Are doulas silly?

[Gertabelle]

OK that’s the question. I am a therapist and I feel like I can tell my wife “You’re doing a good Job,” “I’m so proud of you,.” “You are being so strong.” etc…etc.

I can also get ice chips or water (if permitted) for my wife- I really can! I can tell doctors- "We prefer this or we want to know about that. . . "

So are doulas kind of a silly thing? I can see them being helpful for some couples where culturally the father is very uncomfortable with the process of childbirth but really.

What do you guys think?

Is it kind of a “granola” thing?

My son’s dad is a massage therapist and a cranio-sacral therapist. Talk about being comfortable with birth! And we went to Bradley Method classes (husband-coached childbirth), and I was sure he was going to do just great with the birth. I mean, he had the perfect temperament and knowledge of the human body!

But a woman never knows how she’s going to be in labor and delivery until the time arrives! All through the heavy contractions (late first stage labor), I wouldn’t let him touch me. He tried to rub my back, but I nearly screamed in pain and told him not to lean on me. He tried to talk me through the contractions but I couldn’t stand the noise – poor man. I would never have suspected that his job would be to hold my hand and not let go through three hours of intensifying contractions.

The moment the midwife, however, came in the room, she began rubbing my back and talking to me – and her voice and her touch just blended in perfectly with the pain and the process. Her words and touch were so comforting and reassuring. Go figure. Maybe she just knew how to touch and talk to a woman in labor? I don’t know. But I do know that the dad had to shut up and hold my hand. It wasn’t a slam against him – I actually panicked when he had to let go of my hand for a moment – but his words and touch didn’t work in that moment, even though his whole career is about touch!

Is a doula a “granola” thing? Probably. But it’s not a scam if that’s what you mean.

Of course you know how to talk to your wife. And it’s great that you’re comfortable with the processes of labor and delivery. That being said, unless you have attended to a woman in labor and delivery, and unless your wife has had a child before this, the two of you simply have no idea what the actual process is going to be.

I’m not for or against you having a doula, but if it’s something you or your wife have considered, you might want to look into it just to see if it is right for you. Some people want and love the medicated, high-tech, hospital birth. Some people want and love the all-natural, midwife attended home birth. Whether or not you have a doula will depend on the type of birth experience you and especially your wife want.

God bless you and your family!

Gertie

 

[EvelynEVF]

A doula will also make pre-birth visits, so you would have a chance to ask a lot of questions in a supportive atmosphere, and really talk through a lot of possibilities. And remember that if you have a doula there, and it doesn’t feel right, you can always ask her to be in the next room, or guard the door, or update your family, or whatever. No doula would want to be interfering if her presence didn’t feel right to you.

And depending on the hospital, she may be the only breastfeeding help you get!

 

[CB_Catholic]

When my daughter was in labor with her first she was very irritable and called the shots as to who was going to be with her. She insisted I be there. She pointed to her husband and me and said “You stay”, and told everyone else to leave. I thought she was rather rude, but hey, she was in pain. I sat there and said the Rosary, son-in-law was a wreck. She got an epidural and after that became sweet as pie, but refused to let me leave. It was a premature birth and she had been in the high-risk unit for a week, so she also was anxious about the baby. Anyway, when it came time to push, I had to drag son-in-law out of the corner to watch the birth. They had been to all the classes and everything, but it was as if everything they learned flew out the window. Luckily, it was a short labor and took about 3 pushes to get the baby out. Baby was fine.
Son-in-law recovered enough to cut the cord.

The second time was totally different. She did not insist I drive the 3 hours to be with her and they handled everything just fine, even though it was another preemie. She called up and said “I had a baby girl” and gave me her name and weight and I said “I’ll be down this weekend to see her.” I was kind of glad not to have to go through that again with her.

 

[MrsMW]

My Mom watched my girls with my last baby and 6 months later when I had a hysterectomy. Maybe that is different than being there but I felt so happy my girls were with people who love them! Thumbs up for my Dad too!

Moms are always needed even when you grow up!

 

[Granny_D]

I haven’t posted in ages…because I have been busy…being a DOULA… The post below explains part of the benefits of having a Doula… Other responses have also covered some of what we do or don’t do…

My great grandmother was a Midwife in Ireland… elected by the Village to “catch” the babies… and also to “dress” the corpse of those who died… so Hatching and Dispatching is in my blood.

I LOVE BEING A DOULA! Incredible training and ongoing education… but most of all it is the ability to “mother the mother” that is irreplaceable.

