What is the point of a doula?

[ReallyTired]

I know that they are supposed to offer support before, after and during childbirth.
However they aren't qualified midwifes and don't necessarily have midwifey/ health visitor qualified.

So why would someone prefer a paid doula over an unpaid, husband friend or mother?

Honey... I learnt to type by being brainwashed by Sight and Sound!

thumbwitch - an acquaintance of mine is training as a doula (some year-long course) but has never given birth herself, so looks like there's some variation on that. However she's terrifying and never listens to anyone (I had to swear at her to get her to not practice palpating my stomach without my consent!), which has put me off doulas somewhat.

Have to admit, if my partner was one of various friends' partners, I'd certainly be looking for a doula of some sort to advocate for and support me. I'm lucky in that MrNC has seen labour before and he and other birth partners are used to advocating for me and dealing with medical staff, as am I, so hopefully should be OK...

a doula shouldn't do anything medical and palpating a stomach is not in our remit!

Don't let her put you off doulas (whether you use one or not). Lots of us are alright!

Maybe having given birth before is just preferable!
babs I'm curious as to what I said that made you think I had no children? there can't be many people on here who havn't (outside the work related ads etc)

Babs10000, I'm sorry that you had such bad experiences. Please don't feel a failure though .
When I had my Ds, for whatever reason(had spinal block after he got stuck), he was placed on my chest through the green theatre covers and taken from me within seconds too...he didn't go to the chest/breast until around 3+ hours after birth. He latched on fabulously and I fed him myself for 18 months. With Dd, she went skin to skin immediately and was put to the breast within a really short time. She has never been good at latching on and at 19+ months is still bfeeding, but is still poor at latching. I'm not sure that what you say is entirely right, but I do think it's a good thing to have skin to skin contact straight away and should be encouraged. I think having a friendly Doula is a fab idea(I've never had one)and reading MarsLady's letter brought tears to my eyes , I think that the support that you don't get from MW's is a shortfall that can be caught up by a good 'female companion' (Doula).
I was lucky, I had a fabulous MW both times(same MW 8+ years apart, care of the NHS), I was lucky.
I'm not sure I've really said what I wanted, but my brain is tired.

I had very good ante natal when I lived in Newbury. I was really sad that when I moved that I could not take my community midwife with me. They had a domino midwife system. Where as in Hertfordshire everything is very hospital based.

I had a very good midwife for my son's birth. I gave birth in an NHS hospital which has sadly been closed. The midwife who was with me for the labour had a three year old girl.

I spent well over a week in hospital because my son had medical problems.

Postnatal care that I got from the community midwives was Okish. None of them were bad. It was frustrating having no consistantly and seeing a different midwife everyday. The problem was that over the christmas period lots of community midwives want to take leave.

What is the advantage of an doula over a private midwife, other than cost. I quite like the idea of a private midwife. Ie. having ante natal appointments in the home, seeing plenty of the private midwife after the birth.

I used to think doulas were hippy nonsense but since MN can see their worth. Hell, for b/feeding support alone they are worth it.

RT... as you say one difference is cost, the other is that the Doula doesn't do anything medical whereas the IM can. However, unless the IM has an arrangement with the hospital she can only act as a MW in your home and at the hospital she becomes a doula.

That's intersting Mars (and akick in the teeth for the IM).

"However, unless the IM has an arrangement with the hospital she can only act as a MW in your home and at the hospital she becomes a doula"

In practice it doesn't always work like this though. My IM caught my baby when I transfered into hospital from home with my third. Once the NHS midwife had stated that my IM midwife wasn't allowed to deliver my baby she shut the door to the delivery room - after that the dynamic changed! There was a strong sense that they were working together to help me (how lucky was I - a great IM and a sympathetic NHS midwife - all to myself!) I know other mothers who've gone in with IMs where there has been no arrangement for an honorary contract where the IM has been fairly 'hands on'- including one person who had a physiological breech birth in hospital.

And of course IM can still give medical advice in hospital, even if they theoretically aren't making clinical decisions about care.

Re the OP - I sometimes come across people who are having friends/relatives act as doula. Sometimes it works well, sometimes it doesn't. I personally wonder how much use it is to have another woman with you at the birth if they've a) not given birth themselves and b) have no training in birth support. I also worry about the dynamics of people's relationships with their sisters/SILs/mothers/MILs and how these impact on behaviour during labour. There's also the issue of other people's experiences of labour: there are too many people out there who've had horrible labours themselves who've not had a chance to resolve their own issues surrounding birth. Don't think these are always going to be the best people to have around you in labour, no matter how well intentioned they are.

So yes - I think most people are better off with a doula than with a relative or friend. In societies where birth is still an event that takes place within a social setting then being accompanied in labour by other women from your community is fine, but that's not us really is it?

