Did you have a childbirth doula, and were you glad you did?

[citymama]

I'm thinking that if I am going to attempt a VBAC I sure as heck would like some more support than this very hands-off OB/midwife practice I am seeing - I am not thrilled with them, but I don't think I have a lot of other options that would be covered by insurance. But I live in the city of home births, and therefore, of childbirth doulas. I'm thinking I would like to "hire" (is that the right word?) a doula to support me and DH during the birth, and would love to hear your experiences with a doula. Were you happy to have one? Or did it turn out to be unnecessary? What kind of support did she provide? Would be great to get a sense of what kinds of questions to ask prospective doulas I talk to - I know I will want to know about their VBAC experience. Finally, just curious how much it set you back. Many thanks for your feedback!

[KrisM]

I had one for DD. I was hoping for a VBAC. Although that didn't happen, I am still glad I had the doula. First, it was nice to have someone who just kind of knew what I needed without trying to tell DH. And, she was good at staying in the sidelines, but being there at the same time. And, I have pictures of me and DH while I was in labor.

ETA: I wish I had one for DS1's birth. I often wonder if it would have helped me avoid the c-section. I really believe, although the midwife never said this, that DS's head was pointing more towards my thigh than down. That's where it felt like it was to me and since I never dilated past 4cm after 30 hours after my water broke, I think he just wasn't pushing in the right direction. I think maybe a doula could have figured a way to move him around.

[lmh2402]

we loved having the doula

i was in labor from monday morning until DS was born on thurs morning

doula was with us from tues afternoon until thurs afternoon

we both felt WAY more in control with her supporting us. this was our first child and the baby was asynclitic (head tilted in the womb), so his head wasn't pushing properly to help my cervix dilate

i am 100% convinced that without the doula, i would have been admitted the first time i went to the hospital on wed morning, kept there for a couple of hours, then "forced" to use induction methods...and perhaps ended up in a c-section

b/c our doula was with us, she was able to reassure us enough to feel confident going back home and working on labor progression naturally with her

i could go on and on...but in short, yes - i highly recommend the support of a doula. for you and DH

cost - $1,800. but i think there is a regional component to it, b/c i have friends outside of NYC that did not pay that much.

[SnuggleBuggles]

I had one and was glad. I chose a doula because I wanted a med free hospital birth and thought that would increase my chances. I am sure dh and my CNM would have been enough but it was really nice having the doula there b/c I was not getting along with my CNM during labor. Just my dh? he wouldn't have known baby was likely posterior from my symptoms nor what to do to help.

With ds2, I could have done that one completely alone save for the last 10 minutes before pushing (transition was wicked). No doula, just CNM and dh. It worked well.

I loved having a doula for all the "is this normal" stuff. She had a good bag of tricks, a calming personality, she brought lullabies to play during the birth and she took great pictures.

She was $300.

Beth

[ewpmsw]

I haven't heard many women say they wished they'd had a different or no doula, and I think it's a great idea. Planned to have a doula with DD#1, but the lady recommended to us by birth group misrepresented herself. She said she was in training to be a doula and was in nursing school. Turned out she was only considering both of those things. When I asked for referrences, background check, anything to make me feel more secure about her, she stopped returning my calls, and I couldn't find anyone else before delivery.

Labor was 33 hours and I was really sick the entire time. DH and my mom were my support system. I love them, but there was too much emotional junk with both. Midwife believes that played a part in slowing the labor. In August, I really want a certified doula by my side, esp. if the labor and vomiting are as bad as last time.

[happymom]

I hired a doula because I wanted to try to deliver without pain meds and I thought that a doula would raise the chances. I didn't want to spend too much money though- the doulas in my neighborhood chareg about $1000-$1500 on average. BUT, they come to your home as soon as you are in labor, and labor with you at home. When its time to go to the hospital, they go along with you as well. Of course, they are with you in the hospital too. I found a doula who lived about 45 minutes away- she said she would not come to my home, but would be available by phone while I labored at home and then would meet me in the hospital. She charged $500 for the first 8 hours and an additional- I think- $50 for every additional hour up to-I think- $850 max.

In any case, my doula was not the greatest during labor- I expected her to do more. I ended up with an emergency c-section though, and because it all happened so fast, I really had no clue what had happened and why I had needed the c-section. I was very shaken up and traumatized by it all. About a month after the birth, the doula came to my house to explain everything that had happened. That was very important to me. (my doctor missed my birth so if not for the doula, I wouldnt have had anyone to really explain it all.)

Some questions you might want to ask-
-Will she come to your house when you are laboring at home? Will she accompany you for the car ride to the hospital?
- What kinds of tools does she bring with her? (hot water bottles, massage items..)
-Will she put you into different positions, do massage etc?

[sarahsthreads]

I had a doula for DD2, a VBAC. In my case my labor was incredibly short - I woke up at 12:50 with the first contraction, got to the hospital around 3 (I was absolutely convinced I was *not* in labor yet) and DD2 was born at 4:27. But it was so short and so intense that having my doula there was a godsend. I just remember being so hot, and she was right there with cold washcloths; she was massaging and providing counter pressure and just really taking all the work off DH so he could simply *be* there with me, kwim? She would have come to our house, but like I said, I didn't think I was in real labor until nearly too late!

Like a PP, I also wonder if having a doula the first time around would have helped me avoid a c/s. DD1 was trying to come out ear first, and in hindsight I think trying different positions to labor in would have made all the difference. But *I* didn't know any better, and the nurses weren't all that helpful.

I think the cost was around $400? Worth every penny. If we have another DC she'll be the first person I call after my first midwife visit.

