I think I'd like to find a doula or midwife but have no idea where to start... HELP!

[mamicka]

I'm thinking that a doula or midwife would be helpful with #2 since I'd really like to try VBAC. Where do I start? I don't know anyone IRL who has used one. What's the difference & what do the certifications mean? I'm sorry I'm so ignorant about this... I've started to just find information online & am finding some stuff but it's easier sometimes to hear about stuff from you guys.

TIA!

Allison

[Marisa6826]

Check out www.DONA.org

It's where I found my post partum doula. You can search by state.

I'm sure that Rachel can explain it much better than I can, but it is my understanding that midwives have more medical training than a doula.

I am having a c/s so obviously don't need a birth doula OR a midwife. I decided on a post partum doula to help me afterward for a couple weeks.

Good luck!

-m

[Rachels]

Feel free to contact me if you'd like to talk. I wrote my dissertation about this stuff and would be happy to answer questions.

In short, a midwife is an expert in normal birth. She is trained to provide care as long as you are low-risk in pregnancy and labor. Births attended by midwives have statistically much fewer interventions, including cesarean section (1 in 10 for midwifery clients vs 1 in 4 for obstetrical clients), with no difference in safety or outcomes. Many midwives also provide well-woman gynelogical care. Depending on where you live, midwives attend births in hospitals, birthing centers, and at home. Their willingness or ability to attend VBACs varies by geography, although the safety of doing so is well-documented.

Doulas are birth partners. They are not trained to provide medical care. A doula will be with you in labor and will help you and your partner have the birth you want. Women who have doulas have, as a group, dramatically fewer interventions during birth, have shorter labors, and their babies tend to breastfeed for longer. You can find a doula through www.dona.org or www.alace.org. You might look up this book http://tinyurl.com/6ezmx, which is excellent.

I had both midwives and a doula, and I wouldn't do it any other way! It was great. Let me know if I can answer any more questions!


-Rachel
Mom to Abigail Rose
5/18/02


"When you know better, you do better."
Maya Angelou

http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif Two years and counting!

[tarahsolazy]

There are also different kinds of midwives. Here in Oregon, lay midwives, or "direct entry" midwives are not uncommon. These women have not had formal school-based obstetric training, and are not nurses. They learn about birth and pregnancy through self-study, and apprenticeship type arrangements. They are not licensed medical practiioners. Here in Oregon, they attend homebirths as primary providers, and also accompany women who were planning homebirths into the hospital if that is neccessary. In Oregon, lay midwives cannot deliver babies in hospitals. Certified nurse midwives (CNM) are registered nurses who have a master's degree, specializing in pregnancy and birth (and post-partum) care. They deliver in hospitals or birthcenters, and I'm pretty sure in Oregon they are not supposed (by their license) to do homebirths, but many do. Both kinds of midwives can be the right practitioners for some folks, you just have to figure out where your comfort level is.

(I'm sure Rachel knows more about this than I do, but I thought I'd put in my 2 cents, too)

I am also hoping for a VBAC when I have #2, should we be so lucky. As a neonatalogist, I can't be personally comfortable with homebirth (I see the incredibly rare cases when a problem arises), but I'd love a CNM or a OB + doula to help me succeed. Check out who is available in your area! You might want to look into hypnobirthing, too, sounds fascinating. Also, see what the VBAC policies are in the hospitals that your insurance covers, if you decide to go with a hospital birth. You want a hospital that is supportive, and doesn't have a lot of arbitrary rules, like no food, continuous monitoring, automatic epidural for VBACs, etc.

(Hope this post doesn't offend, I don't mean to!)

[mamicka]

Thanks Marisa & Rachel!

Rachel, I would have never thought about a doula or midwife if I hadn't read your posts on the difference they make. Thanks.

I'll definitely check-out the sites & that book.

Questions:
Are there c-section stats for doulas instead of midwives?
Is there any significant difference in the different certifications or are they all basically the same? (DONA = CAPPA = CDA, etc)
Are there any specific questions I might want to ask when interviewing? I've found lists of questions online but they seem pretty vanilla... anything you would ask from experience?
How involved does my OB need to be in this decision, if at all? (that may not sound right but I can't think of a better way to word it)

I'm in CO & have found some doulas list VBAC attendance as a service so I'm assuming that it's "done" here.

Thanks!
Allison

[mamicka]

Tarah,

Thanks for the info! (I was posting at the same time)

I'll have to find out how the midwife thing works here in CO. I didn't realize it could be so complicated.

