwife, and then not need a doula, assuming all goes well and I stay on the birthing unit?

Or do I not hire a doula, in which case if anything goes wrong and I am transferred, I am totally screwed.

Have name changed to protect my doula (who is on MN). I had a home birth. And I have to say, the doula didn't like the midwives, and the midwives didn't like the doula. After the birth both made negative comments about the other. And I do think the tension contributed to a lack of care from the midwives, and a distraction for me as they were giving opposing instructions at times - the midwives were correct, I think now, but it was difficult for me to work out who to listen to between contractions. If I did it again, I would have a doula, but only call her if I had to go into hospital (consultant-led unit).

I know lots of people say that doulas/midwives all get on fine. Just in our case they didn't.

and I predicted this in advance - when I mentioned doula to midwife at an antenatal she was a bit

I'm not sure why the midwives would view it as you not trusting them to do their jobs. The two roles are quite different. The doula's role is to support you - would the midwives feel miffed about you turning up with your partner as a support person? A doula is primarily another support person, and can give your partner a break and give him a chance to have a snack or whatever. Yes, a doula can also help "fight your corner", but hopefully in the midwife-led birthing unit she wouldn't need to do any advocating and could just concentrate on giving you back rubs or holding the drinks with the bendy straw or whatever.

I had a doula last time round, even though I was in a midwife-led birth centre, and the midwives were fine about it - they pretty much expected it actually. And my doula saw it as part of her job to have a good working relationship with the midwives (she even advertised in the waiting room there!)

Perhaps you could ask any prospective doulas if they've supported women at that particular birthing unit before, how they related to the midwives there, etc, before hiring them?

hmmmm, namechanged, it sounds as though that was a one off thing,. a clash of personalities.. i tend to follow the clinical lead of the MW in terms of echoing any instructions,if any are being given...if somethng is being proposed i know my client does not want, i will pose it as a question to her or her DH, so that they can speak up,if they can , or we can refer to the birth preferences together. no birthing partner, whether a doula, sister, mother , friend etc.. should be competing with the MW or getting in the way, ideally they should complement each other

unless you know the midwife who will be in the birthing centre, and you go through your birth preferences with her, and she is going to stay with you for the entire labour and delivery, then you are still going to get real benefit from a doula IMO

do the MWs understand that a doula is not a replacement but an enhancement and compliment to the care provided, rather than someone pretending to be a clinicially skilled HCP?

Thank you all for your thoughts.

I myself am convinced that doulas are hugely beneficial, and I was surprised that my midwife friend wasn't supportive of the idea.

I think Drama's idea of asking doulas if they've worked at this unit before is great, and will definitely do this if I do hire one.

I think some midwives feel aggrieved at the idea that a doula is there to provide emotional support when they see that as key to the midwife's role. I can see the logic of this. But then most women don't get one to one support in labour on MOST maternity units.

I had a friend act as doula, plus an IM at my homebirth for much of the time. My friend walked me round the block, massaged my back and told me to stop being so frightened (I needed to be told this) ! She was great. My midwife sat, watched, waited. That's what I think a good midwife does a lot of the time.

I have had a couple of negative expereinces, one at a homebirth and one in the hospital. (Hoping namechanged, that i was not your doula as i would hate to have a negative affect on anyones birth).

The one in the hospital i went to see the head of midwifery after to discuss. The one at the home birth was never discussed after, but i feel was to do with the midwives feeling threatened - which i don't understand as i am not there to deliver the baby, but to support my clients.

I feel I do my absolute best to intergrate with the midwife and my clients so that both know i am their to support my cleint, not interfere.

That is just 2 occasions on well over 30 births that I have attended.

Thanks, Hertsnessex. It's reassuring to know it doesn't happen often.

I think I might meet with a local doula and discuss her role at the birth, and whether she has had any problems with local hospital midwives.

Thanks to everyone for their help.