Sarah :)

[Jo..]

I did for DS and managed to have a 24 hour pitocin induced labor with no epidural. Never would have made it without her. ETA I think she was around $300 or $400 which included several home visits prior, NONSTOP support the whole time at the hospital, and postpartum visits including bf help. Well, well, well worth it.

For DD I figured I was an old pro so I didn't need a doula. I labored at home and made it to the hospital 15 minutes before she was born. :love5:

[m448]

I've had one for the last two births and will have one again this time (my last birth and this one will be a homebirth).

Count me in among those who wish they'd hired a doula for the first time around, really when it's most important to have a doula. She would have recognized from the change in my intonations and pain level that DS1 had flipped posterior and would have worked with me to flip him around instead of letting me grovel on the hospital bed. With my second he was asynchlitic and my doula recognized this. With my third my doula (this time one of my closest friends) sifted me during labor, provided counter pressure to alleviate pain during contractions and was wonderful. She will be my doula again this time around.

[citymama]

Thanks everyone for the really helpful feedback.


I had one for DD. I was hoping for a VBAC. Although that didn't happen, I am still glad I had the doula. First, it was nice to have someone who just kind of knew what I needed without trying to tell DH. And, she was good at staying in the sidelines, but being there at the same time. And, I have pictures of me and DH while I was in labor.

ETA: I wish I had one for DS1's birth. I often wonder if it would have helped me avoid the c-section. I really believe, although the midwife never said this, that DS's head was pointing more towards my thigh than down. That's where it felt like it was to me and since I never dilated past 4cm after 30 hours after my water broke, I think he just wasn't pushing in the right direction. I think maybe a doula could have figured a way to move him around.

Sounds like we had similar experiences with the first birth. I too had a long labor and DD had positional issues and I felt like my midwife did not provide the support I needed (hardly any at all). I am curious why the second VBAC failed, and also at what point you realized this was the case. Like most VBAC moms, I am apprehensive about trying to avoid an emergency situation. Feel free to PM me if you prefer - thanks so much.


I had a doula for DD2, a VBAC. In my case my labor was incredibly short - I woke up at 12:50 with the first contraction, got to the hospital around 3 (I was absolutely convinced I was *not* in labor yet) and DD2 was born at 4:27. But it was so short and so intense that having my doula there was a godsend. I just remember being so hot, and she was right there with cold washcloths; she was massaging and providing counter pressure and just really taking all the work off DH so he could simply *be* there with me, kwim? She would have come to our house, but like I said, I didn't think I was in real labor until nearly too late!

Like a PP, I also wonder if having a doula the first time around would have helped me avoid a c/s. DD1 was trying to come out ear first, and in hindsight I think trying different positions to labor in would have made all the difference. But *I* didn't know any better, and the nurses weren't all that helpful.

I think the cost was around $400? Worth every penny. If we have another DC she'll be the first person I call after my first midwife visit.

Sarah :)

Wow, such a short VBAC labor! How was the first labor - long? Did you dilate fully the first time around? Your VBAC sounds like a great experience - please send some of that good mojo my way! :)

[mommyp]

I voted no and it was okay because I was happy with my care and my DH as support. But I would definitely be looking at it in your situation! I've met some great doulas through classes I took before and after DD was born.

[wellyes]

I voted no but I had pain meds :) If you're going natural and can find a doula with VBAC experience then I think it's probably a very worth investment.

[AshleyAnn]

I wish I had had a doula with DD. I was attempting NCB and ended up needing an induction because my blood pressure sky rocketed. My OB was fantasic and completely supported my NCB wishes and agree to most of my wishes. BUT he wasnt around during my labor at all - he only barely made it in the room to catch her - so his agreement with my plans ment squat. The nurses were much more mechanical and needed constant reminding of what I wanted. In the end I 'failed' at NCB because I agree to two shots of narotic pain relief - one to help me sleep and one in the morning when I had been in labor 12+ hours of hard labor and hadn't made any progress and things in the room were too much for me. The nurses said I could shower at 6 am before they started the pit but they expected me to wake myself up (of course there was no alarm clock in the room if I had thought of setting one) so I didn't get a shower. Someone turned all the lights on and the sun was coming in the windows. Then my MIL showed up well before 8am and my mother at 9 and they just kept talking and talking and talking. DH had turned the TV on and was watching some stupid man show. It was too much for me and I couldn't concentrate to work thru the contractions bradley style like I had planned so I asked for the 2nd shot of narcotics so I could just veg for a while longer. If I had had a doula I think she could have helped me keep the room under control and advocated for me when I couldn't tell my family that I really needed them to shut up and turn off the lights. Within 20 minutes of getting that 2nd shot I was crowning and 3 pushes later baby girl was here (I was checked 5 minutes before it was given 0cm, 80% effaced, -1 station same as I had checked out at 34 weeks). I don't remember much of the actual birth just snatches because of the drugs.

Next time I WILL have a doula. I couldn't explain to my husband or anyone else what was going on or what I needed thru the near constant pain. I had a 15 second break between contrations and there just wasn't enough time. DH and my mom did a great job trying to guess and work together to help me but my mom had 2 c-sections 20+ years ago and its our first baby so DH didn't have a clue what to do (no CB classes for us for a multitude of reasons)

[jenfromnj]

I didn't, but I wish I had, and if I ever have another child (I'd want to try VBAC), I would definitely have one. I, like some of the others, had a very long labor with DS (got to hospital Monday morning, DS wasn't born until 10pm Tuesday night), and he had positional issues which ultimately led to a c-section. I definitely wonder still, a year later, if having that kind of support could have helped me to avoid having a c. DH did his best to be supportive, but his only real "training" was reading a couple of books and attending some Bradley classes, and he also was somewhat panicked as the process became more intense. Having someone knowledgeable and level-headed, and who is not at all motivated by the hospital's malpractice-related policies, is something I definitely could have used.

