Advice on whether a doula is for us

Hi all

I'm just now starting to think about the birth etc and after always thinking that I'd have no use for a doula am now thinking otherwise. I just wanted to run my thoughts past you guys to see if, with your experiences either in labour with or without a doula or as a doula yourself, you think a doula is for us.

I use the words we, us and our because DH and I are very much a team. Sure he is a typical bloke and has very little idea what he is in for, but lets be honest here, I'm not in a much better place am I, having not given birth or been involved with anyone else birth (except for some farm animals LOL). DH very much wants to be a part of the labour and birth and we both agree that he will be my primary support person.

We live in a regional city so we have limited choices. I love the idea of a home birth but really don't think it is for us at the moment, perhaps in the future but it is too scary for now. So the choices are, public hospital and private hospital. Both have the same doctors. We are choosing the private hospital as we have cover, we've had some negative family experiences at the public hospital (not to do with maternity/obstetrics), and we like that you get the luxury of a private room and DH can stay.

So my plan is, to labour at home for as long as possible. At the moment we live just 5 minutes from the hospital, 7 in peak hour. Come June we MAY be living 45 minutes away but I figure we'll adjust the plan accordingly when we know. For now we are here. I like the idea of a doula so that no matter what midwife wildcard we draw when we get to hospital (am I right, you just may or may not gel with certain people), and no matter how busy the delivery ward is at the time, there will be someone there for the whole thing, whose sole purpose is to support us. I like the idea that a doula, while providing massage or whatever I need will also be there to support and empower DH. To calm him down when he is upset because I am in pain. To remind him of everything he has read/learnt but temporarily forgotten. To help us focus on the task at hand. To support us to make calm decisions instead of rushed, panicky ones should the need arise. Basically I want a person who can support both of us to be an awesome birthing team. Is this what a doula does/can do?

I like that there will be somebody taking care of DH as well. Not that he really needs taking care of but he is almost as much a part of this as I am and I want him to have a positive birth experience as well. I've spoken with him briefly about it and he is hesitant. We are fairly private people, while friendly, we take a bit to let our guard down. In saying that though, i like the idea that a doula isn't a family member or friend so there is no risk of damaging a relationship in the heat of the moment itms.

There are only about 3 or so doulas in town that I can find. Is it okay to just call them up and ask to meet with them first to see if you "gel" with them?[

Do I need to tell the hospital and/or doctor that I'll be using a doula?

Do you think that our (or I guess my in this case :)) reasons for using a doula are reasonable? I don't want to offend anyone by not wanting them to be the primary support person and wanting them to support DH so much as well.

Should I go and meet some midwives first and see how I feel? I'm hoping to do a hospital visit in a couple of weeks.

Leading to my next questions, when should I hire a doula? Is it too late to wait for another month - 6 weeks?


Your thoughts and experiences are very much appreciated!

Hi dantri, yes that is exactly what a doula does. It sounds like a doula would be a great fit for you and DH. I recommend anyone who is having a hospital birth to have a doula (particularly if you do not know the midwife who will be attending your birth (or who happens to be on duty etc). Having a woman whom you know and who knows you and DH and your wishes can really help you both to relax which will facilitate a much smoother process. If, during labour, you are worrying in the back of your mind which midwife you will get or feeling uncomfortable with who you have gotten, those feelings can interrupt the birth process. Feelings trigger physiological responses in the body, so it's best when a mum feels safe and knows and trusts ALL the people in the room. :)

I feel very strongly about doula support, not because I am one, but because of my experience birthing my first child. It was a traumatic experience and I believe that if I had had a doula, she would have helped me to:
a) prepare better for the birth
b) cope better during the birth
c) accept and process how the birth unfolded
I'm not sure how differently that birth may have played out but I am absolutely certain that I would have felt differently about the birth because I would have had a woman, whom I trusted, helping me work through my feelings so that I felt ok and that I'd done ok. Of course my DH tried to reassure me too but I think I would have listened more if it had come from a woman (who I knew and trusted). I think women instinctually want the comfort, reassurance and companionship of another woman during birth.

Anyway, to me, how the birth unfolds (i.e. whether or not it goes according to your " birth plan") is not as important as how you FEEL about your birth experience afterward and I simply did not have anyone to help me process all my feelings. It's also worth noting that women who use doulas have:
•50% less caesarean sections
•Reduction in the use of forceps by 40%
•60% less requests for epidurals
•40% reduction in the use of synthetic oxytocin for inductions or augmentations
•30% reduction in use of pain medication
•25% reduction in labour length
•Increased rates of breastfeeding at 6 weeks post-partum (51% vs 29%)
•Higher self-esteem (74% vs 59%), less anxiety (28% vs 40%) and less depression (10% vs 23%) at 6 weeks post-partum"
Doulas at Birth - What Is a Doula And Why Do So Many Women Want One?

This is a great video on doulas:
removed

There is a great website called mybirth.com.au It has statistics on intervention rates. It's really worth comparing the public and private hospitals rates of intervention as this is indicative of their practicing style. In particular, look at their caesarean, induction, epidural and episiotomy rates.

