Would anybody ever use a doula when they are planning a medicated birth?

[EricaLynn]

Originally Posted by *Peanut* I never thought of using a midwife, but often thought about using a doula. Eta: before an epidural is when you want to be far away from me.

Do it. If you can find a good one, you won't regret it!

[supergirljennie]

I'm in process of certifying as a doula, but I'm working closely with a Woman to Woman practice in my area, which has 2 OBs and a CNM. In my eyes, my job as a doula is to educate the mother about the pros and cons of every procedure (because the OB really won't do that, and even in a childbirth ed class they don't really touch on the cons). After informing and answering questions, I just let the mama (and the dad too!) know that I will support them, no matter what, in their choices, as long as they know all the information, and then I will support them in whatever they choose to make the birth of their baby an experience, rather than a series of procedures. That is my wish for them, as their doula. I inform, support, and advocate for them. Take the time in interview several doulas, because just because you don't jive with one doesn't mean there isn't a doula out there for you.

Even with an epi birth, most hospitals won't administer one until 4-5cm, and mamas still need support before then. And of course, even if you do want an epidural, I personally encourage each mama to take a contraction individually and see how they cope... there is the possibility with continuous support from a woman who knows in the soul of her being that you were made for birthing, made to do this, and has complete faith in you that you will be able to cope better than you thought and may not need an epi at all. In my experience, the relief I have seen in women's faces who were previously told by their doctors that they were broken (in not those exact words, but created that feeling in the woman by other words or actions) being told by a woman that they can do it completely changes the perception of the pain.

And FWIW, even I who plan having natural births, hit that wall and think, "What the crap was I thinking? An epidural sounds really good right now." And then I remember, that when I hit that point, I'm in transition, that shortest but most intense part of labor, and it's almost over... the baby is almost here! It helps to remember that. Even when you plan a natural labor, you'll still get to that point and think, this was the worst idea ever. That's when a doula and your DH/mother/family support person is great, to remind you of what you want. With my doula client, we discuss this possibility beforehand, and we set up situations like: Okay, you've asked for an epidural... do you want...

an epi right away?
to wait another hour/centimeter?
reminders that you were aiming for natural birth?

etc. We also set up a code word that means, "You better get me the stinkin epidural right now!"

Hope that helps a bit!

[steph410]

i'm not a doula, but i had a doula for 2 of my births. i just wanted to add that the first doula i had never "pushed" me for a natural birth or really "imposed" her viewpoints on me at any time and i really appreciated that. i wanted a natural birth and ended up having one, but she would have supported me no matter what. the info she gave me was always presented as information, not opinions and not strongly advocating natural birth necessarily. i thought she was very professional. she was also a doula for someone who ended up with a c section.

i know that usually doulas are for natural birth, but i personally think they would be an asset to anyone who wanted assistance and a level headed advocate for you during labor.

[MeCo7707]

I have to totally agree with Jen - so well put! At one point in my labor I said "this is kind of starting to suck" and my nurse said "but hun you really are almost to the end" baby arrived 2 hours later - which in a 20 hour labor isn't bad lol. I also agree that some women may think they want medicated then find they are doing fine with natural - and I believe part of the problem is other women saying it's impossible...not one person thought I could have a natural birth...NOT ONE. It was nice to have someone telling me that she did and it could be done.

[cacasey1981]

I think that a doula can be beneficial in both a medicated birth and a c-section. I think training would cover the change of plans during labor (natural -> epi). Some women just want to wait as long as possible and really - no one knows what the pain will be going into the situation.

And for someone who goes into it knowing they want an epi - maybe they don't have a support person, maybe they don't want to "bother" the nurses when they need something, maybe they just need an extra person who has been there before.

For c-sections its great for the mom to have someone who can be with her while her partner stays with the baby. I think it would be hard to choose between needing someone to comfort/attend to you while hearing your lo crying across the room needing the same thing.

[crunchymom2b]

I had a doula for my planned unmedicated birth but wound up with an epidural and she was wonderful. Never judged me, never pushed me. Did everything I needed. I would def. use a doula regardless of the birth (well, except for maybe a planned section since you can onlyhave 1 person with you)

[cinderella08]

Doulas can be very helpful and definitely still needed even if a mom is planning on pain relief. I've attended many births where mom has told me she wants an epidural as soon as possible! As a doula, it is my job to support whatever decision a mom makes, advocate for her, and be there for her through her entire labor - no matter what kind.