Allison

[Rachels]

Yes, there are c-section stats for doulas, too. I think it's a 50% reduction in the number of surgical births, but I don't have my notes in front of me. I had a DONA-certified doula, but the standards are pretty similar. You can go to DONA or ALACE to look up what they require. As for questions, I think it's mainly a matter of comfort and fit. Can you imagine trusting this person, letting her see you naked, letting her see you cry? And your OB should be involved to the extent that you want to be sure he / she is comfortable working with doulas. Personally, I would see it as a deal-breaker if an OB didn't want to have a doula there, since women with doula-assisted births do better across all measures.

-Rachel
Mom to Abigail Rose
5/18/02


"When you know better, you do better."
Maya Angelou

http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif Two years and counting!

[steph2003]

Sounds like you've already gotten great information I just wanted to chime in & add that I used a CNM & gave birth in a hospital because there are no birthing centers where I live. I also had a doula assisting my husband & I. I had the exact birth I wanted & virtually no medical interventions so I'm a huge proponent of both midwives & doulas :)

some questions I asked interviewing doulas were things like - what sort of tools to you use to help the laboring women (ie aromotherapy, tennis ball massages, birthing ball, etc) what books do you recommend reading to try to get an idea of her background & what she has read to prepare to assist a laboring women. How many births have you attended? how many ended in C-sections & why? have you assisted in a VBAC? and this may sound unfair to those who have adopted or had children by C-sections but I wanted my doula to have actually experienced birth, you know? I interviewed one young women who was in training with DONA but wasn't a mom yet which I kinda thought for me personally I wanted to find someone who actually had labored/given birth....had been there/done that before me!

I hope this helps. I had such an awesome experience I talk people's ears off about this stuff.

[Momof3Labs]

I want to have a doula when we have #2. There are virtually no midwives in Illinois, and no birthing centers, so my options are very limited. A friend of mine who is a former La Leche League leader knows several doulas that she highly recommends, and I'll probably check them out first. So if you know anyone involved with LLL in your area, you might ask them for suggestions, too.

[gour0]

I emailed DONA for a list of certified and uncertified doulas in my area. I then emailed everyone on the list. I called all the doulas who emailed me back. Then, I met with the one I liked the best. I'm so sad that we've moved since then because she was AWESOME and I don't want to have to go through all of that again. But, I will in a heartbeat.
I think a Doula is wayyyyy better to have on your team than a loved one because they can be impartial in a way that someone who loves you cannot. So, no Mom for me! Just my DH and someone who knows what she's doing. :) They made a great support team and she really helped my dh to know what I needed from him. BTW, she wasn't certified but had 17 years of doula experience so don't rule out the uncertified people w/o at least asking how many births they've attended. I would also ask specifically about vbacs as that is what you are hoping for. HTH.

[Rachels]

Sometimes uncertified doulas will also work for free or for a dramatic discount. They have to attend a certain number of births after they finish training in order to qualify for certification, and so they're sometimes a good option. The training stuff is very fresh in their minds and you don't go broke. Our doula worked on a sliding scale at the client's discretion. We paid her highest amount without hesitation. There's no way on earth I'd ever consider giving birth without a doula again, and my husband, who was initially really very skeptical, wholeheartedly agrees. Even if I choose a homebirth, I'll have a doula there. I would have had a c-section without her. There's no doubt in my mind about that. And it would have been unnecessary.

-Rachel
Mom to Abigail Rose
5/18/02


"When you know better, you do better."
Maya Angelou

http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif Two years and counting!

[calebsmama03]

Allison -
I'm in CO, too and had both a doula and a midwife. I PM'd you before I read your post here, but feel free to ask me any questions! Looking forward to hearing back from you!

ETA - links! http://www.coloradodoulas.com/
For CNMs, check the websites for whatever hospitals you're thinking of using. My OB's office had a midwife on staff at the time, so there were OBs when I went high risk (preterm labor) and after I passed 34 weeks I was able to see the CNM again. I also know little about the midwife stats at local hospitals form my research (some are less CNM friendly than others around here), so we can chat off-boards about that if you'd like :)
Lynne
Mommy to Caleb 3/3/03
http://www.gynosaur.com/assets/ribbons/ribbon_emerald_18m.gif[/img][/url]

[NEVE and TRISTAN]

I think you'll be thrilled with your decision. I had a midwife and doula (and sadly delivered the 36 hours the doula was out of town for some training). But my midwives were there and my room was so peaceful and the experience was great. I am a birth center patient but when my water broke there was miconimum in it and that got me a ride to the hopsital. But it was still everybit the birth I can live with and loved.

My doula will be with me this time and she has beome a friend, my midwives did a home visit 2 days after birth it really is a special decision and time...

Good luck and keep us posted!!!!


Neve and Tristan born Feb 25, 2003
* EDD 3/19/05 IT'S A GIRL
* DOSSIER SENT TO UKRAINE-siblings

http://home.nc.rr.com/ourbabytristan