You can definitely call the doulas in your area and talk with them. Most doulas offer the first visit free with no obligation to hire them so that you can figure out if they are right for you. Finding the right doula is important. She really needs to be someone you both feel comfortable with and who shares a similar philosohpy of birth. The sooner you book them the better IMO because that allows more time to get to know them and build a relationship of trust (plus, in case they get "booked out").

It's a good idea to write in your birth plan that you will be having a doula and who that will be. Then discuss the birth plan with your care provider before the birth so that you can gauge how they feel about your birth preferences. If they are uncomfortable with you having a doula, this would raise serious concerns for me as it is totally within your right to choose your support people. You do not need their "permission". If you come across that issue then scratch the term "doula" and refer to them as your friend. They can't stop you having a friend with you. The local doulas will know more about the cultures within the local hospitals so ask them too.

Anyway, hope this helps somewhat! :) Feel free to email me if you have more questions...

Christa
xx

Hi dantri, I wrote a really long reply this morning but it's not showing up. :wall: I'll try to re-write it tonight. :doh:
:)

Hi again, yes that is absolutely what a doula does/can do for you as a support person during your labour. It sounds like a doula would be a perfect fit for you and DH.

There is an awesome website called mybirth.com.au and it has statistics on all the hospitals around Australia. This is a great tool for evaluating the type of care or the "practicing style" at each hospital. It would be an interesting comparison between your local public and private hospitals! In particular, check their caesarean, induction, epidural and episiotomy rates. By way of example, there are 2 public and 1 private hospitals clos-ish to me. Their episiotomy stats are 7 - 16 - 30% with the private hospital having the 30%. IMO that is ridiculously high! I'd be steering clear of that hospital. However, in saying that, private hospitals can have some perks (like hubby being able to stay) so it would just make it even more important (if you chose a birthplace with high intervention rates) to surround yourself with a great support team (i.e. DH and doula), make sure you like the midwives and maybe do some extra prep like Hypnobirthing for example. Your local doulas will also know a bit about each hospital so ask what their experience has been with them too.

Personally, I think it's really important to have a woman in the room whom you know and trust (especially if you don't know the midwives or who you will get on the day) and who can be there continuously. This helps the mum (and dad) to feel safe which is so important during the birthing process. The feelings of anyone in the room can have a profound effect on the birthing process and the presence of a doula can protect the couple's emotional space, help you to stay positive and thus have more of a chance that everything will progress smoothly.

BellyBelly actually has an awesome article on doulas and one sentence really stands out to me:
"A recent review of many studies from around the world have concluded that a doula’s support is more effective than hospital staff, friends or family."
Plus of course all the (statistical) benefits of having a doula such as:
•50% less caesarean sections
•Reduction in the use of forceps by 40%
•60% less requests for epidurals
•40% reduction in the use of synthetic oxytocin for inductions or augmentations
•30% reduction in use of pain medication
•25% reduction in labour length
•Increased rates of breastfeeding at 6 weeks post-partum (51% vs 29%)
•Higher self-esteem (74% vs 59%), less anxiety (28% vs 40%) and less depression (10% vs 23%) at 6 weeks post-partum"
That's reason enough for me to believe that having a doula is a very, VERY good idea!! :)

I really wish I had had a doula at my first birth. My first birth was emotionally traumatic and I believe this was because I did not know any of the staff and so their ability to help me relax and encourage me was limited. Having a pre-established relationship is very important (to me at least)! We were counting on my caseload midwife (public hospital program where you get assigned 1 midwife for all your care) to be there but (in a case of very bad luck) she wasn't available when I went into labour so I didn't know anyone except DH of course and I really think this affected how my labour progressed (or didn't as it turned out!). When the midwives who attended said "you're doing great" "it's going to be fine" "just relax" I just could not believe them. I think if I had heard those things from someone I knew and trusted it may have helped. And even if it had still been a difficult labour, I think that having a doula with me would have helped me to process my feelings afterward and be ok with it all. As I said, it was emotionally traumatic (not physically) and I think this is because I felt so alone and scared and things just didn't go to plan.
In comparison, my 2nd and 3rd births were amazing and I attribute this to 2 things:
1. Preparation: I prepared for these births with hypnobirthing, which left me feeling much more confident, relaxed, positive and focussed (plus I had tools to help me through the labour which I didn't for my first).
2. Support: I still didn't know about doulas at my 2nd birth but I did have a midwife that I knew and trusted with me. She was like my doula and midwife all rolled into one! (this is not the norm for hospital births so I was very lucky to have her!) :)

In regards to your other questions:
1. Yes, give the doulas in your area a call. I'm sure they will be happy to meet with you and chat so you can see who you gel with best.
2. Yes, it's a good idea to put in your birth plan that you will be having a doula and who that will be. Then discuss your birth plan with your care provider to see how they feel about your birth preferences. You do not need their "permission" to have a doula with you as a doula does not provide clinical care and is more like a friend or relative (just with more experience with birth!). I would be very uneasy if a care provider/hospital expressed concerns over using a doula!
3. Yes, book your doula asap. The earlier you book her the more time you will have to develop a relationship of trust and friendship with her and is good just in case she gets booked out later on!

