(Closed) doulas or midwives in the hospital … some insight?

posted 6 years ago in Pregnancy
Post # 3
Member
4582 posts
Honey bee
  • Wedding: October 2011

Bumping because I’d also love some info on this. ๐Ÿ™‚

Post # 4
Member
4356 posts
Honey bee
  • Wedding: September 2018

Doulas are non-medical, they are a lay woman who is there to support a birthing mother emotionally and practically.  They have experience of childbirth (but may or may not given birth) and understand the role the womans body has in it, but for medical check-ups you’d need to speak to a midwife/OB.

I think they are a good choice for a natural birth.  Doulas UK says this: “A doula believes in “mothering the mother” – enabling a woman to have the most satisfying and empowered time that she can during pregnancy, birth and the early days as a new mum. This type of support also helps the whole family to relax and enjoy the experience.”

As I am from the UK I am unfamiliar with the birthing support you receive in the US as opposed to here (not that I am a mother) but we recieve a midwife as a matter of course that is “assigned” to us, but may not be the one who actually births your baby, unless you opt for a home birth and/or labour is long enough to accomodate it.  An OB would only come in if needed.  (this is my understanding, I am not a mum but I am sure other bees can shed some light). But then our medical care is “free” as part of our taxes.

ETA: I’m wondering if your midwife is “additional” you could choose someone who will be with you for the birth for sure? I’m just a little confused since midwifery is such a big thing in the UK and I cannot imagine not having one with me, but then I wouldn’t expect the doctor to be there at all unless there was a problem.

Post # 5
Member
2459 posts
Buzzing bee
  • Wedding: November 2010

 had never heard of a Doula until i saw it on this board.

In Australia our health care is free,

There are 3 options in the public system –

  • Shared care with your GP and a midwife – You see your GP for check ups, midwife will be at birth and hospital will provide an obst when needed during your pregnancy and birth.
  • Midwifery Group Practise or Birthing Centres – You are given your own midwife who you see everytime and is at the birth, will come to your house during your pregnancy and after (these are really popular and there is generally a waiting list, I am lucky to be a part of this program.
  • Or you see a midwife or an obstetrician depending on who’s available, generally it is a midwife, for your check ups, supplied by the hospital – these will often be diff for each appt – midwifes will be at birth and obst if there are issues.

But if you have private health insurance if you want to and if it covers pregnancy you can go through the private system in which case you get a fancy room all to yourself after thbirth and your own obstertrician the whole way through, however even with your insurance you have to pay a substantial amount of money as the insurance wont cover everything. 

Our health care system in Aust is so good that many young people who can afford private dont get it, so the Government now taxes higher earners without insurance to encourage them to get it. My husband has it, but I dont, I will get some this year as it is not that expensive, but will still have all my children in the public system as the hospitals are better, the service is completely free, I prefer midwifes to Obst and I dont need a fancy room. 

Post # 6
Member
9824 posts
Buzzing Beekeeper

Honestly  I wish I’d had a doula during my labor this past Friday. A comforting presence to advocate for me and help my birth experience be what I wanted it to be (or as close as possible). I had a bad experience with my nurses and although my midwife was fantastic, she was really only present for the delivery portion of my hospital stay. I wish I’d had a doula there to help me.

ETA: Last part of my response got cut off oops! As far as a midwife, I would totally recommend it. My wish was for a low intervention birth, and although I did end up with interventions due to a labor that was very slow-going, my midwife kept things very minimal. I wasn’t getting checked constantly, fetal monitoring was not constant so I could walk around, use the birthing ball, get on all fours when my back hurt. She followed my birth plan as closely as possible (immediate skin to skin after birth, delayed cord clamping, she used olive oil to help me while I was pushing instead of cutting me). I would go with a midwife again no question. She also gave me every opportunity to go into labor on my own before scheduling an induction. My previous OB wouldn’t let you go barely a week overdue.

