Is there any point having a doula..

if I'm in a caseload midwifery program?
Before I chose this model of care the plan was to have a Doula.
Now that I've decided on caseload though, I am wondering whether I still should have a doula or not, whether there will be conflict etc between them.

The main reason I was thinking to have a Doula was because at my first birth, while the midwife was very good in keeping drugs away from me like I'd requested in my birth plan, no one reminded me of things I'd forgoten about, when I was in nof it state to remember, and DH and my mum (my other support person) were too emotionally involved to detach themselves enough to be thinking about it either.

Ray Ray,

I just replied in another thread about having a birth plan. It was mentioned , actually I will quote it again

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a doula cant turn around to a midwife and say 'dont tell her how she's progressing she doesnt want to know' as it creates tension, but I agree encouraging your partner to is a good idea.

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Now I think thats crap. To me you are paying this person to be that person who stands up for you & your DH's wishes.

I am having a student Doula this time round. Mostly to help her gain her final birth to qualify. Now seems I am not paying for her service its a little different. But I believe if you feel the need to have a doula there to be the one who speaks up & support your wishes along with remembing those little details others miss from as you say being too emotionally involved then I think you should have one BUT make sure the doula understand what you want of her.

I don't think its fair to pay someone to be your voice but then be ok with the idea of them keeping quite to avoid creating a conflict between midwifes & doula's.

Any conflict that may come up between to the two professions shouldn't be in the hands of the labouring couple.

I realise that many midwifes do turn the nose up at the idea of a doula. but again if thats your choice to have one then so be it. its not your job to make sure the two prefessions are accepting of each others role.

FJ, until you have had a doula you wont get what it's all about. This was one complaint of the very many positive that have been on BB. Especially the first time mums get loads of benefit from it - by now you would be more confident and know what to expect... but I wouldn't get flowers, wine, cards and loads of other gifts if I did an average job as a doula. You don't know til you have a doula. You have a student so it will be a little different, if you just want to help her qualify for the birth components but have expectations of an experienced doula then you may end up disappointed. My trainee births were nothing like the births now, when I have loads more confidence, experience to call upon etc.

Working in the hospital system is like a minefield. You have to tread carefully or we'll end up like Ireland where they are trying to get doulas out of the birth room. It's a fine art the whole negotiation thing and I don't expect an inexperienced doula to have mastered that.

With reference to that quote... YES THEY CAN! And they do :) Kelly did an awesome job and was more than happy to assert my preferences when I couldn't or Marc and I were too focused on our birth.

Honestly Ray I think you should have a doula, I honestly believe even if one does have their own private midwife a doula it still beneficial.

Kelly Im not trying to knock you or others who are Doula's, I do get that till I have had one I wont fully understand.

But it sounds to me that people are expected to just accpet that there is a rift between midwifes & doula's so the doula is only going to tell you how to rock the boat & not do it for you. I may be totally off the mark but from all of the things I have read here on BB & on websites that Doula's have promoting their services I was under the impression that this was part of the service the couple is paying for.
The labouring couple should be able to get on with giving birth while the Doula is the voice of reason. I realise that one would need to be tactful in their approach and being the voice to say to the couple, lets take a moment to discuss this in private is great. But what happens when neither are in the right frame of mind to do this. This is where I thought the Doula steps in and says This is what is on the birth plan, this is what was discussed prior to labour, this is what my client wants/doesn't want in this situation.

I don't understand though, I know plenty of doula's that rock the boat. And I never saw any tension between Kelly & my midwives (even the 1 fiesty one we had). I think too though if Kelly had gone all gung ho and started making demands when she could have just made our intentions known without aggression I would have been uncomfortable (but she knew when to say things and how to say them). It really is an art to know what to say and when to say it but I don't think every doula just sits in the corner and quietly whispers into the clients ear "do this..."

Maybe the quote means in an aggressive way? I don't know the context so I'm not 100% sure about this quote. But I don't think all doula's are not as involved with representing their client to the hospital staff.

You know, the other thread made me contemplate the role our doula (the fabbo Kelly) had at the birth of my son.

For us the major reason to have her was insurance. If you are going through the hospital system (we went to a birth centre) there will be a million times you may not fit into the 'rules' and be risked out of the care model you have chosen. I wanted a doula with us if we ended up being transferred and my fabulous midwife care couldn't follow. This in itself made me a lot calmer in the lead up to the labour. As Kelly knows, I became very anxious about the labour becoming over medicalised and she was great at putting me at ease that I could achieve the birth I wanted no matter where I ended up doing it.

For us, the birth went well. I loved my midwife and she did a lot to help us achieve the birth I wanted even when teetering on the edge of having to be transferred. But I do think our wonderful doula helped- her presence alone showed our midwife we were serious and she also strengthened the resolve of everyone in the room that I didn't want interventions when it was being suggested I may need the vacuum to get my baby out. The extra persistence she gave helped me remember wanted and I think it reminded my midwife to keep helping me get there.

Then after the birth I struggled majorally with BFing. She quietly pointed us in the right direction and with a wonderful lactation consultant all our problems were fixed- which wasn't happening with the public lactation advice I was receiving. She also visited us at home for a birth debrief- rather different to the birthed and forgotten treatment I received from the midwives.

So, do I think there a point to having a doula when receiving public midwife care? YES!

I would ABSOLUTELY recommend having a doula, even in caseload. My experience was that the midwives (who were great) and my doula had two different roles. The midwives were very supportive, but were focussed on the 'medical' side of things. My doula was all about emotionally supporting me in a very special way. I too was very concerned they would clash, but they worked great together, complimenting one another really.

I would have my doula again in a second!

Quote RAY RAY

no one reminded me of things I'd forgoten about, when I was in nof it state to remember, and DH and my mum (my other support person) were too emotionally involved to detach themselves enough to be thinking about it either.

I think you answered your own question there babe.

My midwife, Jane Palmer and doula, Cara worked wonderfully together to support me birthing my son. There was always a significant person holding each of my hands telling me the things I needed to hear. It also freed my midwife to make the observations she needed whilst I was still being supported. If I was birthing in hospital I would use a doula again definitely.

Most definately have one....i am!

Hope you don't mind me popping in but just wanted to give a voice from a midwife perspective. I have been involved in births with doula's and there has been no conflict at all. To me, personally, a doula is a support person for the woman and is no different to some women having their mum or friend there. We midwifes aren't horrible creatures who think of a doula as someone to butt heads with or they are treading on our toes. I always follow a birth plan the best I possibly can. We are all in the birth suite together to give the labouring woman and her partner the birth they want.
A doula is a fantastic idea to give you the support you want and also to have someone in with you who knows all of your wishes and is also someone you are comfortable with if a decision needs to be made during your labour when you aren't in your normal frame of mind. Please don't forget that a midwife is there to help you too. Talk to them and let them know.

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Hope you don't mind me popping in but just wanted to give a voice from a midwife perspective. I have been involved in births with doula's and there has been no conflict at all. To me, personally, a doula is a support person for the woman and is no different to some women having their mum or friend there. We midwifes aren't horrible creatures who think of a doula as someone to butt heads with or they are treading on our toes. I always follow a birth plan the best I possibly can. We are all in the birth suite together to give the labouring woman and her partner the birth they want.
A doula is a fantastic idea to give you the support you want and also to have someone in with you who knows all of your wishes and is also someone you are comfortable with if a decision needs to be made during your labour when you aren't in your normal frame of mind. Please don't forget that a midwife is there to help you too. Talk to them and let them know.

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Sorry to hijack the thread but I wondered about your views on a woman bringing an IM with her Nurse Dan?

Feel free to PM me if it's more appropriate than replying here.

Cheers :)

With the benefits your own independent midwife can offer, do you care what they think? ;) Its your birth, your body and your experience - don't let anyone else's insecurities get in the way.

You could always say its your support person or family, they wouldn't know better and they can't do medical procedures or catch the baby anyway.

Thanks Kelly, I have no doubt that the IM I have chosen will work with me to make pregnancy & birth as amazing as it can be. :cheer:

Was just interested in the perception of IM's from a hospital midwife. I was hoping that it might be recognised as a decision based on the failings of the system, rather than a comment on hopsital midwives, and as such that there wouldn't be any conflict.

Hi tsgirl,
I have never worked with an independant midwife but I would treat an IM exactly the same as a doula, with professionalism. Like Kelly said they are there to support you and no respectable midwife would have a problem with any support person being there to support a woman regardless of their qualifications. In my eyes there is absolutely no difference between an IM or doula or partner or any other support person. We are all there to help the woman have the birth experience they want. I would have whoever helps make you the most comfortable in your birth suite during your labour.
Hope that helps.

Cheers Nurse Dan!! :clap:

I forgot to add, all the studies showing the benefits of the doula or professional support person, the benefits were recorded where the support person was not a member of staff of the establishment...

Hi there,

I am a student doula and in addition with my job in the post natal area I deal with midwives all the time. The key is to being diplomatic and knowing how to get your point across without offending anyone......not always an easy task but it can be done!! Honestly, all the midwives I have worked with would likely be grateful for the extra pair of helping hands and it doesn't take them long to figure out that your doula or advocate is an asset to the team.

Cheers

Clare :D

I am having a smw and a doula, mainly because the doula will be my support person and able to be at my home before hospital and the smw is gaining experience in the exposure to the birth. The smw will meet us at the hospital and really I am sure there is no chance of conflict. Mw's and doulas would all have to be lovelt ppl to put up with labouring mums all the time :lol: