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January 2016 Moms
maureenmce
member
To doula or not to doula?
maureenmce
member
That is the question! That I'm struggling with currently anyway. Any thoughts? I'd especially love to hear from any STM's who either used one or decided against using one and why.
As for me, I just... don't really see the point, I guess? I appreciate that doulas advocate for my birth plan and choices, but I'm planning to sort of go with the flow, since I'm a FTM and have no idea how it'll go. I mean, ideally I do not want a c-section unless there's a medical emergency, I'd like to delay cord cutting and have skin to skin contact right after birth, but I think that's all in line with my OB's practice anyway. I could go either way on the epidural, depending on severity of pain and length of labor. So I don't really know if I need anyone fighting the doctor for me. And I'll also have my husband there to advocate for me if I need something, so... am I missing something?
Mostly I just don't want to cut into our maternity leave fund for a doula unless there's an important reason to do it, so I'd love to hear from anyone who thinks there is, just so I can weigh all the options.
Thanks so much!
Re: To doula or not to doula?
I am using the same doula group this time and their prenatal support this pregnancy has been amazing (baby has Down Syndrome and there have been some potentially serious developmental things that could complicate delivery). They've been able to provide a clearer picture of delivery possibilities then my doctors who are not willing to discuss w/me yet.
Also, she was great support for my husband as I labored a long time and she was there cheering him on as much as she was me.
Meaning nurses and relatives. My husband was overwhelmed. As was I. I need some one who will not be scared to death or sick with worry to buffer the hospital experience! A professional!
This time I plan to go completely intervention free but dh has experience now and is always the best person to get me through challenges, especially physical ones and especially when I get too in my head.
For a ftm who wants to avoid interventions at a hospital birth with a Ftd as a partner, I'd strongly recommend a doula. For anyone else, I think a doula is helpful, but maybe not the right decision.
But for your curiosity, this is the statement from the office as to why they don't allow them:
"Because of concerns for increased risk to you or your baby, the doctors at xxxxx. have made a thoughtful, unanimous decision to not allow doulas to participate in the birthing process. It has been our experience that they may serve to create a state of confusion and tension in the delivery room, which may compromise our ability to provide the safest delivery situation possible for you and your baby
Again, with safety in mind, we have also created a xxxxxx birth plan (which can be viewed in the obstetric packet provided at your initial visit), outlining the philosophy of our doctors with regard to labor and delivery. It is our opinion that other birth plans are unnecessary. We feel that our many years of obstetric experience in a setting of modern day challenges (larger babies, more difficult deliveries) enable us to provide sound judgment with regard to each woman’s particular needs during her course of labor."
If I didn't approve of this policy from the beginning I would have looked elsewhere but I comfortable with their birth plan and policies.
I had a wonderful experience with my Dr for the first baby. Despite some complications during birth(baby had a shortened cord and her vitals dropped as I pushed) he worked with me and encouraged me to keep going for the vaginal birth, which we accomplished.
Believe or not, but we are your doulas; except medically trained! I hope you all realize that when"the nurse comes in and is aggressive on the pit" it's because we have orders telling us to do so, not just cuz we feel like it. My #1 job as a nurse IS to be the patient's advocate!!
I didn't have one last time, but the hospital I will be delivering at has a volunteer doula program so I will meet them and (unless I don't like any of them) will have one attend our birth.
To me, they are not a go-between with hospital staff, they are a support person for me and my husband. I feel that this is especially important as I will be attempting TOLAC/VBAC. I didn't labor at all with DD, so essentially I am a FTM when it comes to labor. Maybe it'll be pain relief techniques, maybe it'll be a mental break for my husband, maybe it'll be something else entirely - I can't anticipate our needs during labor at this point but I think I will feel much more comfortable with one.
I wouldn't be comfortable at a hospital that doesn't allow them - I find the idea of having a birth plan dictated to me distasteful. To each her own though, at the end of the day it is your decision OP. As long as you are comfortable with it that is what matters. Good luck!
Eta words
This is the first exposure that my partner has to this process and I've only witnessed a birth with more medical intervention than I'd like. I am hoping to gain a positive & confident person who I can trust to guide me - there is a lot of unknown for both parents, especially the first time.
That being said - I don't believe that when you're in the delivery room that you will think "Dang it! I should have hired a doula." If.you have a good relationship and great communication with your medical team and believe that you have more than enough support then it may not matter. Like a PP said - it depends on the woman. Personally, I don't believe there is such thing as too much support when it comes to this process - beneficial/positive/confident support is invaluable.
That said, I am an informed patient, read completely and 100% approve of the birth plan which is really just their guidelines and an explanation of options (not a pre-determined plan ie 'you must get an epi). I had many conversations with my Dr about what was important to me (most likely epi, no c-sec, delayed clamping, immediate skin to skin) and these are all things they do unless the baby needs emergency intervention.
its a patients responsibility to read up on what is available to them and to find a doctor and practice you trust. Nothing against any one that wants a doula, but it's not for me.
Back to the OP, a few things to keep in mind if money is an issue: there are some health insurance plans that will reimburse you for non-physician labor support. It's something worth looking into if money is an issue. Also remember that even if they don't cover the full amount of their services, if they cover any portion, the total you pay counts toward your out of pocket maximum for the year. Birth doula's can also be paid for using your FSA (if you have one). Being able to pay for their services with pre-tax dollars helps to cut down on the effective cost.
As far as whether or not to use a doula? That's a really personal individual decision. We are using one because we don't want our family in the L&D room with us and feel like it will be good to have someone that will be with us the whole time (L&D nurses have other patients to attend to and the midwife/doctor only comes in intermittently and for pushing). They are trained in comfort techniques (massage, labor positions, etc) and can also provide support to your partner (running to get food, be there for you if a bathroom break is needed, etc). If you have another person that can fill that role - or if you don't want someone in that role - then a doula probably isn't necessary.
Also, a doula will never "fight the doctor for you." Doulas are not allowed to advocate on your behalf with the medical staff. They will only talk to you about what is going on, remind you of questions you may want to ask when an intervention is suggested, etc. There's a great book called The Birth Partner that I highly recommend. Whether or not you choose to use a doula, the book goes through a lot of the things that a doula can help with and can help prepare your partner to take on that role if you choose not to go the doula route.
Most doula practices offer a free consultation. If you are on the fence, set up a meeting and find out what they are all about. The worst that happens is you decide not to hire them.
My dr was quoted in an article when the ban came out and said they'd had several cases of 'bad' doulas dispensing confusing medical advice. I'm sure this is not the norm and a ban does sound extreme.
For me personally it is a non-issue as I was/am not interested in one. Sure the Dr is only there when needed but until then I had wonderful nurse and DH support. My Dr was amazing and was called in due to my LO's vitals dropping. The NICU/c-sec team were on standby but my Dr was so encouraging and helped me achieve the vaginal delivery I was hoping for.