[rachelh]

I voted no but I wish I had.

I had a csection close to 3 1/2 years ago for "arrest of descent." After a lot of reading and research, I do feel that a doula would have helped. I had a perfect labor until I pushed - pushed for two hours and 3 1/2 years later, I am still not sure what happened. I feel that a doula would have been able to help advocate for position changes and a little break in the pushing being DD was never in distress. At the time, we were very strapped for cash and that is really the reason we didn’t hire a doula.

Fast forward almost 3 1/2 years...I am due in any day and am planning a homebirth VBAC. While I feel it is necessary to have a doula if giving birth at home to help with pain management, I would still 100% have a doula if I was attempting a hospital VBAC. You need someone there to advocate for you, make you feel comfortable, and suggest different things/positions that the nurses/doctors may not because they generally do everything "by the book."

In NYC and the surrounding areas, good doulas charge close to $3000 from what I have seen, but you can find people who would be willing to do it for less. I would just recommend you find someone who is VERY familiar with VBAC hospital births.

ETA: Another reason I am having a doula (and would be if I was having a hospital birth) is because I don't want to have any regrets. I don't want to look back and say "if I only had a doula maybe I could have avoided another csection." I will know that I did everything in my power to avoid having a repeat.
Good Luck!

[Melanie]

I said no but I wish I had, however I wish I had paid our hypnobirth instructor to attend the birth (the classes were great!). We still did fine, but I think it'd have been better with the instructor there. Same Idea as a Doula. They advocate for you and help you through the process.

[wifecat]

I was induced four weeks early for complications and cervadil was working for me - my water broke, I was having contractions 3 minutes apart - and they convinced me I needed pitocin. I was easily swayed at that point, and just wanted my baby out safely - I think a doula could have saved me from pitocin and convinced me/them to let me labor on my own for longer than I did.

My labor was fine - great, in fact - but next time - I'll have a doula.

[sarahsthreads]

Thanks everyone for the really helpful feedback.

Wow, such a short VBAC labor! How was the first labor - long? Did you dilate fully the first time around? Your VBAC sounds like a great experience - please send some of that good mojo my way! :)

Not terribly long for a first baby, really, my water broke around dinner time Sat. night, but it had meconium in it and I wasn't contracting, so they told me to go in and get ready to be induced. DD1 was born via c/s at 2 pm on Sunday. I did fully dilate, and pushed for 2 hours, but she wasn't positioned right. I managed to get as far as 8 cm but gave in to an epidural at that point because the nurses kept pressuring me to have one. DD1 was never in any distress, but the OB convinced us that I had to have a c/s because of failure to progress. (What an awful phrase that is!) The best thing I have to say about DD1's birth is that I came home with a beautiful, healthy baby. The rest...well, I came home with a healthy baby and that's all that matters.

Would having a doula for the first birth have changed the outcome? I don't know. But looking back on it I can see a clear chain of events that made a c/s more and more likely as we went along. I feel like our doula could have helped us better understand what we were agreeing to and what the consequences of each decision might be. Also, when DH was *snoring* across the room in the fold-out chair and I needed his help to breathe through contractions in the middle of the night, a doula would have been able to throw bean bags at him to get him to wake up! :D

I will definitely send you good VBAC mojo! I don't really know how I got so lucky, but I will say that switching to a midwife practice and having a doula made all the difference for me.

Good luck!
Sarah :)

[s7714]

I voted referring to my first delivery, because I wish I would have had a doula there--for the only reason that I always wonder if I'd had someone better versed in pushing positions and the art of pushing, then perhaps I would have been able to avoid a c-section.

My second delivery was a VBAC and went so quickly I didn't need a doula and I doubt one could have arrived in time. I was actually scheduled for a repeat c/s, but my DD decided to arrive so quickly via the traditional route, even my OB didn't make it there in time! (My first contraction was at literally midnight, my water broke at 12:35, got to the hospital at 12:45 and my DD arrived at 1:05 am.)

[kijip]

My answer is not up there:

No, I was not glad. It was more than not helpful, I had to tell her to leave.

She was making my birth into her political statement and exerting a lot of pressure on me, all while not doing any of the things she said she would do- massage, positioning, helping J. She sat and read unless she was busy dishing out preconceived advice. Not cool, in the least. I did not hire one for #2.

[citymama]

I voted referring to my first delivery, because I wish I would have had a doula there--for the only reason that I always wonder if I'd had someone better versed in pushing positions and the art of pushing, then perhaps I would have been able to avoid a c-section.

My second delivery was a VBAC and went so quickly I didn't need a doula and I doubt one could have arrived in time. I was actually scheduled for a repeat c/s, but my DD decided to arrive so quickly via the traditional route, even my OB didn't make it there in time! (My first contraction was at literally midnight, my water broke at 12:35, got to the hospital at 12:45 and my DD arrived at 1:05 am.)

WOW! So I have to ask you the same question I did sarahsthreads, who also had a quick VBAC - did you get to the 10 cm and pushing stage with #1, or what was the factor that made the second birth so much quicker? I know second births are often speedier for moms who had first births vaginally, but I assumed there was no such advantage for moms whose first were delivered via c/s. Like you and some others here, I did labor with my first for many, many hours, but couldn't dilate past 6 or was it 7 cm, largely because of baby's transverse position.