Circle of Life - Celtic Doula
celtic.doula@gmail.com

A doula will also make pre-birth visits, so you would have a chance to ask a lot of questions in a supportive atmosphere, and really talk through a lot of possibilities. And remember that if you have a doula there, and it doesn’t feel right, you can always ask her to be in the next room, or guard the door, or update your family, or whatever. No doula would want to be interfering if her presence didn’t feel right to you.

And depending on the hospital, she may be the only breastfeeding help you get!

 

[mdr]

Our experiences w/doulas has been A++++++++++

Our doula, and now a friend, taught our childbirth classes for our 1st baby. She is also DONA certified, and a very comfortable, funny person to be around.

For our 1st baby, I had a really long labor in-hospital, after my water broke, that stalled after about 18-20 hours. All the pleasantness of a long labor: exhaustion, off-and-on nausea, HUNGER, disorientation during the transition phase. You name it, our doula was there. She helped in so many ways, even down to knowing where the extra blankets were kept when my feet were cold. She was there all night & all the next day, only napping in the chair when things were calm. Eventually, I had to have a C-section because the baby wasn’t coming down, and her heart rate was showing some distress. Besides, it had been 24hrs since my water had broken, and hospitals don’t let moms go longer than that for fear of infection.

Anyway, our lovely doula stayed in the labor room while my husband and I went to the operating room, and even though we had to wait over 2 hours for them to bring us the baby (the hospital was so crowded, there weren’t any more bassinets available, and those were the only legal way they could move the babies to and from the nursery), she stayed to help me through the first feeding, supporting the baby while I learned about latching on, etc. My DH was so relieved to have her there, so he could focus on being the hubby. Poor guy didn’t have the least idea how to help me breastfeed, but he was a wonderful handholder, back rubber, cheerleader, and sweetie.

After that, we both swore never to have another baby without our doula, and we had 3 more with her help: 2 unmedicated, all-natural births, with tag-team doulas on baby #3 when our friend had to go take an exam that couldn’t be rescheduled, and a roller-coaster for our youngest! (PIH leading to induced labor at 41 weeks, the baby being stuck and unable to descend, a dramatic heart deceleration on the monitor so that the OB literally ran through the halls to prep for an emergency C-section, cord looped around the baby’s neck & shoulder, etc.) Our doula was there every step of the way.

One thing that a private doula provides that we don’t always think about: continuity. Laboring through the hospital’s shift change is really stressful, and it can happen even in shorter labors if your timing is unlucky. With a doula, even when the labor & delivery nurses come and go, you have the same face and voice nearby.

Sorry to be so long-winded! When my DH saw the topic, he immediately said “No, they’re not silly, in fact I wish ours were still here to help now!”

 

[Granny_D]

O
One thing that a private doula provides that we don’t always think about: continuity. Laboring through the hospital’s shift change is really stressful, and it can happen even in shorter labors if your timing is unlucky. With a doula, even when the labor & delivery nurses come and go, you have the same face and voice nearby.

Thank you for the above quote…“continuity” is an incredible thing when you are in the hospital. Different faces, voices and approaches… Doulas also work with those who choose a Birth Center or have a Home Birth.

I am overjoyed to hear of stories of natural births following a c-section

Granny D

 

[awantz]

I didn’t have a Douala during either of my first two births. I don’t intend to have one at this birth or any future child’s birth. My husband knows me better than a Douala would and therefore does a better job. I’ll stick with what I know works.

 

[MrsMW]

Personally, I never liked the idea of having someone other than my husband go through the labor process with me. To me, it was a *private *thing… something *special *between husband and wife… and some random person just didn’t seem to fit. I don’t “get” the need for a doula, but that’s just me.

Do you get any medical care before and after the baby is born?

If I had done that I literally would be dead.

 

[Jennifer_J]

Do you get any medical care before and after the baby is born?

If I had done that I literally would be dead.

I don’t think Em had an unassissted birth, but there are people who do that…

 

[wabrams]

A midwife is certified to actually deliver a baby; they have more medical training and in states where midwifery is legal, are qualified to provide certain medical care (such as giving pitocin after the birth to help the uterus contract, stitching up perineal tears). A doula is solely trained to provide support for the mom–backrubs, emotional support, and they are trained to offer advice such as positioning for the mom to help the baby move down the birth canal, or to turn the baby. BUT they are not medical personnel and cannot give medical advice.

