To doula or not to doula? Anyone have any views?

[Poppyjen]

Hi ladies

just musing over whether or not to have a birth doula this time around for DC2. Its still early days for me but I thought it couldn't hurt to do a bit of research and I suspect that hey do get booked up quite early.

Basically I had an EMCS with DS for the charmingly named "failure to progress" (got to just shy of 10cm dilated after induction and then he got stuck - back to back and generally in very awkward position). This time I would love to try VBAC (in hospital) and both DH and I are wondering if it would be worth having a little extra support.

This may not be the best place to post this, but if anyone has any opinions I would be very grateful. Thanks!

I had a doula and she was fabulous, really helped me deal with the pain of labour/contractions. We prepared a very detailed birth plan so that we both knew exactly what would happen if we deviated from a natural water birth. She was my birth partner during labour, and when things went wrong, she sat with my parents whilst I was in theatre with my husband.

It is expensive but you can get trainee doulas for less money. I asked for doula vouchers as a maternity gift from work and that helped too.

My doula had children, had cs, vbac, water, home and natural birth herself so she had been through everything. She was also aware of the processes that can take a birth away from natural birth.

Be warned, some MWs have had some bad doulas and this does colour the MW's opinion. When I also had 'failure to progress' one of the MWs accused my doula of telling me not to push. I was too busy at the time to tell the MW my opinion of that!

I've just booked a doula for dc2's birth and I'm already feeling better about the whole thing. I had quite a scary time with dc1, very unsympathetic shouty mw and no support so was feeling quite apprehensive about doing it again!

Thanks! That's very encouraging, I have contacted a couple to have a preliminary chat. I am a bit clueless though, I am not sure what I should be asking them. To be honest I am still a little unsure of what they would actually do - I love the idea but does anyone know how doulas will for example work with the midwives? I don't want to feel like there are too many cooks if you know what I mean!

3 VBs with doula here. (2 different doulas as moved house before DC3). Would definitely recommend. I have quick births so people questioned whether it was worth it, but it was.

They don't exactly work 'with' the MW - they don't do any of the things that MWs do, so don't get in their way. They are their to support you (and your DP too) It's quite hard to explain, but they are great.

My births were all in hospital and the MWs were really busy and overworked, didn't have time to stay with me etc. My doula was there throughout, giving useful suggestions about position, supporting me in the things I wanted (NOT to lie on my back) etc. I definitely feel that having a doula was instrumental to good outcomes in all 3 births.

Each time there was something that 'could' have gone wrong IYSWIM (difficult transition stage, very fast second stage, placenta that didn't want to come away). I feel having the doula helped in keeping me calm, focused, and bringing things on track. She also helped DP in backing him up when he was supporting me in pushing for what I wanted.

I had a doula with DC1 (HB). I would say for the most part I was really happy with her.

I just typed out a synopsis of how my birth went wrong when the MWs turned up and my doula wasn't confident enough to stop them doing some really stupid things, and ignoring my birth plan. But if my doula reads it (she's on here) she'll be mortified and she already feels bad about it.

I would say though that it's worth interviewing several and pick the one who you think will help you the most. I wish mine had been more assertive and confident in her role.

We're not having one this time, as DH says he now feels confident enough to do the assertive bit himself.

That's interesting ImpYCelyn - sorry to hear things didn't go to plan. Would you say then that her lack of assertiveness was due to lack of experience or just personality? I ask because a couple of the doulas in my local area haven't got much experience under their belt, especially re VBACs but they seem lovely.

I am starting to think that experience really is key

Good question, OP. A friend I trust is encouraging me to think about having a doula to work with me and my OH in a MLU birth, though my immediate instinct is not to, so it's on my mind a bit. It may be far too late now anyway - I'm nearly 35 weeks (first-timer) and honestly don't feel I have the energy to start interviewing people.

My anxieties about the birth are to do with being rushed according to someone's schedule, or that me or my partner will have to spend large chunks of the labour resisting interventions we don't want unless they are absolutely medically necessary. (And I know a home birth is the solution to some of this, but we've decided against one, partly on the grounds of our flat not having a sufficiently strong floor to support a full birthing pool.)

But my instinct tells me strongly I will want to be left alone in labour. assuming everything is going normally - I don't like being the focus of attention when stressed or feeling vulnerable/under the weather, and I'm trying to hypnobirth, so will be concentrating on staying in the zone. I don't really want anyone other than my partner around, and certainly not prolonged one-on-one attention, unless it's strictly medically necessary. Am i being unreasonable?

Also, can someone give me a ballpark figure on what a doula and trainee doula would cost? Central London, if that matters.

We've decided to have a doula this time round (DC2) and I'm hoping for a vbac in the birth centre.

I was induced at 42 weeks with DS - hyperstimulated immediately, laboured flat on my back (which shifted him from LOA to LOP) with a monitor on the whole time - literally couldn't move or the damn thing lost his heartbeat - before finally having a crash section due to fetal distress/suspected hypoxia. My birth plan never even came out of the bag and all the yoga/active birth stuff didn't get a look in.

We did hypnobirthing last time, which helped in that I was calm and relaxed and managed with no pain relief (not too sure I felt so calm and relaxed but the midwives kept commenting on it as did the anesthetist who gave me the spina and it's in my notes - I only started to panic when I realised that they thought DS was dying!).

This time I have really had to fight to get a vbac at the birth centre signed off. It was such a struggle that it made me decide (quite late, at 31 weeks) to hire a doula to help support us both. To be honest, it's DH I worry about more as he was really overwhelmed by the craziness of DS's labour and then theatre. We've chosen a doula who's really experienced at the hospital we're going to - the consultant midwife and my consultant obs were both like "oh, yes, we like her, she's a sensible doula" - who's also experienced in supporting vbacs (but has had a full range of births herself - EMCS, ventouse, natural, planned section for twins).