Post # 7
Member
5544 posts
Bee Keeper
  • Wedding: December 2011

Also be aware that there are two types of midwives. There are nurse midwives, who have a 4 year nursing degree plus a masters of nursing degree. They can provide primary care to a low risk pregnancy (so if you have diabetes, preeclamsia, and some other conditions they will refer you to a OB) but if you have an otherwise normal pregnancy, they can be your primary and can deliver you in a few settings, some do home or birthing center births for a natural birth but they also work in hospitals for a full medical birth, or any combination usually. They are generally more likely to use alternative medical practices like non-pharmatalogical pain managment (relaxation, breathing, massage) but can offer medical interventions if you want or need them. If you end up needed a c-section for a medical reason (a nurse midwife is less likey to decide you “need” one than an OB because it fits their schedule or something), they can assist an OB but in most states can’t actual do it. Generally, even in a hospital setting, nurse midwives are much less likely than an OB to push medical interventions like pitocin, artifically rupturing membranes and invasive or constant monitors. 

There are also just Certified Midwives who are more than a lay-person like a doula but not given the same degree of education a nurse midwife is. They take courses and get a certification instead of having gone through a full nursing and masters program. Many nurse midwife practices also have certified midwives. They are usually resereved more for birthing center and home birth because they don’t have the same medical training.

A doula is totally non-medical and there to be a personal support to you and your partner. They will be there from however early in your labor you want them, and sometimes a while after. Unlike any nurses, OBs or midwives, they will  be taking care of just you while the others are likely to have more than one. She is there to provide non-medical support, so pain managment, encouragment, relaxation, and help you with things like positioning and be a general support to you. They also can help advocate for you and generally have a better understanding of the procedures so that you can be fully informed, not that your OB, midwifes and nurses won’t help with that, but this is someone to be totally supportive of you. 

As for insurance, I am not 100% sure but I am fairly certain nurse midwives are usually covered, they are generally cheaper than OBs. If you have a doula you will still have an OB or a midwife and from what I have seen, very few insurances cover a doula. 

I hope this helps some!

Post # 8
Member
1659 posts
Bumble bee
  • Wedding: July 2012

I had a doula and I couldn’t have done it without her. She helped me through contractions, communicated to the hospital staff, held my legs during pushing, kept me motivated, and helped with nursing.

If you’re planning on an unmediated birth, a doula is necessary IMO. 

Post # 9
Member
2695 posts
Sugar bee
  • Wedding: April 2010

I was watching pregnant and in heels on tv and one of the mom’s opted for at home midwife birth. They interviewed some midwives which I would have never thought to do.  They ended up going with one that was more rigid in personality which surprised me considering the personality of the couple.  But they asked some really good questions during the interviews about their procedures, do they monitor fetal heartbeat, etc.  And at what point would they go to the hospital if needed.  You might goggle things to ask a midwife???  The midwife they choose actually helped get them in touch with a pain relaxation coach.  So that’s something to consider as well.

Post # 10
Member
62 posts
Worker bee
  • Wedding: June 2013

Watch The Business of Being Born. It’s a great documentary comparing midwives and hospital ob/gyns.

I think a lot varies by state. For example, I live in St. Louis and there are midwives that can work in Missouri but just across the river in Illinois their cerification (CPM) is not legally recognized.

I’d google for midwives/doulas near you and ask them questions.  There is a lot of resources out there to help you find someone.  Asking them your questions and reading their websites will help.