For instance, a midwife, if the baby is posterior, can say, “The baby needs to get turned, so I need you [the mom] to get on your knees in the bed to get that to happen.” The doula would say, “The doctor/midwife says the baby is posterior, and sometimes it helps if the mom gets in a different position.”

Sam said it pretty well.

Midwife: can give medical advice, administer pain medicine, deliver the baby, etc. Many midwifes are registered nurses who have had extra education to get the midwife title. Those that aren’t nurses before-hand had to go through rigorous medical training to get the title. So, in either case, a midwife can essentially do everything that a nurse can.

Doula: can give emotional and physical support, act as a third party advocate for the mother, document the event, etc. Doulas technically don’t need certification, but it is strongly recommended. Certification is primarily home-based learning with several births attended and can take as few as three months or as long as 2-3 years (depending on the program’s time limit to complete everything).

Just to add a little bit to this part of the discussion. A *nurse *midwife and a midwife are different entities. A nurse midwife is someone who went to nursing school (RN), has a bachelor’s in nursing and a masters degree in nursing with an emphasis on labor/delivery/midwife. They act on the same level as a nurse practitioner or physician assistant (aka mid-level practioner). They caa order exams, order narcotics to be used, do regular annual gynecology exams, deliver babies vaginally, etc.

A regular midwife can’t do most of those things on their own and don’t have near as much medical training.

 

[Jennifer_J]

Just to add a little bit to this part of the discussion. A *nurse *midwife and a midwife are different entities. A nurse midwife is someone who went to nursing school (RN), has a bachelor’s in nursing and a masters degree in nursing with an emphasis on labor/delivery/midwife. They act on the same level as a nurse practitioner or physician assistant (aka mid-level practioner). They caa order exams, order narcotics to be used, do regular annual gynecology exams, deliver babies vaginally, etc.

A regular midwife can’t do most of those things on their own and don’t have near as much medical training.

Actually a “regular” midwife can do all the things you listed, as well. Midwives are medically trained–as well as or even better than nurse midwives (depending on the state). Also, they often see birth as a NATURAL NORMAL event and not as a medical event…

 

[EvelynEVF]

And “normal” midwives come in all shapes and sizes, too. There are direct entry (ie non-nurses) midwives who learned everything they know by apprenticeship, like many Mennonite and Amish midwives. There are other DEMs who went to midwifery school for three years and did the huge national certification exam to obtain the Certified Professional Midwife credential. And then there is everything in between. Anybody with a CPM has been evaluated on 700 individual skills (no, that isn’t a typo) and sat for an all-day exam.

Both my births were attended by midwives who learned by apprenticing. One did have the CPM and one didn’t. Both had caught well over a thousand babies by the time they got to mine. One was a Mennonite lady who would do twins and vbacs and breeches at home, because she knew how. She had delivered dozens of sets of twins with no problems, and probably a hundred breeches.

The other midwife did most of her work in developing countries, without running water, clean supplies, or electric light. She had moms who had rickets and honest-to-goodness cephalopelvic disproportion because of it, moms who couldn’t go to the hospital even in an emergency because the baby would be held hostage until the bill was paid, women with terrible nutrition, etc.

It was amazing what they could do without relying on modern medicine. They often didn’t have the option of saying, “Well, if anything goes wrong, we’ll just head for the OR.” To them, me pushing for five hours with good vitals was no problem at all, whereas in my local hospital I would have been sectioned after 2. My son was asynclitic, and we had all sorts of options to persuade him to realign. I’ve heard many stories of csecs for failure to progress, where the baby is “discovered” to have been posterior. In the midwifery model of care, everybody knows how that baby is positioned at every third trimester prenatal visit.

Not to say anything against women who choose to birth in the hospital. We all need to birth where we feel safest. I just want to point out that most midwives are extraordinarily skilled professionals.

 

[Em_in_FL]

Do you get any medical care before and after the baby is born?

If I had done that I literally would be dead.

I don’t think Em had an unassissted birth, but there are people who do that…

OMGOSH no! I’m a big believer in low-risk!
I had my babies in the hospital… with a nurse-midwife.

 

[MrsMW]

OMGOSH no! I’m a big believer in low-risk!
I had my babies in the hospital… with a nurse-midwife.

I love the idea of a nurse midwife. I am still a beliver in the hospital.For me I needed an operating room and a doctor. Plus if you are at home after a birth a mom will want to get up and do things for the family. Better to be in a hospital where the nurses get it for you! My husband is great but we all know men who aren’t.

More and more hospitals are doing the nurse-midwife thing. I think it is a good thing.

