Going with Doula & Midwife ? Possible VBAC

Hi.

I am expecting #2.
I`m new to Australia, so still trying to figure out how it all works here.

I am thinking of hiring a private m/w and a doula.
I`m open to trying for a home birth, but mostly think I will try and stay at home as long as possible then go to the hospital.

My last child was an elective c.section, so this will potentially be a vbac.
DH thinks I should just book in and have another C. section, but I think I would at least like to have my options open. DH is also happy though to spend the money on paying for a private midwife and doula...I dont have family or friends in this country, so even if I end up having baby in hospital and even another c.section, do you think its worth having both m/w and doula?

I`m feeling quite anxious and bit confused trying to work it all out :(
I dont have friends here who have had babies to ask advise or as in NZ an independant (free) midwife (which in NZ I would have already had appointments with) to go over how it all works and help me think about birth plan and options etc. I dont even know anything about prenatal groups etc, do MWs here (even public ones at the hospital) tell you all about that stuff or do doulas help you out with that stuff???

I like to know as much as I can so I feel I`m making an informed choice based on what feels the best for me and my family, I dont feel comfortable just rocking up to the hospital for appointments and letting them influence how this pregnancy and birth goes with me just following their lead...but maybe I can trust the system more than I think??


Oh, and if I have a private MW is she allowed to help me deliver at any hospital or is she only allowed to at home or at selected hospitals.
So far I`m considering Mercy...but am booked with RWH, though I have not been for any appointments yet.

Hi Salsa,

Generally, independent (private) midwives cannot act as midwives in any Australian hospital. If you go to hospital, they can only be a support person.

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I am thinking of hiring a private m/w and a doula.
I`m open to trying for a home birth, but mostly think I will try and stay at home as long as possible then go to the hospital.

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If you stay at home this long - all that is left to do is birth, why not just do it? If you have a midwife there she is more than qualified to assist you, especially in the rare event of any complications.

Your best chance of achieving a VBAC is at home with a known midwife.

I would suggest contacting a few midwives in your area and meeting with them to see what you think they can offer you.

Best wishes,
C

Thanks for your reply .
lol - I did begin to wonder if I stayed at home as long as I could, there would probably be no point going to the hospital.

I want to keep my option open of homebirthing or hospital because of fear. Fear of things going wrong and fear of what I can cope with ( though I dont know if going to hospital will be able to offer me much relief anyway if its a vbac?) Also my house (which is rented) has a very thin wall between us the neighbour!!!

We do not have much in the way of support here either, but I guess thats alot of why we are looking at getting a doula. But I suppose I feel a hospital can offer help in that way - yet in reality, when I think back to my DS and being in hospital, I transfered to a birth unit the next day as I didnt want to be put in a shared room with other peoples babies crying and their visitors etc. Then I went home after 1.5 days at the birth unit cause I didnt like it and felt a lack of support considering my c.sect.


I`m finding it a bit to get my head around how it all works here. It fustrates me that things are not as simple as they are in NZ.

A brief overview of maternity choices - depends a lot on where you are, but the basics:

1. Public Hospital Maternity Unit: free, you will see a midwife or Obstetrician for ante-natal appointments, but not the same one each time and you don't get to choose who. Some public hospitals have midwifery programs where you see one midwife or a small team for the duration, but these are few and far between. You can also elect to see your local GP for ante-natal appointments.

2. Private Hospital, Private Obstetrician - paid for by you or your health insurance.

3. Private Midwife for birth support in a hospital or for homebirth. Paid for by you.

Without much support around you, a doula and midwife could be a fantastic choice for you. If you go to hospital, you won't know anyone there, likely to be just who ever is there on the day. In terms of support, a private midwife can offer one-to-one care throughout pg and postnatal, likewise for a doula.

I am having a doula and midwife for this birth. Couldn't be happier with my choice. I know I will be well supported and nurtured and I feel really safe in this environment.