Here’s a couple Indiana resources:

http://www.indianabirthchoices.com/STATE-DIRECTORY.html#anchor_175

http://www.fortwaynedoula.com/fort_wayne_doulas/2006/10/birth_doulas.html

 

Post # 12
Member
638 posts
Busy bee
  • Wedding: April 2007

Sounds like what you might want is a doula. This is someone you’ll meet with multiple times before delivery, build a relationship with, will be by your side at the hospital throughout the delivery helping coach you as well as communicate with the staff or translate medical options for you if needed. When you are laboring in many hospitals you’ll find you check in and then everyone leaves you and your partner alone to labor. That can be kinda scary for a first time mom. Having a doula there she can be as hands on or hands off as you want. But you have someone to ask questions with that and you are her #1 priority… she’s not also worrying about any other laboring moms on the unit. In this area doula’s range from $500 – $800. It is usually not covered by insurance but sometimes you can pay for it with an HSA or FSA account if you have one. I LOVED my doula with my first delivery – even though it was super fast and I joke she made some easy money. AND I can’t wait to work with her again in the very near future (I’m 36 wks right now). NOTE: All medical appts were continued with my OBGYN practice, they delivered my baby, and did my follow-up care.

I’m lucky enough to be in a practice that has both OB’s and Midwifes on staff. With my first it was luck of the draw that the midwife was on call ๐Ÿ™‚ They’ve since grown the practice and I’m 90% sure I’ll be able to have a midwife this time too. My doula actually has their cell numbers and says if requested and available they’ll usually come in even if they aren’t on call for patients who prefer a midwife. I love the OB as well – and he’s very ‘natural/no med’ friendly – I just feel the midwifes are quicker to try different things and have a broader knowledge.

As for switching from your practice to a midwife…. some have privledges to deliver in a hospital some don’t. So that’s the first question. If you hubby isn’t into a birthing center I doubt he’d be into a home birth ๐Ÿ™‚ Do some research to see if any of your local OBGYN practices also have midwifes. These are the ones that will most likely be able to deliver in the hospital with you. If you had a midwife it would be switching to them for your pre-natal and post-partem care. Whether that be at their house or in a new practice.

Hope that’s helpful!

Post # 13
Member
7587 posts
Bumble Beekeeper
  • Wedding: December 2010

I had a midwife and it was covered by insurance, because she was a nurse midwife with a practice. Best decision ever, until my pregnancy got super complicated, but I wouldn’t have changed it. She has also provided me with great care and insight since the birth as well. 

Post # 14
Member
881 posts
Busy bee
  • Wedding: September 2012

I think having a doula to help encourage you through the process is wonderful and it sounds like that would give you the relationship/support you are looking for.  They would be with you during labor regardless of which doctor you got from your OB’s practice.  Just a word of caution to everyone using  a midwife.  As PP have mentioned, midwives are not fully trained to handle every situation that may arise during childbirth.  Hopefully everything goes smoothly in which case I think it is a great option for those wishing to experience a natural birth.  However, my sister-in-law gave birth a few months ago and used a midwife for exactly that reason.  Unfortunately, she experienced life-threatening complications.  Luckily, the birthing center was connected to a hospital and an OB happened to be nearby and was able to come in and perform emergency surgery which saved her life.  If that OB had been delivering another baby at the time, or if my sister-in-law had opted for a home birth she would not be with us today.  I completely understand wanting to use a midwife but I think making sure that you also have a doctor available/nearby in case the unexpected happens is good practice.  Wishing you all a healthy 9 months and textbook labor/delivery!

Post # 15
Member
7777 posts
Bumble Beekeeper

I had a midwife that pretty much filled the role of a doula. In the UK, the midwife sits with you for your ENTIRE labor. They don’t really leave the room. They are there to get you whatever you need and to help you through it. I really loved having that person there with me. My midwife was only a couple years older than me so we got on pretty well. She distracted me, got me water, helped me through contractions, held my hand and even stayed with me when they rolled me into the operating theatre to do my forceps delivery.I needed that support because I had such a difficult labor and my Darling Husband was so confused and scared that he wasn’t much help.

I would really recommend getting a doula. It’s so worth it. We’ll probably be back in the states when we have our next baby and I will be hiring one 100%.

Post # 16
Member
1695 posts
Bumble bee
  • Wedding: March 2012

I will be having a doula.  It’s still early on of course, so I can’t offer much advice just yet.  We met with her last week and so far so good.  I will let you know how things go.

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