 

[wabrams]

Actually a “regular” midwife can do all the things you listed, as well. Midwives are medically trained–as well as or even better than nurse midwives (depending on the state). Also, they often see birth as a NATURAL NORMAL event and not as a medical event…

No they aren’t. Nurse Midwifes see patients that aren’t even pregnant or trying (normal, annual visits), they have DEA numbers (unlike a “regular” midwife), and can order and interpret ultrsound exams. Only ones I know who see it as a medical event are OB/GYNs.

To become a nurse midwife, you have to have a BSN. “Regular” midwifes can have a degree in anything.

 

[Jennifer_J]

No they aren’t. Nurse Midwifes see patients that aren’t even pregnant or trying (normal, annual visits), they have DEA numbers (unlike a “regular” midwife), and can order and interpret ultrsound exams. Only ones I know who see it as a medical event are OB/GYNs.

To become a nurse midwife, you have to have a BSN. “Regular” midwifes can have a degree in anything.

Let’s use precise terms. I’ll link to this site, because it explains it more clearly than you or I have at this point…
kidshealth.org/parent/pregnancy_newborn/pregnancy/midwives.html

<<What Kind of Training Does a Midwife Have?
Midwives today come from a variety of backgrounds. The subtitle a midwife uses will indicate the level of education and training. Most American midwives are certified nurse-midwives (CNMs) who:

have at least a bachelor’s degree and may have a master’s or doctoral degree
have completed both nursing and midwifery training
have passed national and state licensing exams to become certified
are licensed in every state
may work in conjunction with doctors
About 96% of births assisted by certified nurse-midwives occur in hospitals.

A certified midwife (CM) is not a registered nurse but otherwise meets the same qualifications as a certified nurse-midwife. Because this certification has only existed since 1996, there are few CMs. Currently, only some states recognize this certification as sufficient for licensing.

A lay or direct-entry midwife may or may not have a college degree or a certification. Direct-entry midwives may have trained through apprenticeship, workshops, formal instruction, or a combination of these. Not all states require them to work in conjunction with doctors, and they usually practice in homes or non-hospital birth centers. But not every state regulates direct-entry midwives or allows them to practice.

A certified professional midwife (CPM) is certified by the North American Registry of Midwives after passing written exams and hands-on skill evaluations. Direct-entry midwives and certified nurse-midwives can apply for this certification. They’re required to have out-of-hospital birth experience, and usually practice in homes and birth centers. Their legal status varies according to state.>>

Most will provide both prenatal and postpartem care, and conduct basic gynecolgical services. It may depend on the state and their regulations regarding other types of services. I’ve used both Docs and Midwives (CNP, and CPM) for my care at various times and they ALL provided every service I have needed.

 

[EvelynEVF]

You’ll see a huge difference on the range of services provided based on the state. I know a midwife in my state, where CPMs were recently legalized, who came from the west coast. Here, direct-entry midwives don’t do a whole lot of well-woman care unless associated with a birth center or some other practice. On the west coast, however, this midwife was not only legal, but licensed, and able to receive medicaid payments! So she could order labs and ultrasounds and have a full range of services that wouldn’t be available in a state where midwives need to practice more discreetly.

 

[Kerry_in_WA]

So, hey, I’m a labor and delivery nurse, and unlike what one of the earlier posters said, not all labor and del nurses are part of some vast conspiracy with Dr’s to make sure you have an intervention laden delivery. That being said, I can tell you from witnessing many doula births that it all depends on your doula. There are some that feel that their one class and whatever experiences they have had puts them in a position to make medical recommendations. I had one family which I still remember where the mom had a serious infection and the baby’s well-being was jeopardized. The family was deferring to the doula when they were trying to decide whether to consent to a c/s. The baby ended up in the NICU. As for choices like episiotomies, they are mostly not done these days. I have only seen a handful in the last 6 yrs. They are mainly done when there is a serious risk if pushing were to continue vs expediting delivery. So don’t rely on the doula for that. What I do think is great about doulas has already been mentioned. A good doula is there for back rubs, aroma therapy if desired, helping with position changes, encouragement, helping with breathing…all things a husband could do but in a long labor it is nice to have a break. Esp if the mom wants to avoid the epidural. Do your homework and ask lots of questions.

 

[EvelynEVF]

I see by your handle that you are in the northwest US. That’s why you don’t see many episiotomies Those of us in the midwest see lots of routine interventions like episotomies and forced counted pushing while supine, etc.

So yep, do your homework, wherever you are!