My answer is not up there:

No, I was not glad. It was more than not helpful, I had to tell her to leave.

She was making my birth into her political statement and exerting a lot of pressure on me, all while not doing any of the things she said she would do- massage, positioning, helping J. She sat and read unless she was busy dishing out preconceived advice. Not cool, in the least. I did not hire one for #2.

Yikes! How awful. Anything from your first meetings with her that might have helped you foresee this? Did she come highly recommended? I feel like this is sort of what happened with my midwife - she was warm and fuzzy during prenatal visits and AWOL during labor. The midwivery student working with her was the closest thing I had to a doula, and I was so grateful she was there. (DH was wonderful as well, but I guess what I am looking for is more expertise in childbirth than someone to hold my hand!)

[jgenie]

I had a doula for both my deliveries and she was worth her weight in GOLD!! I'm in the NYC area and paid $1000. We hired a doula because I was TERRIFIED of labor and delivery. We are away from family and DH doesn't do blood at all - he got sick watching the initial cut for a c-section delivery on TV. I was terrified that he would pass out during my delivery and I would have to go through it alone.

She came to our house for a home visit and went through different coping techniques and positions with us which happened to be a blessing because DS1 arrived 4 days after our initial consultation. Both my DSs arrived a month early so with DS1 we hadn't taken our childbirth class yet so we were clueless, and I mean clueless with a capital C, when I went into labor. She helped keep me focused and was able to tell us what was happening and what was coming.

Both my labors went very quickly (3.5 hours with the first and 1 hour with the second from the moment my water broke to birth) so she didn't get to pull out anything from her bag of tricks but she was a calming presence and great at advocating for me. She stayed with us after each birth to help us get settled and then came to our house when we came home to help with breastfeeding and answer any other questions we had.

The biggest thing she did for me was to help shift my mindset from birth being an awful experience to be survived to seeing it as the wonderful natural process it was. I was able to go med free with both deliveries and I credit that entirely to the mindset shift.

[funda62]

I wanted one for the first baby but the hospital did not allow private "nurses". The second time around I was kind of fuzzy on VBAC vs. repeat section and ended up with an emergency section anyway and never really thought about a doula.

[JTsMom]

With Jason, I thought I'd be fine without one, and was very very wrong. I love DH, he's wonderful, but top-notch labor support is not his strong suit. He went into panic mode, and just didn't know how to help me, and since I'm not the kind of person who will ask you to do anything for me, we were not a good team.

Jason was posterior, and my labor was long, strong contractions from the start (my water broke before I really started laboring), I was vomiting, and they made me lay still in bed on my side. The practice I was seeing had 3 midwives- 2 great and 1 who I just didn't care for at all- guess who showed up? She was of NO help. She didn't say more than a few words to me until she said it was time for a C/s. My "distressed" baby was born with a 9.9 Apgar, despite his heart condition. I am convinced if I had a doula, I would have progressed faster, felt more confident, and possibly even avoided the C/s.

This time around, I plan on hiring one, although I haven't yet- I'm interviewing someone next week. I know the average rate in our area is $500.

[egoldber]

I had a doula with my second and third babies, even though my third was a planned c-section. She was worth every penny both times.

[mousemom]

I paid $650 for my doula. It was definitely worth it and I would do it again. I actually didn’t hire her till very late because I was debating the cost. I did interview a couple of other doulas who were slightly cheaper (around 400-500), but I felt more comfortable with this one and she also happened to be the most experienced doula in my area (as well as also being a midwife).

We have no family here, so I knew the only support I would have would be from DH. I really wanted someone knowledgeable to help me, as well as to help take some of the pressure off him. My own OB was on board with my desire for a natural birth, but the hospital in general is not very natural birth friendly and I knew the chances of having my own dr at the birth were not great. It helped me to relax and feel more confident going in to know that I would have somebody who understood and supported what I wanted. I also wanted someone else there so that if something went wrong and DS needed to be taken somewhere else, DH could go with the baby and there would still be someone with me.

In the end, the support she provided was very valuable in helping me have the med-free birth I was hoping for. She was on-call 24-7 in the weeks prior to the birth, she helped us create our birth plan, provided support when I was butting heads with the non-natural birth friendly on-call dr, essentially managed my labor until my own dr arrived the next morning, and stayed right with me when I was overwhelmed by the pain during transition.

Probably, the most important thing was that she kept communicating with me throughout the delivery. During the very-fast pushing stage, for example, some of the nurses in the room were talking about me as if I weren’t there, but my doula continued to talk to and respond to me. (for example, one nurse commented “She’s vocalizing too much”; my doula, on the other hand, when I said “I don’t think I can do this”, immediately responded with “What are you talking about? You are doing it!”)

During pushing, the baby's heart rate dropped. I was not totally aware of what was going on, but I saw my doula reassure my husband that the episiotomy the dr wanted was needed (and my dr had done a total of one episiotomy in the last year, so I knew she was not pro-episiotomy in general). When my doula turned to me and said “You need to have this baby now!”, I knew she was concerned for the baby and I gave that last push everything I had.

Following the birth, she helped me try to get DS to latch, made sure I had warm blankets when I was shivering, made sure I got some lunch brought to me, explained what had happened earlier when the baby's heart rate dropped, and just generally helped me get settled. She also called after we were home to see how things were going.

[daisymommy]

For the first 2 births (which were with midwives in the hospital by the way) I didn't have a doula.

Hated birth #1, birth #2 was better. But both times it was just me and DH against the world at times.

