Are birth plans a waste of time?

[BellyBelly]

The benefits are huge. From 16 studies around the world:

Labour Statistics
• 50% reduction on caesarian rate
• 20% shorter labour
• 60% reduction in the need for epidurals
• 40% reduction in forcep use
• 40% reduction in Syntocinon use (induction)
• 30% reduction in analgesia use (narcotics)

Benefits for Mothers
• Better bonding with baby and partner after birth
• Lower rates of Post Natal Depression
• Higher rates of successful breastfeeding
• Greater sense of achievement
• Greater sense of support
• Greater satisfaction with her partners role in supporting her in labour

Benefits for Fathers
• Less pressure as the sole support person
• Ability to have breaks without abandoning partner
• Encouragement and guidance in how to support a labouring woman
• Emotional support and reassurance
• Greater satisfaction for the support you are able to provide your partner
• Greater sense of involvement in being able to absorb the birth experience

Benefits for Baby
• Less admissions to neonatal/special care nurseries
• Higher rates of breastfeeding success
• Higher AGPAR ratings after birth

[~clover~]

I wish I found this site earlier.
I'm not planning on having anymore babies, but I really would love to have a doula if I ever did have any more.
I'd never heard of them before.

With my first birth my mum & MIL were great, my 2nd it was only DH & I, but I had an excellent MW.
With DS MIL was there (DH had to travel from 2 hours away), but she sat in the corner & stayed out of the way. I had noone holding my hand for the hour or more til DH got there & the MW pretty much left me to labour. I felt pretty alone. Then DH nearly did pass out, & I was alone again.
I was hooked up to a monitor & couldn't really move due to macconium. I was lucky that it was a quick labour though.

But to have someone to help me through it like that would've been good. The MW's this time around were great too, but were only really there for the actual birth. & even though I screamed at them to 'pull it out!!' they said 'No, your going to push this baby out yourself!'

[tsgirl]

The benefits are huge. From 16 studies around the world:

Labour Statistics
? 50% reduction on caesarian rate
? 20% shorter labour
? 60% reduction in the need for epidurals
? 40% reduction in forcep use
? 40% reduction in Syntocinon use (induction)
? 30% reduction in analgesia use (narcotics)

Benefits for Mothers
? Better bonding with baby and partner after birth
? Lower rates of Post Natal Depression
? Higher rates of successful breastfeeding
? Greater sense of achievement
? Greater sense of support
? Greater satisfaction with her partners role in supporting her in labour

Benefits for Fathers
? Less pressure as the sole support person
? Ability to have breaks without abandoning partner
? Encouragement and guidance in how to support a labouring woman
? Emotional support and reassurance
? Greater satisfaction for the support you are able to provide your partner
? Greater sense of involvement in being able to absorb the birth experience

Benefits for Baby
? Less admissions to neonatal/special care nurseries
? Higher rates of breastfeeding success
? Higher AGPAR ratings after birth

Kelly are those stats specific to Doulas or are they the stats related to having support through pregnancy from consistent skilled caregiver?

I think this is a really interesting discussion. It highlights the contract BETWEEN the individuals involved in the birthing process. I agree with FJ that I would expect a Doula to act in the situation re: progress not being reported. Similarly, I agree with Kelly that potentially the worst outcome is for the Doula to end up in conflict with the OB/MW. The idea that you catch more flies with honey than vinegar is an important one. It irritates me that 'the game' continues in the health system, but ultimately the only way to effect change is for OBs/MWs to experience normal delivery on enough occasions that they come to recognise how it 'can' be. That will never happen if the battlelines are drawn so firmly that the system is tipped even further against a woman delivery normally in a hospital environment. A Doula CAN assist a woman against the pressures of the system IF the woman has invested time and energy in educating herself.

So again, for me, it's important that a Doula isn't viewed as someone who can 'give' you a particular experience, but rather someone who will work 'with' you for the most positive experience.

[BellyBelly]

They are doula studies - where they were not employed by the hospital.

[Tobily]

I think in the progression scenario specifically - I would probably say something about that. Simply because in the big scheme of things it is a relatively minor request - on a par with things like keeping the lights down etc. It's one of those things that is purely for the mother's comfort and mental state. There is no reason for them to disrespect that so I think in that specific instance I would remind them, or at the very least encourage the father to.

I think though that we do need to remember that a doula's primary role is that of birth support - focusing on the mother and her partner, supporting them through the process of birth itself. Advocacy at a birth is a very small part of what we do because we are essentially quite restricted. This comes back to what kelly was saying, there is an increasing perception that doula's are paid "birth bouncers". We are not and I am crystal clear with my clients about this. Often the situations that cause conflict are those with OBs and midwives in attendence that aren't very tolerant on their decisions being questioned generally - by parents and much less by what they might view as a paid "ring in". Confrontational doula's get thrown out of births by carers like this and that it is a deterimental outcome for everyone - the doula, the couple who then left completely on their own, and every couple with a doula that crosses the path of that carer thereafter.

Absolutely agree too that there a too many new doulas with zero idea about how to act professionally in hospitals and I think its a disgraceful shortfall in certain "training" programs.

We walk a very fine line. They'll chuck a doula out but a father will get away with more. They don't like throwing father's out. So unfortunately in a hostile environment he may be the only one who can say what needs to be said. I talk to dads alot about this before births and like kelly, ask passive questions during labour. When I can see things coming I ask them in the presence of the caregiver if they're ok with it and if they need to time to think and discuss. That is all I can do.

I give this to all my clients:

Promises of a Doula..

You cannot hurt my feelings in labour.

I won't lie to you in labour.

I will do everything in my power so you do not suffer.

I will help you feel safe.

I cannot speak for you but I will make sure that you have a voice and I will make sure you are heard.