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Old 06-01-2011, 07:15 AM   #21
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Re: Would anybody ever use a doula when they are planning a medicated birth?

I've had one baby without a doula and one baby with, and I would never be without one again (preferably the same one, as she was totally awesome). My homebirth turned into a hospital transport, and she walked me in while the midwives and my husband parked; she knew where the popsicles were hidden and stayed by my side for every minute of my 30 hour labor.

Even though I got an epidural when I was at the hospital, she still sat by the bed and talked with me, encouraged me to sleep, protected the quiet space in the room and encouraged my husband to rest, too. When it came time to push and the epidural had worn off, she was whispering in my ear, keeping things calm, encouraging me and keeping me focused, talking me through the pain.

Afterwards, when I was teetering on the edge of disappointment for having to go to the hospital, she pulled me back - she said that of all the births she's attended, this was one of the hardest and that she was proud of how hard we'd all worked, and glad that we'd made the decision to go to the hospital while we still had a choice, before it was urgent, and that making that choice let me still have a vaginal birth with midwives - both a hospital CNM and my homebirth midwife were there.

In short, she was awesome and as a result, my birth was awesome.


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Old 06-01-2011, 07:24 AM   #22
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Re: Would anybody ever use a doula when they are planning a medicated birth?

I haven't hired a doula for any of my births, but I can think of plenty of reasons to have one for a planned epidural. To me, a doula is about supporting mom through the birth process, not just about helping mom go natural. And even a mom with an epidural needs support.
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Old 06-01-2011, 09:56 AM   #23
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Re: Would anybody ever use a doula when they are planning a medicated birth?

I have been meaning to comment on this thread, but have only had my phone, so I didn't want to type all of this on that

So, I think that it would be easier to support a woman as a doula who already said, "yes I want an epidural and a doula". I wouldn't have a problem with that, even if it isn't what I would choose for myself.

My first client said that she wanted to go natural, took a local natural-birthing child prep series of classes, and did everything thing she could to "try" for a natural birth. When she called me at the hospital, she had already requested a narcotic!! It was rough. We did pretty good once until that wore off, and then it was back to "reminding" her why she wanted a natural birth, but at that point, I wasn't sure that she had ever Really wanted it, even though she had put that out originally.

We had a "safe" work- a word that when she used it, she did not want me to discourage the use of the epidural any more. After 8 hours of GOOD progress, she used the safe word, and I backed off. 12 hours later she had a c-section for FTP. It was really tough, because I felt like she had misrepresented her wishes. If she had said in the beginning, "I really can't stand pain at all and I will be getting drugs ASAP", I probably wouldn't have been there for 24 hours. She would have gotten the epidural at 5:00 pm instead of 4 am, and the c-section would have happened much earlier. Her baby was posterior, and just was not coming out if she was in bed, on her back, especially with NO help from the doctors or nurses. It made my job very hard, because I kept trying to help her in her original goal of having a vaginal birth, but in the end, she didn't help herself at all. Once she got the epidural, she really wasn't motivated at all to help the baby change positions. All of that sounds really judgemental, but please be assured that I only was encouraging to her. It was confusing to me why she put out there that she was so motivated to have a natural birth, when it took almost no time for her to ask for the drugs. Her water had broken spontaneously and she was all the way to 7cm when she decided that she couldn't take it any more, and no amount of encouraging from me would convince her that she was actually very close, as she was spontaneously pushing!

As I said, I would have no problem supporting a woman who said straight up- "I want the drugs, but I want someone there with me". Great, no problem. I really did feel like leaving when my client requested the epi, because I could tell she was so close, and I felt like it would only be bad for her (especially since she couldn't stand to be on her back when unmedicated- there was probably a reason for that!!). But I didn't. I stayed and tried to help, even though it felt like I was trudging through sand to help her advocate for herself and get the nurses to help. It was a very eye-opening experience. I hope the next one in the hospital is better.

