doula - would they help with breathing/crowning etc?

[NumptyMum]

Hi - I'm really looking to hear from anyone who has experienced support from a doula during childbirth. I'm pg with DC2 but with DC1 I was induced due to low amniotic fluid, and monitoring showed that the chord was being squashed in each contraction so I had to lay on my back (so much for all the positions/movements I hoped would help). I'm really proud that I did manage on g&a but it was not a good experience, mw1 was v supportive but after shift change mw2 was less helpful (eg mw1 would tell me when to breathe on the g&a whereas mw2 said 'you'll know'... yeah, thanks). However the worst part was that having given birth to DS successfully he was on me for all of 30seconds before heavy internal bleeding meant the room was full of people and I was wheeled away to be stitched up internally. I think this was due to me not NOT pushing when DS crowned, iyswim... and again, I'm wondering whether if I'd had someone supportive this would have gone better.

I know things might be different this time but if I plan on worst case scenario, ie same situation again where I can't move, will a doula be able to help me with breathing and NOT pushing when crowning? Or was I just v unlucky to have unsupportive mw? (DH said she seemed more intent on doing her paperwork, my g&a even ran out at one point!).

What do you think?

That has been my experience of most MW's tbh, DH thought they were angels at the time and did wonders but when you sat down and actually considered what they helped with during the birth it was in fact very little.
Mostly trying to move things along.
The doula I don't think is allowed to be the one in charge of the pushing and the birth so you'd still have to go with the midwifes advice but apparently having the doula in the room makes the MW's quite competitive and determined to show off her knowledge and actually help you with positioning and drug free pain relief, massage etc.

When are you due, I have a doula booked for June and will report back if that's helpful ?

Thanks! I'm due at the end of June - but likely to be mid July if family history is anything to go by... however I don't know how quickly doula's get booked up so I probably need to look into it now. I think I was lucky with the first mw, just a shame the shift changed at the crucial point... If only there were a way of timetabling labour .

Has anyone had experience of actually using a doula already?

Thanks,

Hi numpty and also milly I am a Doula and can I just say that we are employed by the couple to support them through their birth. We are not, not allowed if you like, to do or say anything to our clients except to give clinical advice, Does that make sense? We are working with them and not working for the midwife.

What I mean is, if we have done antenatal sessions with our couples then hopefully they will feel empowered and confident in their approach to their own labour and birth. Hopefully we will have prepared them and perhaps especially the dad as to what to expect, and how to do breathing and how to use the G&A. Ialways make an effort to actually practice some deep breathing with my clients and dad too so that when it comes to it, the G&A is not an unknown quantity and they kind of know what to do, it does take a few goes to get the hang of.

Having said that, obviously we want to keep a positive vibe in the room and also to keep relations with hc personell, ie mw's and docs favourable. We wouldn't contradict a mw but if I had a lady who was struggling to know how to follow her body at the pushing stage, I would come very close to her head and I would speak very quietly to just her and remind her what we had talked about and tell her how well she was doing. I would also say that at pushing stage it's not very helpful to be using G&A so I would probably ease that fromyou, and remind youhow to work with your body.

If there was a problem and the client needed more guidance with pushing, then I would fully expect the mw to be competent enough to guide you through it and I wouldn't intefere except to support them and tell them they're doing fabulosly.

It sounds to me as if you may have had a 3rd degree tear that required stitching in theatre, you should have had this explained to you at the time, unless it was an acute emergency then there would have been time for staff to do this and am hoping baby was given to dad for more precious skin to skin. This is also where a doula could have been supportive, in making sure that this actually happened.

I work with my clients alot leading up to birth so that they go into it, fully informed and feeling confident.

Sounds also as if you could do with debriefing a little your first birth so that you canlet go of it and concentrate on this labour.

And remember, this is a different experience, it is not what happened before and there is no reason to think the same things will happen.

I wish you the very best of luck.

as a doula, I cannot take an active clinical role in the birth, but have never been prevented from breathing with a client, and giving encouragement to push/ hold off from pushing.. but i cannot say, right, 'its time to push' or anything that could be construed as a clinical role.

as liaghen says, we work with clients antenatally to give as much direction, advice and support pre birth so the client feels more empowered and in control and will feel more supported during the birth

if you had a previous heamorrhage, then you should really debrief the birth with a MW as liaghen hs also suggested, to get to grips with why it happened..if there is any reason, ifyswim

not pushing when the baby is crowning is normal, letting the head crown rather than pushing can make the delivery more controlled, or you can end up delivering too quickly..

even if you are induced again, there is no reason you should be on your back immobile again , even with constnt monitoring, you can use a birth ball, sit or lean on the bed rather than lie flat

a doula could certainly be of benefit to you, IMO

Thank you both for your comments, that was certainly my impression of a doula's role, frankly I do not intend to have a mw anywhere near me unless there is something wrong, which there was last time and the mw didn't notice until the very last minute
If the doula just reminds you to move around I think they've paid for themselves as mw seem to like the bed and you flat on it.

Unfortunately last time my first mw (the helpful one) was very willing for me to try moving round - I had a birth ball with me - but the monitor showed that DS's cord was getting squished and so I moved back to the bed - I think we poss tried this a couple of times, and also lying on my side, but only lying on my back seemed to stop cord being squished. So I don't blame the mw for the way I ended up having to deliver on my back, even though I know it made things more tricky. What I really wished for was to feel more able to get the breathing right for g&a (and actually know when the contractions were going to hit, they were uneven due to being on drip); and I guess more than anything I wish I'd had more guidance re crowning. However I can see that poss things were just moving too quickly at that point and perhaps nothing would have stopped the heamorrahage - I'll look into your suggestion of having a debrief re this with my community mw, if I can. I have booked into a yoga class to practice my breathing, and I'm really hoping that having given birth before I won't need to be induced this time... but then I know of no-one who has had a textbook straightforward birth so I don't want to kid myself that's what I'll get!

Thanks for all the input .

Have you read/seen stand and deliver and other brilliant ways to give birth by Emma Mahony ?
It talks about pressure on the cord being relieved by being in water and various other solutions to the 101 things that may crop up, I doubt I'll remember any of them on D-Day, but my doula's favorite question to mw's is "and what if we do nothing" and make them give a full explanation, which may set them off on a train of thought as to what they are going to suggest we do about it, rather than lie down there whilst we stick an epidural in

i had an induction first time that ended with a c.s and my second birth was a straightforward, no intervention delivery .. so it can happen getting as much info and support beforehand can really help

good luck!