What do Independant midwives and Doulas do?

[nunnie]

Are they only there at the birth if it is a VB?
Will they attend consultant appointments too or do they steer clear of that?

So if I was swaying more towards and ELCS then it is probably not worth getting one?

Doulas aren't medically trained so a totally different person to an IM. A Doula looks after you, makes sure your wishes are carried out, that you understand what staff want of you. During pregnancy they will usually meet with you three times, first to get to know you, then to do antenatal sessions with you, help you through any problems you have, understand the choices you need to look at. They will take you on from when you contact them and will offer unlimited support by calls, emails etc and if you need support going to appointments or you want to meet the HOM they can go to those. They will be on call from 38 to 42 weeks for you and usually only you, although with an elective they will just need that date booked.

The saying we use is we look after the head end and the MW looks after the rest.

You can book a Doula for an ELCS either if you need someone to go in with you if your partner isn't able to or because you feel you need the antenatal support or for someone to be with you when you're not in theater to support you while you wait or to help in recovery, breastfeeding support etc.

I have a fear of a spinal and I know DH won't be able to support me on this due to not being present at my EMCS (wasn't allowed) and not seeing what happened and how frightening it was. I just want someone there who will ease my fears slightly if that makes sense.

Probably a Doula would be your best option. Have a look at the Doula UK website to find a local one or you can email DUK and ask for advice.

Part of antenatal sessions would be debriefing your last birth experience and working through the fear to either get a handle on it or at least so your Doula knows how to support you on the day. Whilst they can be funny about partners being there they may be more understanding of a Doula holding your hand through the needle.

Thank you I will send them an email.

Hi Nunnie

as a doula I'd have to agree with confuddled - a doula would probably be the best option to work with you on your fears and coping strategies before the birth and support you on the day.

I actually often work with women from quite early in their pregnancies (I've been booked at 12 weeks before!) so this isn't unusual and sometimes, if couples want us to, we attend appointments.

If you need any help finding someone local I can post on the Doula UK forum for you and see who's free in your area. You can message me if you'd like me to do that.

Take care

I have an independent midwife and she is amazing! If you can afford an IM then I would have one anyday over a doula. No offence to any doulas out there, but an IM provides all the emotional and physical support needed for your pregnancy birth and mine will be with me for 6 wks after the birth too, so if you are having a c/s surely this would be better support for you. Also, I used to work in a hospital and a doula would not be allowed into theatre at all, however, lots of theatres will let IM's in. If you want details of im's let me know.

oh and hi! i'm new here, due end of april!

Is the Doula site up to date? There doesn't seem to be any listed in my area at all?

I am in Lancashire (Hospital will be Sharoe Green Unit Preston).

Hello sirgeorge, I was under the belief that they would allow a Doula if I wasn't having another birthing partner with me.

Thank you everyone.

Independant midwife doesn't look like an option either, as they have come up with West Yorkshire, Greater Manchester and Derbyshire all of which are way too far away from me.

sorry, yes you are right, for an elective they will let a 'birth partner' in with you, but not for the spinal/epidural, they make them wait outside until this is finished.

Would that not be the same with a IM then? My fear isn't having the needle it is something else if I am honest, the needle doesn't bother me.

if the im is familiar with the hospital I think they are a bit more lenient! Is there not an IM within an hours radius cos i know they travel much further than the nhs would, mine is at least an hour away from me.

But if I labour early I'm not sure they will get there in time as I labour very very quickly, and am lucky to make it in time myself.

Plus non of the ones I have found are within a 2 hour radius to be honest.

I think you are misinformed about Doulas. Yes we can't treat mothers but then unless you are unhappy with your hospital there's no reason why you need extra medical care. Doulas and IMs do totally different jobs and neither would claim to do the other's job.

Men are asked to wait outside because it's not a nice thing to watch your partner go through, my partner is still affected by watching his XW go through an epidural. At mine I was nervous about it so was decided Mum could hold my hand and then swap with OH. It's your body and your birth you are in charge. Even if you have a GA you can have someone in with you even though it's generally against hospital policy because they can be there for baby, cut cord, skin to skin etc. Having a Doula will help you look at there options and how you go about getting them.

Doulas are usually close to you and tend to work within an hour. They tend to know hospitals well and often go to the hospital to do training or to talk to the staff on their chosen specialty. There are some hospitals that are currently only allowing one birth partner because of flu but Doulas are exempt from that because hospitals recognise the importance of Doulas.

As a Doula I wouldn't be having a baby without one and I have a brilliant one ready.