Unfortunately, though, many women don't understand that doulas cannot "advocate" for the mother. THey can only encourage her to speak up for herself. A doula tries to suggest things that might help, but it is VERY hard for the doula to speak directly to the staff in some hospitals (like my local hospital) because many times the suggestions that are made by the doula are seen as confrontational by the staff. It was only after the mother repeatedly asked to try a hands-and-knees position that the nurses finally helped out, despite me mentioning it many times before that. So having a doula is really not an insurance policy- the mother needs to be informed and speak up for herself, and her partner also needs to know what the mother wishes. The doula's hands, many times, are tied.

It's a really rough position to be in. I really would rather be a midwife, for that very reason. I need some more birth experience before anyone will take me on as an apprentice, though.
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Old 06-01-2011, 01:42 PM   #24
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Re: Would anybody ever use a doula when they are planning a medicated birth?

My doula makes it a point to find out your preferences in the initial meetings, and has no issue with medicated vs. natural. Doulas are there to support the mamas decisions and wishes, not push their agenda on them, kwim? So no matter what route I wanted to go, my doula would support it. If I asked for information, or felt I wasn't educated enough, she would gladly provide educational information, or even her opinion if I wanted it, but again she doesn't force it on you.

As far as knowing when to stop supporting natural, it's really a case by case thing. I told my doula no matter how badly I beg, no drugs. I would regret it later, and know I would. But, some mamas change their minds. As long as you feel like the mama is knowledgeable about what she's choosing, and you've gently reminded her of what she originally wanted and why, if she wants to change her mind, talking with her about her fears and reasons for changing should give you a good indication of if she really wants to change her mind, or if it's just an in the moment type of thing. If that makes sense.
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Old 06-01-2011, 02:04 PM   #25
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I am not a doula and I have never used a doula. However, I will give a warning to those first time mothers. You have never done labor before and you honestly do not know what to expect. Having goals is a great thing but just remember that things change and your goals might not be the same in intense labor. Just remember to be flexible. A good doula will know that, especially when their client is a first time mama. A great doula also knows that she is NOT the nurse or the doctor and respects her position while still supporting and advocating for the mother and baby. Doulas can be great in the right situations.
I'm so tired of hearing about how important a birth is. It is absolutely nothing more than an obstacle between a family and a baby.
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Old 06-01-2011, 02:09 PM   #26
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Re: Would anybody ever use a doula when they are planning a medicated birth?

I hired my doula to help me fight the hospital for my VBA2C. She is more of the natural no meds type, but totally stood by my decision to get an epi with a goal of waiting until at least 5cm. She respected my choices and stood by me and fought for them with me. They weren't what she would have chosen but she totally understand why I chose the epi and why I went ahead and let the dr break my water. I my Doula.
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Old 06-01-2011, 03:23 PM   #27
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Re: Would anybody ever use a doula when they are planning a medicated birth?

A doula is supposed to support a woman through her labor journey, no matter what road she takes. But giving information to arm the mother with information to make informed decisions is okay, as long as it is not laced with our own personal perceptions and opinions. It is a hard road to walk, especially for those of us who are passionate about non medicated births. There are many doulas who will not take on hospital births or medicated births because they cannot get past their bias, and that is to be respected as well because they recognize their inability to get past that.