I'm a fan of IMs so that's good to hear fabsmum about IMs in hospital with a sympathetic NHS mw. Glad to hear it worked out for you.

Tell you what Mars - it was very interesting. My IM has very little hospital experience, but 10 years as an IM (with a respected London practice).

Re: the breech birth.... it was with a mum who'd booked a homebirth. Baby was discovered to be breech only during labour and mum decided to transfer in. When they got there consultant etc went in to mum and basically told her that if she didn't agree to a c-section she 'had' to have a breech extraction. She declined. Consultant then spoke to IM outside of the delivery room. Told her she had to tell client to agree to breech extraction. IM explained that she couldn't do that - would explain but could not apply pressure. Consultant went off in huff leaving IM and NHS midwife with mum, who was making good progress. As delivery approached NHS midwife kept faffing about, looking for new gloves etc, leaving IM basically in control. Good job too really as IM was only one present with reasonable experience of physiological breech birth. Baby born and all was well.

But you can't begin to image the legal and emotional mess that would have resulted if things had gone pear shaped with the birth. Eeek!

My IM is one BRAVE woman.

As was the mum herself!

It's fecking criminal that they can't get insurance. That breech mum was lucky indeed. It's outrageous that no one in that hospital had physiological breech experience.

I think there are times when you need to completely forget your birth plan. I think if I was pregnant with a breech baby I would opt for a c section. I would want to get the baby out in a living state without brain damage.

Hospital births are great in situations where there is a real problem with the birth process. The problem with hospitals is lack of patience when a normal labour takes longer than people would like, or there is an obcession with continous montioring and the woman is made to lie on her back.

Having and independent midwife or an doula should avoid the cassade affect of where one thing and another leads to unnecessary intervention. I haven't got a link but I remember reading something that the World Health Organisation reckoned that about 10% of pregnancies needed a c-section to ensure that both mother and baby are safe. Yet seven years ago my mother reckoned that the hospital she worked at had about 25%. I believe in the US its higher.

I wanted to link to an article a local paper done on me and got some clients perspectives aswell ass it explains more clearly - although I think mars done that very well (even half-cut!).

As a doula my own matra is that I aim for every client for feel Reassured, Informed, and Empowered, top that with a Tender (i.e. caring) birth and you have RITE!

Mars already posted an explanation of what Doulas 'Do' - so you already get the jist!

xx

they are not for everyone, that much is true.

i think mars and others have ably demonstrated the point

i did a talk recently at a conference, not even about doulaing, and i have since found out that the consultant obs who was also giving a talk has started recommending doulas on the strength of my talk!

i have been told it was like having a mum/older sister with you.. without the baggage!

also, i have very strong links with the local hospital, and good relationships with HoM and Consultant MW which is useful

doulas don;t just do the birth, but hte run up to it, debrief previous births, help with breastfeeding if neccesary, have access to huge amount of info for mothers, and are a familiar and kind face for the parents in labour.

i have seen mothers and fathers visbily 'let go' when i arrive , and really crack on with labour.

i am not under any illusions that i am a replacement for a midwife or any other support, but another facet , another element of support... one that is unconditional, non judgemental and constant.

doulas have to keep themsleves updated on birth and breastfeeding info, and have enough knowledge to know when it is necessary to step away from the birth plan and empower and support the mother to do what she needs to

RT... I agree that sometimes mums have to junk the birthplan and I've been births where exactly that has happened!

I don't think that a vaginal breech birth equals a brain damaged baby.

Also, a doula supports her clients through C-births as well.

notcitrus - the info I had was a few years old but this link also suggests that a doula is a woman who has had at least one baby herself.

I guess there must have been some kind of non-discrimination PC bollox or something that changed that criterion to allow women who have never given birth to be doulas. TBH, I don't think that is necessarily a good idea (don't all shoot me!) and your friend does sound a bit scary!

Message withdrawn

a fanatical...

Thumb your link is to an agency which has fees.

I also know doulas who haven't given birth yet. Some find it harder to get work, but they do get work and the more they get the easier it is to get work iyswim.

ar, marslady, it might be - I was originally told the info by a doula herself but that was a few years ago, as I said.

Anyway, so long as they provide the same level of support then there is no reason they would be any different to ones who have given birth.

RT - the mum I mention didn't go ahead and have a vaginal breech birth because she was inflexible, but because she believed that she could give birth to her baby safely that way. As indeed she did.

I haven't read all of the thread but my knowledge/experience is:

My dh was an absolute star during labour (some men aren't).

We asked the midwives who they consider has the best childbirth experience and they said 'Ladies with a Doula'.

I don't know why. I was considering having one as my dh almost wasn't at the birth (Army in Afghanistan).