The Doula Directory should be up to date but one of us can get a message out if you can't see anyone on there.

You could also try Nurturing Birth's directory.

Sorry sirgeorge but many theatres do allow doulas in for sections.

As a doula, I would be able to support the mother from day one of her pregnancy; not only towards the end.

Yes, a doula is non-medical but she/he can support the mother and provide independent, non-biased information about birth choices and a host of info before birth and after birth. Info and support about infant feeding and also can help you in a practical way in the home following birth (rather like a mother's help).

Even if she didn't support you in the theatre itself, she could discuss what will happen, what the room will look like, who will be there and what their jobs will entail etc. Going into theatre can be quite daunting and there are usually quite a few people in there. Having the correct info can really help to ease how the mothers feels if she's a little anxious.

My DH was there when I had both of my epidurals - he was allowed to stay and wasn't asked to go. If he had have been asked, he would have insisted he stay. I think perhaps that was onlu in some hospitals that partners were asked to leave.

And yes - a friend's DH insisted on being in theatre for a GA CS and they let him. A doula can give you detailed info on all of these things.

There aren't a lot listed near you and the way DUK is set up now I'm not sure who is closest to you, as said before it can be posted on the forum to see who can cover it. Had a look at Nurturing Birth and this lady covers your hospital.

nunnie I've had my birth partner (either my mum or dh) with me for the entire ELCS process which included placing the epidural or spinal. It is completely standard in the two hospitals I've birthed at for the partner to remain present with you during that time - they've found it much better for the woman & therefore easier for the anaesthetist. If you have particular anxiety about this part could you not discuss with the anaesthetist (you should get an anaesthetic appointment at some point after 28 weeks for an ELCS) the possibility of having a doula (if your dh feels too anxious) stay with you while they put the spinal in?

Having the spinal placed for an elective is completely different than during an EMCS - for a start you aren't contracting. It wasn't scary at all for me or dh (mum is a midwife so she's seen it all before) - I sat on the edge of the theatre bed, arching my back over a pillow while dh chatted to the midwife & held my hand. It has always been over very quickly (I'm overweight so it takes longer than usual) & there isn't anything scary to see.

Thank you everyone, I will look into it further. My fear isn't the needle itself.
With my EMCS I had a spinal and when they cut me I felt it, it was then decided the spinal had failed to work and I was knocked out. So my real fear is this happening again. I know it is rare and unlikely to happen again, but now that it has happened and it was only 5 months ago it is still quite raw and now I am pregnant again has become one of the main fears I have. I know the advice will be to have a VBAC if I feel that strongly but unfortunatly my DD was born naturally and I had a retained placenta which needed manually removing which involved theatre and a spinal so the fear and I was told that due to the way the placenta had attatched to scar tissue then it was likely it would happen again, but didn't get the chance to find out with DS. So even if I went for a VBAC I would still have this fear.

The reason I wanted a Doula really as apose to an IM is because I don't feel I want DH in the theatre incase it happens again as it wasn't nice and I don't want him to see that, but I still want a familiar face there, I don't really need someone medically trained as such just support and experience.

Do I have to decide now, or can it wait until after my 1st consultant appointment so I have more of an idea what my options are?

If someone could please find out if there is anyone local to me that would be lovely, I live just outside Preston. It would just be to know at the moment, haven't really discussed it with DH yet as he works away, just needed more info before I talked with him about it.

Thank you again everyone.

They can't predict retained placenta, I had this with my last client, she has always had homebirths and they said no this time because she'd had a retained placenta last time which we fought and won. They can't be sure what the placenta will attach to, just like you can be placenta previa in one pregnancy but not the next.

You may find speaking to a Doula as early as possible will help, I know personally that just knowing she's there and we have got a handle on the situation helps when I'm there and doctors are going on about something I don't like. I'm a high risk pregnancy and see the hospital fortnightly so I have to go along with them to a certain extent and make my decisions on the day so knowing I am doing that helps me feel prepared when they start getting scary.

If one of the others hasn't posted when I get online I shall.

Thank you, I know they can't predict it, but it played on my mind throughout my last pregnancy and it will play on my mind with this one unless they can tell me it definatly won't happen again, which they won't, I will continue to worry and more so now considering the spinal issue.

I am thinking the same as you about chatting to one sooner just because I have so many questions a nd worries that I will be with the Consultant for hours if I don't get some answers before

Does it help that you have the same chance of retaining as anyone else in any pregnancy? Look at as statistics, you've had your one in whatever chance so you've got the other chances to go

It's a shame you're not near me, I think my Doula would be the perfect woman for the job.