With Andrew, who was born at home, we had a midwife and a privately hired doula. She was worth her weight in gold! She came over to my house 2 times for a few hours at a time, and I just spilled my guts out to her telling her everything I did and did not want to happen. I told her how I dealt with pain, and how I wanted her to participate/help during my pain.

She was like an extension of me during labor--but minus the fuzzy headed thinking. So she could remember what I needed and wanted even when I was too out of it to think very clearly; she was my advocate and ally. I loved her! It was a great birth :)

[AnnieW625]

My answer is not up there:

No, I was not glad. It was more than not helpful, I had to tell her to leave.

She was making my birth into her political statement and exerting a lot of pressure on me, all while not doing any of the things she said she would do- massage, positioning, helping J. She sat and read unless she was busy dishing out preconceived advice. Not cool, in the least. I did not hire one for #2.

I didn't vote, and we didn't have one for DD. DH is pretty patient with me and had no problem making sure that the nursing staff did as I requested. I am debating about having one this time, but really what Kijip stated above is one of the reasons I am not sure I really want a doula. For as big as my area (500,000 people) is I only know of two doulas. One has 20+ yrs. experience and is a certified nurse midwife, and the other is my yoga teacher. Everyone I know who has had the first CNM loves her so that makes her hugely popular, and she requires that she see you during the pregnancy, and well I can't really afford all those extra visits and my insurance/clinic (Kaiser) already has midwifes so I can see them at anytime if I really want to instead of seeing the regular OB. My thing with the yoga teacher is that as much as I like her I can totally see her trying to make a political statement (because she is also new to the doula thing) and honestly I know that if I need drugs with this labor I am not going to turn them down esp. if I have to have pitocin, and penicilin for Strep B (like I had with DD). Yes I would prefer a natural child birth mainly because I hate needles (I don't even give blood), but if it's not possible then it's just not possible. I like to keep an open mind about everything so I think that's a positive on my part.

I will say that if I feel like I need extra help once I have the baby I might hire the yoga teacher as a post partum doula.

[brgnmom]

My DH and I paid a hefty deposit to reserve a doula, and she did *not* show up for anything. In fact, I have never met her in person--we corresponded through email, mail and by phone. She cashed the check and when we asked for a refund, she refused. I still have to file a lawsuit, although it's not a huge priority (I'm pregnant and we're moving soon, and there are much more important things in life to me right now to focus upon). I did file a police report around the time my DS was born, and the officer advised that I learn the lesson of not submitting a deposit before meeting the doula in person.

I didn't want to waste the first part of my DS's life going after a refund from the dishonest doula. BUT thankfully my OB and her affiliated hospital no longer refer patients to this particular doula. And I also had an attorney write a letter on my behalf to that doula.

After my experience, I'm thankful that my DH and I had a very intimate L&D experience. I don't feel the need for a doula to help with my future L&D experiences. I'm glad that others of you have had mostly positive experiences, but thought that I would share mine.

[Globetrotter]

Yes, even if you end up with a c/s.

I was hoping for a vbac, but ds went two weeks postdate so I ended up with a scheduled c/s instead.

My doula ended up helping before the c/s and after, and she and the midwives helped me get ds to nurse right away. She also gave dh a break for a couple of hours a day while I was in the hospital, helped me use the restroom, etc...

I also recommend a birth plan, which the doula can help you enforce. i really wish I had one the FIRST time around! I would also recommend Birthing from within, if you have time. We arranged for a one time all-day session on a SAturday, and it was actually helpful even with post-surgical pain.

One thing.. I thought my doula was too passive, and she worked for my ob, which wasn't an ideal situation in some ways. I don't know how she would have been if I had ended up with a vbac. On the other hand, I rejected another doula because she seemed too assertive, way out of my comfort zone.

ETA: You should meet in person to make sure your personalities mesh.

[brgnmom]

I also recommend a birth plan, which the doula can help you enforce. i really wish I had one the FIRST time around! I would also recommend Birthing from within, if you have time. We arranged for a one time all-day session on a SAturday, and it was actually helpful even with post-surgical pain.

One thing.. I thought my doula was too passive, and she worked for my ob, which wasn't an ideal situation in some ways. I don't know how she would have been if I had ended up with a vbac. On the other hand, I rejected another doula because she seemed too assertive, way out of my comfort zone.

ETA: You should meet in person to make sure your personalities mesh.

:yeahthat: I definitely recommend a birth plan. My OB works with a midwife closely, and so thankfully they helped me by looking over and following my birth plan. Even though my doula wasn't present, I still had the support of my DH which was even better. We took a Bradley birthing class (I *highly* recommend this) in preparation for my DS's birth, and that prepared us really well. I did end up getting an epidural and a very low-level of pitocin to help my L&D progress eventually. But I was able to enjoy my experience even without the doula and didn't need a c-section.

[sste]

Citymama, no real doula advice as I have never had one except to echo wellyes to get a doula with vbac experience. I think that *some* of the things a doula does with regard to positioning may be limited or at least altered by the continous fetal monitoring (assuming you are doing that, I think its pretty standard on vbac).

The thing about your post that caught my eye though is that I think in a perfect world a doula should be someone to lavish extra attention and care on the mom - - not to make up for having a cold or less than trustworthy ob or midwife. To the extent the issue is wanting to avoid an unnecessary c-section its not at all clear to me that many doulas are going to be able to reposition the baby (inversion style) and they obviously don't have override power in terms of medical decisionmaking. Not to say doulas are useless in this circumstance just that the *best* way to avoid a questionable c-section is to hire an ob/midwife who is known for their conservative style with respect to cs and in your case many, many cases worth of experience in vbac. Is there any way you can change to a practice more suited to you (of course you can still hire a doula)?

