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Childbirth

Share experiences and get support around labour, birth and recovery.

What is the point of a doula?

82 replies

ReallyTired · 06/08/2008 22:45

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?

OP posts:
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ReallyTired · 07/08/2008 23:43

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

hf128219,
If your dh is away then having an doula seems sensible to me. It would be awful to have no support while in labour.

I'm glad that your dh was a star. My dh was fanastic supporting me. I think that a lot men do support their partners and do an excellent job. My husband would have been gutted if he had not been at the birth of his son.

"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 still think she was naive to ignore the consultant's advice. I'm glad she got away with it. Breech deliveries are high risk whicy is why many hospitals do c-sections instead.

If the birth had been straightforward then why did the independent midwife transfer her to the hospital? I assume that the IM must have felt the mother and baby were at high risk.

What is the point of going to the hospital if you aren't going to follow their advice? Contray to popular belief obestric consultants aren't evil bastards desperate to cut up women.

Obestric consultants are experts when things go seriously wrong. Midwives are experts in normal healthy child birth. A problem with hospitals is that the consultants are in charge and they look for problems where none exist. It completely over medicalises childbirth.

OP posts:
MarsLady · 08/08/2008 02:36

RT it wasn't the IM that transferred her in. "Baby was discovered to be breech only during labour and mum decided to transfer in."

Some information on C-birth vs Vaginal birth from AIMS

No one doubts the expertise of Consultants, but there is still a lot to be said about the expertise and experience of MWs.

One of the things a doula does is encourages her client to ask questions. This way the client doesn't make decisions because of scare tactics (believe me I've seen some beauties in action) but she makes an informed medical decision. Often she will listen to what the Consultant has to say and take that advice, but first she will ask the questions: Is this the only way forward? Have I time to wait and see? etc.

fabsmum · 08/08/2008 08:29

"I still think she was naive to ignore the consultant's advice. I'm glad she got away with it."

She wasn't naive and she didn't ignore the advice of the consultant. She listened and decided not to follow it. It was her right to do so. If none of us had questioned our right not to follow the recommendations of doctors we'd probably all still be having induction at term, giving birth flat on our backs, with our legs in stirrups and having routine elective episiotomies - all practices instigated by obstetricians.

"If the birth had been straightforward then why did the independent midwife transfer her to the hospital? I assume that the IM must have felt the mother and baby were at high risk."

Breech births do carry more risk than vaginal births, which is why the mother felt safer being in hospital. It doesn't logically follow that this mother was better off with a c-section once she got there.

"What is the point of going to the hospital if you aren't going to follow their advice?"

Because hospitals have protocols for treatment which don't necessarily take individual situations into account. One example of this might be that a hospital has a policy for blanket induction for post-dates at 40+10, another hospital may have a different policy of offering induction at 40+12. Mothers have to decide what's best for them based on their own individual circumstances after listening to the advice from health professionals. It's also true that there is not always a consensus among obstetricians about what is the best way forward with certain pregnancy conditions.

"Contray to popular belief obestric consultants aren't evil bastards desperate to cut up women"

No. I agree.

"Obestric consultants are experts when things go seriously wrong. Midwives are experts in normal healthy child birth."

Yes - and there are many, many midwives, including the primary expert on breech birth Mary Cronk, who see breech as a 'variation of the norm'. There are midwives with good experience of breech birth who feel very strongly that if a labour with a breech baby progresses normally and well and then breech birth can be safe. I was not talking about a birth where things had gone terribly wrong - I was talking about someone who was having a labour where things were progressing very well.

kiskidee · 08/08/2008 09:06

can i add to fabmum's last post...

i hope i get it right.

when a breech birth is progressing normally and midwives are allowed to continue to assist the labour and delivery, the skills of delivering breech babies are strengthened and passed on within the midwifery community.

A blanket policy of delivering all breech babies by c/birth has brought Western medicine to the point where all breeches are considered unsafe and midwives generally have lost the knowledge skill and confidence to perform them.

lulumama · 08/08/2008 09:11

breech birth has become this scary situation requiring csection, where in fact, a normally progressing breech, where the baby is descending and labour is normal, can deliver vaginally.. the great breech expert mary cronk makes it quite clear that if baby is not descending, and it looks as though augmentation might be needed,. then a c.section is the way to go..

midwives should know how to deliver a breech.. although mary cronk is a proponent of hands off the breech.. as they have to know how to deliver an undiagnosed breech.

a big trial into breech birth, the name of which escapes me, was flawed from beginning to end and has led to a skewed opinion of breech.

totally agree with fabsmum and mars's posts

fabsmum · 08/08/2008 10:02

I think it's important to remember with research into breech is that studies comparing vaginal breech birth with c-section delivery do not look at outcomes for operative delivery against physiological vaginal birth with an experienced practioner: often they are comparing operative birth with breech extraction. The other issue is that these trials don't factor in the increased risks to babies born following operative births when comparing outcomes.

The trial you mention is the Hannah Breech Trial

Some interesting discussion of it
[http://www.radmid.demon.co.uk/breechbanks.htm here]

fabsmum · 08/08/2008 10:03

Doh!
here

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