Just because a mom is experiencing little or no pain doesn't mean she needs to be any less supported. Yes, she won't really need help coping with the pain - but a doula can still be so beneficial. A doula can stay with mom 100% of the time so that dad can take a quick nap, go make phone calls, or go get something to eat. She will also continue to be an advocate for the mom. Oftentimes doctors don't even ask before they do something and mom may not realize what they are doing until it is too late! I've had doctors do an internal exam and come >< close to popping moms bag of waters without her consent but I always watch close and jump in with something along the lines of "Sarah, the doctor is about to rupture your membranes, are you ok with that"? And that usually stops the doctor dead in his tracks and mom either agrees, or says no - she doesn't not consent to that. While not in her training, a doula of course can also provide photography skills for mom is she desires pictures of her birth. After birth a doula can help facilitate bonding, breastfeeding, and keep mom company while dad accompanies baby to the nursery for pediatrician visits, ect..


Doulas can be quite helpful during a planned c-section!

As a doula, I've been let into the OR for 2 out of 5 cesareans I've attended. So it isn't typical - but even hospitals (which is ALL I've ever encountered) that have a one person only in the OR policy - are sometimes flexible regarding doulas. Even if the doula isn't allowed 100% of the time, daddy generally always goes with baby to the nursery or to recovery while mom gets sutured up and is transferred to recovery. I've waited outside the OR and when dad leaves, I go in to be with mom.

Doulas can also provide calmness and facilitate communication, ect before the birth and of course after the birth. Generally, everyone is so consumed in the baby that a mom is often forgotten about after a birth - cesarean or vaginal. When a mom is coming down from her adrenaline rush and is still being pumped full of pain meds and epidural meds, ect.. and is having the shakes - I like to focus only on mom while 9 out of 10 people are focusing on the baby. Get mom warm blankets, get her a few ice chips for her dry mouth, tell her she did great and you are proud of her, adjust her bed so she is comfy, get her more pillows so she can get comfy enough to hold her baby. Also - statistically babies born by cesarean have more difficulty breastfeeding and a doula who is trained in breastfeeding can facilitate that as well.

With a mom who has just come out of surgery, it is also important to still be an advocate for her regarding her wishes. I always encourage a mom to write a separate birth plan - or at least a section in their main plan - for a cesarean delivery. Oftentimes, something very important to a mom is that nobody (no relatives, no nurses once baby has left the OR, sometimes not even dad) is to hold the baby until she does - same as if she had a vaginal birth. When mom is under heavy doses of pain medication she may not remember this and may not be able to defend herself - I've had to gently remind everyone in the room of moms wishes to be the first to connect with her baby.



There are so many benefits to having a doula for a planned medicated birth or even a planned cesarean birth!

[monkeysmom615]

Originally Posted by jeebee I am thinking of doing my doula cert. I was just wondering about this today, if somebody knows beforehand they are definitely going to get an epidural and have a completely medicated hospital birth, would they still hire a doula? I only ever hear of doulas for when a woman is trying to achieve a natural birth, but I know that doulas are trained to deal with a variety of birth situations. Also, is there ever a problem when a woman initially wants to go natural but then changes her mind during labor? I mean, how do you know as a doula when it is time to stop trying to assist somebody achieve natural when they have changed their mind... because i know many women get to a point when they say 'I can't do this'. How do you know when you should stop trying to tell them they can, and try to support their wish for pain relief? Anybody who is a doula, please feel free to give me any stories, anecdotes or advice and let me know how you like the job!

I can offer a little insight into "...is there ever a problem when a woman initially wants to go natural but then changes her mind during labor?"

I wanted to try for an unmedicated birth (in the hospital) and my DH and Mom (who were both there for my laboring) were fully supportive...until...I couldn't stop convulsing. I would shake during contractions when they started to get really painful. Then it eventually became constant shaking/convulsing even between contractions and nothing I was doing was helping me anymore. So, knowing that I was no longer really able to think straight, and they were both super worried about me, both my DH and my Mom finally got through to me and got me to agree to the epi. It ended up being the right thing! I was finally able to relax a bit, fully dilate and push out my DS in 20 minutes.

So sometimes there are situations where a mama changes her mind and really truly means it. I think you just have to know your mama and trust her and yourself.

ETA: I would totally hire a Doula if I could get the fundage together. I think no matter what kind of a birth you are going for a Doula can be really beneficial!

[crunch!910]

I'm one person that doesn't see a lot of sense in getting a doula to help with labor pains, when you intend to get an epidural *shrugs*.

[cinderella08]

Originally Posted by crunch!910 I'm one person that doesn't see a lot of sense in getting a doula to help with labor pains, when you intend to get an epidural *shrugs*.

Oh you are right! Most definitely there is no need for a doula to help with labor pains if a mama plans on getting an epidural - however - there are so many more benefits to having a doula and things a doula can do for a mama - even during a medicated birth.