But a woman needs to be supported no matter what through labor and delivery. And there needs to be a doula available for any kind of birth, be it non medicated in the woods, homebirth, non medicated in the hospital, medicated in the hospital or a csection. Birth is not a road that should be traveled alone, it is a sacred and solomn time, and the thing I remind women who are doulas who have a hard time getting past their own opinions is that many of them came into the doula business because they had an experiance that they felt like they didn't have choices or that their experiance was less than stellar and not what they wanted. So I remind them that just because they wanted a non medicated birth doesn't mean that every woman wants that. I know a woman who accidentally had a non medicated birth, she went in with intentions of having the epi the second she was able to, but her birth went WAY faster than any of us every expected, she was a first time momma and that baby came out from first contraction to actual full delivery in less than 2 hours, so by the time she got to the hospital, she was fully dialated. She went on to have an awesome non medicated birth, no complications and really the pain factor was not even a huge thing to her. But it was that she had a plan, she had a different birth in mind and that was not the birth she wanted. She was devastated because she was told constantly that she needed to wait until contractions were every 3-5 minutes apart, they never really got any closer than 7 minutes apart until just before she got to the hospital. She was told by many that because she was a first time momma, she would probably be in labor awhile. So she assumed she had plenty of time, and she felt like she was out of control and that she didn't get the experiance she envisioned. I was like huh?! when I heard that, I mean I thought it sounded awesome and was totally stoked for her, but she had to grieve that experiance like many of us who have ended up with birth experianaces that either left us in the aftermath of trauma, misinformed or bullied into something or that like her, our experiance was not what we envisioned. A doula would have been awesome for her to walk her through those emotions, to help her grieve the loss of her hopes and expectations. A doula could have really supported her in that sense.

Now I know that this is not a huge majority, but there are some mommas out there who feel like they were bullied by a nurse who felt that the natural way was the only way to do it, and while I agree for my personal self and birth, it is still just as disrespectful to deny a woman of her wishes as long as it has been handled in a way that informs the woman of what she is asking for and what the after effects could be, what the side effects are in the moment, etc...and so a doula can be there to advocate for the mother in that situation as well, she can help be that voice that the mother needs when she is getting bullied. A good doula can tell the difference between bullying and informing so the mother can make an informed decision that is best for her and the baby.

A good doula will lay her personal opinions aside and will support the mother, because that is what we are doulas for, to support mommas and babes.
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Old 06-01-2011, 03:59 PM   #28
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Re: Would anybody ever use a doula when they are planning a medicated birth?

I would not personally use one because I only feel like *I* need a doula if I'm going for a natural birth, otherwise my husband can support me just fine.

I would think there are plenty of women who could use or need a doula if they were having an epidural or c-section, sometimes their partners aren't as supportive or maybe they need the post partum services or breastfeeding help/counseling!

I do think that women should be up front about what they really want from their birth experience. But sometimes they might not know what they're getting themselves into, especially the first time moms.
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Old 06-01-2011, 04:25 PM   #29
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Re: Would anybody ever use a doula when they are planning a medicated birth?

I haven't read other responses but I don't see much of a point in hiring a doula if you aren't trying for a natural birth. I think nurses would be a fine substitute in that situation.

I had a doula for DS's birth and I ended up getting an epidural. I was 42 weeks and 2 days pregnant. I had barely slept in days. I had many bouts of "false" labor. I was so uncomfortable that I didn't even feel like I could catch a full breath. I had been in "real" labor for 16ish hours and made it to 8cm without an epidural. It seemed like I was stalling out so my MW broke my water. The contractions got unbelievably intense. An hour later, I didn't have anything left. I couldn't cope. I was exhausted. I begged for an epidural. My birth team tried to shrug me off. I had told them to do this if I started talking about epidurals. I couldn't get them to hear me. I really needed one, I couldn't do it anymore. My doula was the only one that heard me. She stepped up and advocated for me. She essentially got me my epidural! I'm so glad she was there. She will be there for all of my children. I love her.

DS was born after 22.5 hours of "real" labor. The last two hours of that were spent pushing. The epidural didn't take super well but it gave me the mercy I needed. I had a "hot spot" across my abdomen where I felt everything. I got an hour or so to relax and it started wearing off. I felt everything through pushing. I wanted to get up and squat to push but my MW wouldn't let me because of the epidural. I really think I could have done it though.
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Old 06-01-2011, 04:42 PM   #30
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Re: Would anybody ever use a doula when they are planning a medicated birth?

I don't know what the situation is like in Australia, but here, we have many families with husbands away serving in the military. They are often away from family too. If I was alone, I might hire a doula just for support during the labor/birth so I would know someone in advance. I am a private person iRL and wouldn't want a friend in the room during it.

ETA- not just military, but any single mom or mom who knows she may be alone during labor
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