Anyway, I love this video about doulas - food for thought: xxxx

Best wishes and feel free to email me if you have any more q's. :)

Christa
xx

Hi dantri, I've now submitted my 2nd reply and it's not showing up yet. The message said it has to be reviewed by a moderator. Maybe we're not allowed to put links or something in our posts?? I wish the forum rules were more obvious!! I have no idea what needs "moderating".... :confused:

Anyway, I'll wait til tomorrow and then post again hopefully with more success.

If you want to email me in the meantime, I'll be happy to send you my post.

Christa
:)

Hi again, yes that is absolutely what a doula does/can do for you as a support person during your labour. It sounds like a doula would be a perfect fit for you and DH.

There is an awesome website called mybirth (dot com dot au) and it has statistics on all the hospitals around Australia. This is a great tool for evaluating the type of care or the "practicing style" at each hospital. It would be an interesting comparison between your local public and private hospitals! In particular, check their caesarean, induction, epidural and episiotomy rates. By way of example, there are 2 public and 1 private hospitals clos-ish to me. Their episiotomy stats are 7 - 16 - 30% with the private hospital having the 30%. IMO that is ridiculously high! I'd be steering clear of that hospital. However, in saying that, private hospitals can have some perks (like hubby being able to stay) so it would just make it even more important (if you chose a birthplace with high intervention rates) to surround yourself with a great support team (i.e. DH and doula), make sure you like the midwives and maybe do some extra prep like Hypnobirthing for example. Your local doulas will also know a bit about each hospital so ask what their experience has been with them too.

Personally, I think it's really important to have a woman in the room whom you know and trust (especially if you don't know the midwives or who you will get on the day) and who can be there continuously. This helps the mum (and dad) to feel safe which is so important during the birthing process. The feelings of anyone in the room can have a profound effect on the birthing process and the presence of a doula can protect the couple's emotional space, help you to stay positive and thus have more of a chance that everything will progress smoothly.

BellyBelly actually has an awesome article on doulas and one sentence really stands out to me:
"A recent review of many studies from around the world have concluded that a doula’s support is more effective than hospital staff, friends or family."
Plus of course all the (statistical) benefits of having a doula such as:
•50% less caesarean sections
•Reduction in the use of forceps by 40%
•60% less requests for epidurals
•40% reduction in the use of synthetic oxytocin for inductions or augmentations
•30% reduction in use of pain medication
•25% reduction in labour length
•Increased rates of breastfeeding at 6 weeks post-partum (51% vs 29%)
•Higher self-esteem (74% vs 59%), less anxiety (28% vs 40%) and less depression (10% vs 23%) at 6 weeks post-partum"
That's reason enough for me to believe that having a doula is a very, VERY good idea!! :)

I really wish I had had a doula at my first birth. My first birth was emotionally traumatic and I believe this was because I did not know any of the staff and so their ability to help me relax and encourage me was limited. Having a pre-established relationship is very important (to me at least)! We were counting on my caseload midwife (public hospital program where you get assigned 1 midwife for all your care) to be there but (in a case of very bad luck) she wasn't available when I went into labour so I didn't know anyone except DH of course and I really think this affected how my labour progressed (or didn't as it turned out!). When the midwives who attended said "you're doing great" "it's going to be fine" "just relax" I just could not believe them. I think if I had heard those things from someone I knew and trusted it may have helped. And even if it had still been a difficult labour, I think that having a doula with me would have helped me to process my feelings afterward and be ok with it all. As I said, it was emotionally traumatic (not physically) and I think this is because I felt so alone and scared and things just didn't go to plan.
In comparison, my 2nd and 3rd births were amazing and I attribute this to 2 things:
1. Preparation: I prepared for these births with hypnobirthing, which left me feeling much more confident, relaxed, positive and focussed (plus I had tools to help me through the labour which I didn't for my first).
2. Support: I still didn't know about doulas at my 2nd birth but I did have a midwife that I knew and trusted with me. She was like my doula and midwife all rolled into one! (this is not the norm for hospital births so I was very lucky to have her!) :)

In regards to your other questions:
1. Yes, give the doulas in your area a call. I'm sure they will be happy to meet with you and chat so you can see who you gel with best.
2. Yes, it's a good idea to put in your birth plan that you will be having a doula and who that will be. Then discuss your birth plan with your care provider to see how they feel about your birth preferences. You do not need their "permission" to have a doula with you as a doula does not provide clinical care and is more like a friend or relative (just with more experience with birth!). I would be very uneasy if a care provider/hospital expressed concerns over using a doula!
3. Yes, book your doula asap. The earlier you book her the more time you will have to develop a relationship of trust and friendship with her and is good just in case she gets booked out later on!

Best wishes and feel free to email me if you have any more q's. :)

Christa
xx