I think her support will allow DH to actually partner me with hypnobirthing and she'll also help communicate our wishes with the midwives and their wishes to us (the midwives did change about during DS's birth, so it was hard to keep track of who was who in the room). I'm not necessarily expecting her to partner me as such, more guide us both when we need it but leave us to it if it's all going well.

Anyway, we're in North London (zone 2) and our doula is 900 pounds - includes 2 antenatal visits and postnatal visit (as well as postnatal support via phone for 6 weeks) as well as staying with us throughout labour, birth and bonding. We did talk to another doula who was seven hundred and fifty pounds but we didn't click in the same way (I didn't think she seemed assertive or experienced enough and she pooh-poohed hypnobirthing).

Am 34 weeks now and baby was breech at a scan last week. So even if the baby stays breech and I have a planned section, I still think the doula will be helpful eg in helping us plan as "natural" a section as possible etc.

Sorry for the massive ramble!

Poppyjen I think probably a combination of both. She's very mild-mannered and sweet and optimistic, very pro natural birth etc, and I think it never occurred to her that MWs on a homebirth team would have so little respect for my wishes and would interfere so much with an otherwise perfect natural birth. There were no problems and no hint of problems, but the MW panicked when she realised she was on her own with a student, and the hours she thought she had ahead of her to sort things out was more like 10-15mins, and the second MW wasn't answering her phone.

But I think that was compounded by her being a trainee and not having been the doula for many births (I was her second or third on her own, I think). Last time I saw her she said she often reflects on how it went and would do everything she could now to stop MWs doing that again. So although it wasn't great for me, hopefully it's helped the women she's been with since.

Also she really wanted to have a good relationship with the MWs and not antagonise them. She now feels that that's not her problem and getting women a good birth experience is more important.

So I think either a qualified and experienced doula would be preferable, or alternatively a trainee who is prepared to be really assertive and fight for what you want, someone who is at least ready for the possibility that they might have to.

Hardcheese - we had a hypnobirth and want to do it again. That's the only regret I have about not having a doula this time - DH was completely free to be with me and help me focus and get through it. It was really wonderful for the two of us. The doula dealt with all the phoning the hospital/arguing with the hospital and we didn't have to worry about any of it. The rest of the time she just faded away except if we needed her for something.

She was the one though that convinced the hospital I was in labour ("she wouldn't be able to talk to us on the phone if she was", I was in transition) and likewise persuaded the MW to actually bring the equipment into the house. Although they pretty much ignored her after that. She managed to get back in control though, and was able to stop them doing things to DC after birth while I was basically in shock (had a very hard and fast labour), like cutting the cord straight away and cleaning off the vernix. Also stopped them administering Vit K injection to DC and the 3rd stage injection to me, I wanted a physiological 3rd stage. So was really helpful then. And when I still too shocked to be able to hold the baby and do skin-to-skin she set up DH and the baby for skin-to-skin together, so at least one of us did it.

Just explain to potential doulas that you don't want them to get in the way, what you do want, and see who can accept that.

I still think the birth would have gone even less the way we wanted if I hadn't had a doula.

I have just hired a Doula. I'm 28 weeks pregnant with DC2. I had my first appointment with her yesterday. Mainly spent de-briefing the previous birth. At the moment I am feeling really positive about the meeting and am confident I have made the right decision. I never thought I'd hire one when I was pregnant with DC1. But a lot of things could have gone a lot better at the first birth and I realised that I can only do one thing: Stay calm when in labour or get the reluctant MWs to understand what I need. Hence I now have a doula so she can support me and liaise with the MWs and I can get on with what a I need to do.

I have to say though that I know the doula from before (helped me with breastfeeding DC1) so it was a very easy choice for me.

Hardcheese; if you look on the doula UK website, and narrow by postal code, you can find mentoring (training) doulas, I emailed two last night, and they both got back to me by morning.
They both charge £200 plus mileage, I will be moving to Crawley, so you might find central London more more expensive.

Forgot to say, I had a doula with my dd, and she was wonderful, she kept me totally focused on my breathing. Good thing, dh was pretty useless, I mean overwhelmed!

Doulas (or 'continuous support during labour') have been shown to reduce the need for interventions in birth: Cochrane Review

Hope that helps!

There should be a page on Doula UK about what questions to ask a doula at interview, I can't get on there right now to get a link though.

In London recognised doulas are more costly, you're looking at £6-800 IIRC (elsewhere more like £500) mentored doulas are up to £200, but either way it is worth contacting them directly and asking, as some are able to be flexible (which is why not all publish their prices).

A doula will work with your MW in terms of co-operating, and being professional etc, but will not perform any medical tasks or give medical advice. She is also there for you to support your choices regardless of their own opinion, or anyone else's.

A belated thank you to all who posted on here, it has really helped. I am more determined than ever to have a VBAC without continuous monitoring, and I am coming more and more to the conclusion that I would like to push to be able to use the birth pool. I know that this is going to be an uphill struggle so I am very much looking forward to having a doula on our side :)

A few people have said that the "easiest" way for me to be able to use a pool etc would be to have a home birth but I really don't think that is for me. I am just hoping that making my wishes clear from the outset and having the extra support will help :)

For information, a doula in my area (Kent) will cost around £500-£600 for 2 antenatal visits, concall for 2 weeks either side of due date and 2 post natal visits. Seems to be much more expensive in London (as with everything - we were in London when we had DS - all of you ladies having babies in London, you have my sympathies!)