[s7714]

WOW! So I have to ask you the same question I did sarahsthreads, who also had a quick VBAC - did you get to the 10 cm and pushing stage with #1, or what was the factor that made the second birth so much quicker? I know second births are often speedier for moms who had first births vaginally, but I assumed there was no such advantage for moms whose first were delivered via c/s. Like you and some others here, I did labor with my first for many, many hours, but couldn't dilate past 6 or was it 7 cm, largely because of baby's transverse position.


With my first DD, I had my first contraction at like 3 am and was at 10 cm by 7 am. I pushed from 7 am until almost 3 that afternoon. I say that loosely as it was the nurse floating in every few minutes, having me push for 5-10 minutes and then floating out again--it wasn't pushing continuously. At about 2:30 my OB came in again, went through a round of pushing and said my DD hadn't budged one bit. He ordered up some pitocin (which I was nervous about taking, because I was totally med free up to that point and I'd heard pitocin contractions were hell). Within a few minutes of being on the pitocin my DD still wasn't moving and her heart rate started going up so they took me in for a c-section. She was facing sideways and her head was quite wedged in my pelvis. Even the two OBs who did the c-section were surprised at how stuck she was when they were trying to pull her out the other direction. Needless to say, that is why I wonder if having a doula there solely to help me work though positions and pushing could have helped shift my DD into a better position.

DD2 had a bigger head than my first, so the whole idea of DD1 just being too big for my pelvis was thrown out the window. DD2 sailed out so quickly it was shocking to everyone, including the ER dr and nurses. Fast and furious labor/deliveries run in my family, so it really took us by surprise when my DD1 got "stuck". I will say that the few pushes it took to get DD2 out felt immensely different than the pushes I did with DD1. With DD1, when I pushed it felt like all the energy of the push was just slamming into my pelvis like a brick wall. With DD2 I totally felt the energy of the push flowing down and out of my body. I know that sounds corny and honestly I'm not one of those "be in tune with your body vibe" earth mommas, but that's really the way it felt!

[m448]

Doulas don't use version to turn babies just like homebirth midwives don't. Positioning of the mom is a much more effective and gentle way to reposition a baby. Everything from hands and knees position (rocking) to bring a baby up off the cervix and engage effectively again to using an tilted angle/handstand then lunges (which worked for me) at home. There are many techniques a doula can use to help a baby turn which a hospital midwife or an OB would not have in their arsenal of tools.

I also think sometimes people don't see the need for a doula because they are still optimistic that the hospital has the mom's best interest at heart. Not so. The hospital isn't out to do outright harm but their bottom line is not getting sued and keeping licenses. Seeing how little evidence based practices are used in maternity wards across the country is enough to realize this reality.

Doulas also act as informed advocates. My friend's husband requested a squat bar for his wife once she was ready for it. The nurses hemmed, hawed, delayed and then finally said that they would have to look for it since they didn't remember where it was located. The doula, having had many clients at the hospital responded, "sure it's in the third closet on the right where you always keep it." Having a doula in your back pocket is NEVER a bad idea. Just find a qualified doula and realize that one of the doula licensing associations is closely aligned with most hospitals so I would avoid that specific one.

[m448]

Just wanted to add that a good doula will let you grill/interview her to see if you mesh with her personality. You should have at least a handful if not more visits during the pregnancy and she should be available via phone at the least to answer questions. Also a good doula will not balk at being with you at home while you labor before going to the hospital. Always check references.

[SnuggleBuggles]

Doulas also act as informed advocates. My friend's husband requested a squat bar for his wife once she was ready for it. The nurses hemmed, hawed, delayed and then finally said that they would have to look for it since they didn't remember where it was located. The doula, having had many clients at the hospital responded, "sure it's in the third closet on the right where you always keep it." Having a doula in your back pocket is NEVER a bad idea. Just find a qualified doula and realize that one of the doula licensing associations is closely aligned with most hospitals so I would avoid that specific one.

Plus, I think that by walking in with a doula you already set the tone for what kind of mom/ patient you will be. I am sure some nurses roll their eyes about doulas and no pain meds (the birth instructors at our hospital were like this and they were also L&D nurses). By showing up with a doula they can flip a coin before being assigned to you, knowing full well that you might want and need things that aren't the typical.

I was really glad to have my doula when there was a nurse shift change and the new nurse was totally unsupportive (the first had been fabulous).

Beth

[mousemom]

Plus, I think that by walking in with a doula you already set the tone for what kind of mom/ patient you will be. I am sure some nurses roll their eyes about doulas and no pain meds (the birth instructors at our hospital were like this and they were also L&D nurses). By showing up with a doula they can flip a coin before being assigned to you, knowing full well that you might want and need things that aren't the typical.

I was really glad to have my doula when there was a nurse shift change and the new nurse was totally unsupportive (the first had been fabulous).

Beth

Yes, I think this was important for us too. The first nurse who checked us in was obviously not comfortable with a med-free, non-interventional approach. But the shift changed just after we were checked in (and then again in the morning) and the nurses assigned to us were obviously ones who were comfortable with our approach.

[sste]

M448, can the doula still reposition a mom in the ways you describe if you are doing vbac with continous fetal monitoring? OP, not to hijack but I have been wondering about this myself because my impression (??) is that the continous fetal monitoring would make the squat bar, birthing ball, and standing not an option. Are there other repositionings that are an option with vbac style fetal monitoring?