The decision to homebirth is different for everyone. Maybe talk to some people who have done it, read their birth stories, watch videos to get a feel for it.

C

Hi there!
ATM you're making me want to move to NZ for my #3! I want a VBA2C but feel the need to have hospital booked too. I would love a midwife but we are still sorting out the logistics of paying for one. If you can afford it why not have both, even if you do end up in hospital 2 supports are better than one?!?! And if you stay home doula can focus on you while Mw focusses on baby. I have found that independent mw's and hospital mw's are both very supportive of my choice, it's the GP's and Ob's who are not so happy...

Also, check the hospital policies re: VBAC and have a birth plan that can be followed so you don't have to think while you're in labour.

I had a failed VBAC for #2 and I can see why now and intend to change that for #3.

Good luck and God bless
Sarah :)

Thanks for the replies.
We/I have gone through a few ideas and am now going with midwife care from the hospital plus a few OB visits and we have employed a Doula to help us with it all. I am feeling good about going through the hospital and was very happy with the OB I met today - lets hope shes the one who`s on duty at the time if I need it!!


Sarah - congratulations on #3 and I hope you get the support to help you achieve your VBAC. Im guessing like me, you have been trying to do as much homework on the subject as you can. Its a it overwhelming at times, but good one you for giving it another chance!!!

Hi Salsa, I had 3 babies in NZ, know what you're saying about the funded homebirth over there.

A couple of clients I have supported for VBAC over here (I'm a doula) have also hired a Private Midwife. The plan was, the midwife would accompany the woman while she laboured at home, and because the mw can check the baby's heartbeat (a doula can't do that - but parents of course can hire a doppler and do that if they want), there's that extra reassurance that all is well. I remember reading about a UK midwife who commented, "with regards to the risk of uterine rupture, I would rather have the focussed, one-to-one care of a midwife who really knows and gets me, to observe the early signs of possible rupture or dehiscence, that be in an institution where reliance is placed on a machine to pick that up."

The beauty of hiring a midwife to support you at home while you labour during your VBAC, is that you have a couple of routes open to you and you don't have to make the call until you're in that moment:

1. You can stay at home as long as possible, with the skilled support of a midwife who specialises in keeping birth normal and safe, and possibly also with a doula who specialises in emotional support and confidence. And then when you feel it's the right time, transfer to the hospital with both these angels alongside every step of the way. In the hospital, the midwife's role changes to one of support only, however, her clinical skill still is there to help you make wise decisions.

2. Since your midwife is with you, if at the last minute you think, "I'm confortable here, I'm feeling confident - I don't want to move!" - you can stay put and have your baby at home. It might even be in your birth pool.

I have had one client choose the first option and one choose the second option. The nice thing about hiring your own midwife to support you for your VBAC is that BOTH options remain open to you, and you don't have to make the call until you're in that moment - at which point you really do know which route is the right one for you.

One of my clients who chose to hire a midwife decided that she could not afford to hire me as well, so in a sense I "did myself out of job" but when I got the happy news of how she gave birth at home in her own loungeroom I was so happy.

Yes, I want to have the option open as I would in NZ to stay home and birth or go to hospital during the time Im actually in labour, but our financial situation has changed since we arrived and being as we know so few people here - espcially as we do not know others with kids here, I felt to go with hospital care. I know that a hospital experience may not end up giving me alot of support, but in my current situation (which is somewhat vulnerable and bit lonely being new here and having a pregnancy and baby in a different system) I feel better with the choice of the hospital. But otherwise, yes, an independant midwife and potential homebirth - and not having to decide till Im ready would be great.
We are going through Mercy and I think so far they are not too bad...

Hi Salsa,

Even with no funds you can still get support, there are free trainee doulas and mw's and they often have a bit of experience too. Esp. if you are feeling vulnerable and lonely you need that support, come along to all the group meetings you can too - we might bump into each other!!!

All the best

Sarah :hug: