Doulas

daska

Have to say that if there were any prospect of my having another child I'd beg and borrow the money to get the Doula I had for DS2 back - she was fabulous! I wasn't scared of the birth, I'd managed DS1's with "not enough gas to make a difference". I just wanted someone there to support me as I knew his dad wouldn't have a clue. As it was I was very glad she was there as the treatment I received at the hands of midwives I had during DS2's birth was quite appalling, very unlike DS1's for whom I had a superb midwife and plenty of family support. On balance I would say that if you have the budget for one and can find one you like and trust then go for it.

lostinrates

mountainofdebt wrote: »

I'm interested to know what would happen if mum (and therefore the doula) wanted (a) to happen but for whatever reason that wasn't possible or recommended by the medical staff.

would the doula have the final say so or as she isn't technically the next of kin she would have no say in the matter?

each to her own I guess especially as they are paying for it themselves but it does seem abit hippy happy clappy to me ......no doubt in the very near future every woman will need one otherwise they will be accused of being an unfit mother - and that's even before the breast feeding police and anti going back to work brigade start

I followed all the links given to see what doulas would have been available to me here hadn I been lucky enough to warrant one. There is not much choice where I am, and the nearest did look 'happy clappy' but she also looked kind and enthusiastic and listed lots of other great skills. Although her website enthused all things natural there was space for how to have a positive Caesarian. I was surprised by how much I liked the idea tbh.

The last people in the world i would want straight after giving birth would be my female relatives, much as I love them they are also not natural caregivers ( nor am I ) and that quality of caring and helping and being a little nurturing would be wonderful. My dh would be great, but he is not around. More importantly, OP ha said she wants support and lacks a circle outside of her dh because of geographic constraints. It sounds pragmatic rather than hippyish to arrange this rather than go with the flow.

I don't think anything is likely to be made requisite! For a start there is not the money to in either public funds or many private ones, and I think for those who have the natural suppor group of family they fill the role, and for those who don't want it there is no role to fill.

Once again, good luck OP. I hope every thing goes wonderfully well for you.:)

Gillyx

I think it really depends on your hospital and just how busy they are. Also what if any pain relief you get. After 36 hours in labour I got an epidural in, once that went in my hospitals policy was you aren't left alone, so we had a midwife in the room at all times.

The delivery suite staff were fantastic, the labour ward staff, not great. One midwife ran me a cold bath, no hot water at all, to get into, luckily my OH was on hand to sort that out

For a lot of people, if you have a birth at full term 37 weeks + and you have no other medical conditions they do prefer you to labour at home anyway, so it's whether you'd need a doula for that part.

I don't have an opinion either way, if you think it would help go for it

jackyann

I just have to say that having been a midwife (many years ago) and having several young friends who are midwives as well as colleagues over the years, I would never dream of being disrespectful to midwives.
Many midwives think that having a supportive birth partner is very helpful (and indeed, research shows this overwhelmingly) and as this thread shows, not everyone is able to conjure up the right kind of birth partner.
Doulas who are reputably trained would not "interfere" although they might help as a go-between. For instance, my birth partner helped in a discussion about a c-section, explaining "although a c-sec may be necessary, J would prefer labour to continue until either she or the baby are at risk". My birth partner would not have said "she doesn't want a c-sec" if the medical advice was definitely to go ahead.

I would not wish to get individually involved in the "scar" debate, but would say that most c-secs, even those that are done quickly, are done with time to be careful about the cut. Occasionally, if seconds are likely to count, if the baby is awkwardly placed, or premature (harder to pull out) then a wider cut has to be made - sometimes vertically rather than the usual horizontal. That may explain some differences in scars.

Just_Peachy

Hi, I would just like to add that if you get offered a student midwife while in labour, do not refuse!! We were so lucky to have a student midwife who stayed with me from the moment they broke my waters until when my son was born (was only a 5 hour labour). Obviously she was overseen by a qualified midwife but the student had time to stay with us and was just brilliant.

I know your birthing partner is a personal choice but I am of the opinion that I would not like anyone there but my partner, I felt it was a special time I wanted us two to share, but again I understand it's personal as does depend on the partner.

My only advice regarding the birth is please, please do not listen to others! Your birth will not be the same as any story you've been told, when giving birth all I kept thinking about was how people had told me 'at this point, this happens' or 'the pain lasted for x amount of time' I panicked because I kept thinking of things i'd been told when in reality I had quite an easy birth and I regret not just going with my body. Obviously it's painful but just try not to compare how you're feeling to how others felt. Good luck

pigpen

Nicki wrote: »

What nonsense!

An emergency c section costs the NHS over £3k to perform. A vaginal birth a tiny fraction of that. So your contention is that the NHS wanted to spend £3k unnecessarily just because one of its operating rooms was empty at the time :rotfl: :rotfl:

I am delighted that whatever they thought was the risk didn't materialise, but nothing you can say will convince me that the ONLY reason a section was suggested was because no one was using the operating room.

The doctor who did my 2 c sections also had an NHS practise by the way. Perhaps he hacked and slashed the "plebs" and did embroidery on the posh girls then

That is what they proposed yes.. absolutely not a good reason at all. If one had been necessary that is a different matter entirely. The consultant didn't think a section was necessary it was the midwives who were pushing for it which is why I politely declined their offer. My daughter was fine, the baby was fine but had a couple of decel's when they decided she should be on her side and he was fine once she moved back onto her back/semi-upright position. The registrar came in a few times, checked the trace said it looked ok but she would get a second opinion, the consultant came in, looked, took blood from the baby said everything was fine and the midwives STILL went on about 'needing a section' and 'we might not be able to do it later'.. I don't NEED you to believe it, I was there I know what was said.

NHS surgeons have less time to get the process done, they don't have time to do pretty embroidery. One of mine was baby out and partially sewn up in 20 minutes, he didn't bother with the rest of the sewing, bit like work I think

quinechinoise

Nicki wrote: »

If its reassurance throughout a long labour the OP is looking for, that isn't what you get from a private obstetrician.

There is also the issue which you have to bear in mind, that if you plan for a natural delivery privately and end up with an EMC, it will cost you about 3 times as much as you have budgeted for, and if your baby needs special care, you will be charged for however long he or she spends in the hospital before they are transferred out to the NHS if you aren't going to be able to pay for them to stay private for as long as it takes.

I, too, had both of my kids privately. It depends on what you find reassuring. To me, it was reassuring to have the same person for all ante-, birth and post-natal care, to know that he was on call 24/7 whenever I had a query and that he would also do the c-section if required (thankfully, none were required). I phoned my OB and he met me at the hospital when I was arriving and stayed on site throughout labour and birth - not hanging out in the delivery room all the time but certainly within easy reach... say, within shouting distance. He was very supportive and did all the staff liaising for me - chasing up the anaesthetist, paediatrician, lactation consultant, etc.

I agree re NICU costs. My OB said to just transfer baby straight to NHS (it was a NHS hospital anyway) if anything went pear-shaped but he wasn't anticipating any complications (and there were none). However, my OB's fees were inclusive so there was no extra change for c-sections.

I won't fault the care from any of the NHS midwives but it was my OB who was my rock. I think my husband slept through quite a bit of it... Not a problem. I'd brought plenty of crossword puzzles, etc.

I think a doula might do some similar support. Like... reminding you of your birth plan and making sure you are certain if you want to change things, running after staff if you need something and they aren't there, telling you everything will be fine, encouraging you, bossing you into taking a nap (or trying to) if labour is dragging on too long, humouring you if you're convinced you can waddle to the toilet yourself even through you're on a drip, etc.

An OB just fills in the gaps because a doula cannot do anything medical for you. However, a good doula could mean increased support at home - deferring transferring to hospital (unless you suspect a short labour and/or waters have broken) - and seamless postnatal care such as providing breastfeeding support (instead of a lactation consultant) and perhaps also looking after you and baby for the first few days. Not quite as much as a maternity nurse but a significant support nevertheless.

There are so many types of maternity and obstetrics care that it pays to consider all your options and pick what suits you best. And to not worry too much about it - you do what's right at the time, based on the information available. (With hindsight, if I had hired a doula then I probably wouldn't have hired a lactation consultant. But it was definitely the right choice for me to go with an OB; I don't think I'd have enjoyed a homebirth, whether NHS or independent.)

aliasojo

pigpen wrote: »

NHS surgeons have less time to get the process done, they don't have time to do pretty embroidery.

I had to have an emergency section with daughter.

I was told afterwards by a very chatty nurse that I was lucky to get a particular female surgeon as she took time to stitch the wound as neatly as she could whereas the other chap who was on, had a reputation for being a bit cut and thrust about it all. As long as the job was done 'pretty' scars were way down his list of importance.

I expect this is no different to anything else in life, some people always make a big effort to do their best, others do enough to get the job done.

dizziblonde

aliasojo wrote: »

I had to have an emergency section with daughter.

I was told afterwards by a very chatty nurse that I was lucky to get a particular female surgeon as she took time to stitch the wound as neatly as she could whereas the other chap who was on, had a reputation for being a bit cut and thrust about it all. As long as the job was done 'pretty' scars were way down his list of importance.

I expect this is no different to anything else in life, some people always make a big effort to do their best, others do enough to get the job done.

I do remember when they were stitching up the mess they'd made of my undercarriage (combination of an episiotomy, forceps and my daughter deciding to do a pirouette mid-labour to come "flying out back-to-back" just for added amusement value) they wouldn't tell me what they were doing furtling about down there for ages, until they admitted there was a "bit of a tear we're stitching up" - they were on a good hour and I ended up asking them if they were trying to replicate the Bayeux Tapestry at one point!

(Can't really complain on the repair job though - bad 3rd degree tear and I was pregnant again 4 months later so they must have restored it to a decent level of functionality!)

Jojo_the_Tightfisted

Nicki wrote: »

Also, having had 2 sections, I can reassure you that unless your daughter is a fan of the Hollywood wax, her scar far from being disfiguring would not even be visible. The incision is made about 2 inches below the hair line, so would be covered by the landing strip on even a moderately waxed woman, and fades to virtually invisible anyway within about a year. (I have other keloid scars on other parts of the body which are pink and raised, but both c section scars are barely visible and are flat and white). Even if she did have a tiny scar, unless she plans to make her living as a stripper (and even then), its still a rubbish reason to put a baby's life at risk.

My elective scar is two inches above the hair line, was repeatedly infected whilst in hospital, opened up twice and is still fragile and painful to the touch twenty years later. I had lots of pinging pains when I had DD2, which I was told by the consultant overseeing the second pregnancy was probably due to the registrar causing more adhesions than necessary by being 'a bit slapdash about it'.

Occasionally, if I sneeze without holding it or turn over too quickly in bed, I still get the most intense pain in it.

Had it been below the hairline, the first wax strip to touch the area would quite likely tear the skin. I wasn't at all overweight, there was no hurry about the procedure, DD was a healthy weight. The fact they started cutting before the epidural had taken full effect didn't help, but I still felt like I had been butchered.




And then other people squeal about how awful it must be for women to have their wotsits stretched by a baby and how they would always have a section on that basis alone!


For DD2, I had a VBAC and OH wasn't much good. He said he didn't know if he could be there for it, so the entire labour was spent wondering if he was going to go outside and not come back. He found it deeply traumatic and he would never want to be in that situation of seeing someone in pain and not being able to do anything about it again.



At least with a doula, there would be somebody who wasn't going to disappear, say they've changed their mind (working in Gynae, there were men who did that and dumped their partners in the delivery room) or be generally pathetic. Or mums who decide they know best and just upset their daughters by such things as telling them they're embarrassing if they make a sound, pressuring them to lay on their backs and not do a thing.

To know somebody is there that knows and respects their decisions, won't panic, will liase with partners, staff, help them to decide, anything that the NHS or families cannot or will not provide, well, that sounds like a good thing to me.


Had I had the money, I would have hired one without a shadow of a doubt.