I guess I am also curious as to whether doulas obtain a ton of repositioning experience and education based on their training - - we have looked into doulas in the past and when I check the website the training looked variable. You could have as little as about 30 hours of workshop-style education? I am in no way anti-doula - - I am just not clear on whether I can assume that all doulas will be able to do midwife style repositioning??

[SnuggleBuggles]

I can't answer for M448 but I know even when I was hooked up for intermittent monitoring I had a range of motion and sat on the ball, in a rocking chair and stood. Telemetry monitoring may be available too which would let you be more free from the restrictions of the wire. If they really want to, they have technology that allows for monitoring when in the tub...so be sure and press about options. They might not offer them up but they could have them. Which is a case for a knowledgeable doula- they know what can be done. :)

Beth

[sste]

Hmmm . . . I think intermittent may be different from continual monitoring (vbac). But, if I found out anything more I will let you all know! Thanks snugglebuggles.

[SnuggleBuggles]

There is internal monitoring and external. Otherwise the continuous vs intermittent is the same technology, just the length of time hooked up differs.

Beth

[mousemom]

I guess I am also curious as to whether doulas obtain a ton of repositioning experience and education based on their training - - we have looked into doulas in the past and when I check the website the training looked variable. You could have as little as about 30 hours of workshop-style education? I am in no way anti-doula - - I am just not clear on whether I can assume that all doulas will be able to do midwife style repositioning??

I can't answer about the monitoring/positioning, but I do think that the training is quite variable and I could tell when I was interviewing that different doulas had very different methods and styles. That's why it is important to talk to any potential candidates, ask them questions about their techniques, experiences, etc., and check their references. When I was interviewing, I pulled together a list of questions about things that were important to me from several different sites online. I would not assume that they have this experience, but would ask them directly.

[m448]

Exactly what Beth said. Having a doula and being educated would mean you could deny CFM and go for intermittent AS WELL as laboring for a good bit at home with the doula. Some moms are more comfortable laboring at home and leaving for the hospital only at the very last moment even VBAC moms. Heck some moms are comfortable with HBACs.

Yes look into the types of training a doula has but more than "workshops on paper" I would interview the doula myself and being that I'm tapped into the local birth network a bit I'd grill my midwife on the doula in action since my midwife (a homebirth CPM) has been in the biz for 15+ years. The same goes for grilling a trusted non-hospital affiliated childbirth instructor or fellow moms with similar birth philosophies. Since I've given birth I'm also quite familiar with my body and my needs during labor. I'm not a quiet, peaceful hypnobirthing mom. I'm a hands-and-knees, toning in another level, leave me the heck alone except for counterpressure mom. My doulas have known this and respected it as well as enforced it for those who have wished to push the issue.

Also, while doulas can't legally voice decisions for you, they can most certainly guide you and hubby in decision making with subtle cues as well as advocating for a decision you've expressed but docs and nurses have chosen to ignore.

[AnnieW625]

We took a Bradley birthing class (I *highly* recommend this) in preparation for my DS's birth, and that prepared us really well. I did end up getting an epidural and a very low-level of pitocin to help my L&D progress eventually. But I was able to enjoy my experience even without the doula and didn't need a c-section.

To the OP: Unless they have 8 week Bradley classes out there you aren't going to be able to do it. I looked into it in February, and since it's a 13 week program only it wouldn't have worked for me because I needed to start in January, and not February.

[nov04]

If we were going to have a third (we're finished though), I would unquestionably have the same doula attend our birth. She was amazing. I chose her from a long list of doulas in our area and her credientials (IBCLC and R.N.) meshed with what I wanted. We chatted and I realized she was perfect for me.

I think the most important thing she did though was to soothe my pre-birth anxiety about what had happened during my first pg and high-stress delivery. She gave me my control back. no one was going to make me feel helpless again or tell me I was now predisposed to bleeding on my brain during my next labour.

We didn't have the birth we planned, but because of her, I'm fine with it. A hospital R.N. saw how wonderfully I was doing through my surges. She thought it would be the perfect time to inform that it would be at most 5 hours until I delivered. I lost all focus and begged for an epi because I lost my sense of timelessness during my hypnobirthing. That was a tiny fraction of time during my 26+ hour labour and I knew I had controlled everything I could possibly have controlled.

GL deciding

[sste]

Thanks everyone and OP for bringing up this topic!

Maybe I will look into a doula too . . . though I am pretty uniquely lucky in my situation with my OB. She is a holistic-focused, solo provider, with a 5% c-section rate, will deliver anything but your first baby breech and has the skills to do so, and goes to real lengths to make sure her patients have a good birth experience. So, I am unusual I think nationally in not feeling like my decisions or feelings were ignored (the opposite!) and I have no doubt that my c-section was medically necessary.

I think what I am trying to get it is that I feel like something has gone terribly wrong in our system when so many women hire doulas not for the extra tlc but because they feel like they need to be "protected" from their midwive/ob or the medical system. That is not an OK state of affairs. To me, if my motivation for a doula was protection/advocacy, it would be a red flag for needing to think about switching providers or hospitals. Though I do recognize I am pretty unusually blessed in the amount of health care choice and connections I have.

[m448]

Thanks everyone and OP for bringing up this topic!

Maybe I will look into a doula too . . . though I am pretty uniquely lucky in my situation with my OB. She is a holistic-focused, solo provider, with a 5% c-section rate, will deliver anything but your first baby breech and has the skills to do so, and goes to real lengths to make sure her patients have a good birth experience. So, I am unusual I think nationally in not feeling like my decisions or feelings were ignored (the opposite!) and I have no doubt that my c-section was medically necessary.

I think what I am trying to get it is that I feel like something has gone terribly wrong in our system when so many women hire doulas not for the extra tlc but because they feel like they need to be "protected" from their midwive/ob or the medical system. That is not an OK state of affairs. To me, if my motivation for a doula was protection/advocacy, it would be a red flag for needing to think about switching providers or hospitals. Though I do recognize I am pretty unusually blessed in the amount of health care choice and connections I have.

Quite true and I wholeheartedly agree. Unfortunately not every woman is ready for a homebirth and believe it or not for naturally birth minded mom even in my area (triangle, raleigh/durham/chapel hill area) a woman interested in using her insurance network for a birth would be hard pressed to find a great care giver. The ones that were naturally minded were pushed out of the biz (yes pushed, I totally know the backstory on those) and the one birth center is about an hour away from most peopleon a good day. Which is likely why homebirth is such a popular option in this area.

A homebirth midwife with quite a bit of experience trusts the birthing process and allows a mom to be vulnerable when she most needs it without feeling paranoid. My midwife does twins, HBACs (even multiple Cs) and I believe will do some breeches as well. You have a gem in your OB because nationally it certainly is not the case.

[nov04]

To me, if my motivation for a doula was protection/advocacy, it would be a red flag for needing to think about switching providers or hospitals. Though I do recognize I am pretty unusually blessed in the amount of health care choice and connections I have.

good point, but our experience was different.

I trusted my OB but she happened to be stuck in surgery all day and I was at the mercy of the bunch of hospital personel who were more interested in monitoring me to see if I were going to have a stroke myself than getting me to L&D and concentrating on my labour.

We moved for our second birth. My Dr. for second birth was wonderful through the whole pg and birth. He was totally fine with my doula and had worked with her before. It made me adore him even more.

One can't know what sort of circumstances are going to come up the day of the birth and having a doula present helps with that.

[SnuggleBuggles]

[/b]

Quite true and I wholeheartedly agree. Unfortunately not every woman is ready for a homebirth and believe it or not for naturally birth minded mom even in my area (triangle, raleigh/durham/chapel hill area) a woman interested in using her insurance network for a birth would be hard pressed to find a great care giver. The ones that were naturally minded were pushed out of the biz (yes pushed, I totally know the backstory on those) and the one birth center is about an hour away from most peopleon a good day. Which is likely why homebirth is such a popular option in this area.

A homebirth midwife with quite a bit of experience trusts the birthing process and allows a mom to be vulnerable when she most needs it without feeling paranoid. My midwife does twins, HBACs (even multiple Cs) and I believe will do some breeches as well. You have a gem in your OB because nationally it certainly is not the case.

:yeahthat: PP and I used the same CNM in NC as she was one of the very few in the whole area.

In my new city I was lucky that I my health insurance covered a birthing center. The other major carrier in my area did not cover them so I would have paid completely OOP for my birth. I would have and could have paid for it and I completely believe that it was worth it. But, not everyone can and that means they are left with hospitals and care providers that may not be pro- mom. The biggest maternity hospital in my city is so intervention happy that even good CNMs that practice there have their hands tied by hospital policy. It is really a sad state of things right now, imo.

Beth

[MommyAllison]

I voted "No and glad we did it that way" - but I do think doulas are an amazing resource and recommend them to others often. :) I personally preferred laboring without one for a few reasons. I prefer to labor alone with DH, and had done tons of reading to be pretty well educated on what interventions might be called for in certain situations, and what things to try to avoid interventions. My labors were both quick, and with DH's help I got into my zone and it worked great for us.

However, I have quite a few friends who are doulas, and one in particular whom I really respect as a doula and love as a friend, who I knew I could call if labor stalled or whatever. That friend was my backup, actually, when DH was out of town when I was 35 & 36 weeks pregnant with DS. She was on call for me, and if I'd gone into labor, she would have been my labor partner (DH was on the exact opposite side of the globe so wouldn't have made it back in time - my labor with DS was 3 hours). So that probably made me subconsciously more comfortable, knowing I could call on my friend if I really needed a doula.

Like I said above, I do really support the idea of doulas, and have recommended them to several close friends, and one of whom who had a crazy labor with her first baby, including tearing in 4 directions, being stitched, then unstitched, then taken to the OR and re-stitched, resulting in more issues since she was totally out of it for hours after that and didn't get to be with her baby for way too long. She was totally scarred emotionally and mentally after her first birth, and I think a doula would be really, really helpful for her, especially since her DH is pretty unhelpful during labor.

If my labors were different, I'd have a doula. If my DH was not so amazing during labor, I'd have a doula. If I didn't feel so in need of solitude during labor, I'd have a doula. :) I had a midwife with DS, who was wonderful (and now retired, unfortunately), and plan to use a midwife (probably homebirth) in any future pregnancies. With DS' labor, a doula would have been redundant with *my* midwife, as she wanted to be at the hospital as soon as I got there, and I really didn't need any extra support prior to that.

And what really drives me crazy is when people call a friend who hangs out with them during labor their "doula". MIL is a labor & delivery nurse and was another friend's "doula" for her birth. Really, she was just a nurse, off the clock. It was in the same L&D ward she works in, she has not had any doula training and is very much a medically minded nurse when it comes to labor & birth. That friend ended up with a c-section, for many reasons, but I think a trained doula would have probably helped her labor to progress, and given her things to try. It dilutes the meaning of a doula to have any labor support person be called a "doula".