Midwife? Doctor? Doula?
I’ve arrived to the states 32 weeks pregnant and I am pressed with the dilemma of a birth plan. I have had a baby in Germany and in Maryland, and now I am in Salt Lake City evaluating my priorities and wondering what my options are. I have had two similar experiences where my water breaks early and then I need pitocin and an epidural. Based on my past experience, I was wondering if I should stick with a doctor or go with a midwife or maybe a doula/doctor combo.
Any experiences you could share would be helpful in my decision making at this time.
September 22nd, 2006 06:09
I arrived in a new state for my husband’s summer internship at 32 weeks in my second pregnancy this last May. (My son was born on July 10th.) Because I had major complications with my first pregnancy, requiring an emergency c-section at 31 weeks, I was more than a little aprehensive about the care that I would receive in a new state with a new doctor.
Before I arrived I asked other women in the area (LDS contacts at the firm my husband would be interning for) for recommendations and chose a wonderful OB/GYN. She really put me at ease, and turned out to be a wonderful experience.
I don’t know what to tell you as far as choosing a midwife or doctor, but I would definitely try and get recommendations from other women first.
September 22nd, 2006 06:13
Well, there’s not a whole lot you can do about your water breaking ‘early,’ (although I’m not sure what you mean exactly; before labor starts?) but decide what you want and then find a caregiver that will help you get it. Where I live, midwives practice almost the same as doctors, but it might be different in SLC. A midwife practicing the midwifery model of care is great! If you can’t find that (ask around in your ward, neighborhood, etc) then a doula is a MUST to help you through. Good luck!!
September 22nd, 2006 06:42
Jen, I suppose with your history you should go with a Doctor, and doula is also a good idea because if you want to have some ability to control pain and work it through they can be wonderful to work with.
I have my issues with midwifes but if that is what you choose you won’t hear anymore from me.
As a nurse that works with babies and has been on deliveries I will say don’t fret about a birth plan. As nice as they can be, I haven’t ever really seen too many perfect deliveries. Now you can be prepared with what you really want but also use common sense, and be flexible. Things can happen and often do, being the most prepared for any contingency is the best thing to do.
Don’t be afraid to ask lots of questions. After your water broke how much time did they give you for natural labor to start. You can safely go up to 12 hours, and perhaps even a little longer without pitocin. Check hospital policies, talk with several doctors about how they will approach things. In this way you can make an informed choice. As a baby nurse I personally have made choices that are the best for the baby, not necessarily what I want. I can say that I have been lucky and not had too many problems. Follow your heart, that is the best advice to give you.
Good Luck.
Tanya
September 22nd, 2006 08:14
My daughter was born with a Doctor/Doula combination. Really, it was great. The doctor was really and truly on there at the very end; my doula was there the whole time.
With my son, I delivered at a hospital again, but this time with a midwife. At least here in Washington, it can be tricky to find a midwife with hospital privileges. She (and her apprentice) were right there with me, as my doula had been.
So, I had a hospital birth both times, and, for me, the difference was pretty minimal, seeing as how in the first my doula was there all along and with my second the midwife was there all along.
I do suggest having an arrangement where you have some sort of birth assistant with you. Some L&D (labor & delivery) nurses are great, but, man, when their shift is up, you don’t know who you’ll get. If you have your own hired birth assistant, you know that you have someone you can trust who’ll be with you the whole way through, and there’s no worry about changing shifts and the like.
Given that you have a history of tricky labors, I’d opt for a doctor and a doula, but if you decide to go midwife, just be sure that she has hospital priveleges (so you can be sure that she’ll not only be a allowed to be there, but be allowed to take care of the birth–as opposed to the doctor on call coming in and taking over) because it does sound like you’d best be delivering in a hospital (as opposed to a birthing center or home).
September 22nd, 2006 09:47
Another plus for the doctor/doula option that I just thoguht of…
With my midwife, at the end, she had to focus on the delivery (from the ‘catching the baby’ standpoint), whereas with the doula, she was free to focus on me and help me stay focused and do what I needed to do as the doctor was taking care of that part.
September 22nd, 2006 10:00
I’m sure you could find a midwife that would handle your birth beautifully - even if you still needed pitocin and an epidural in the end. Midwives run the gamet in philosophies so you just need to spend time talking to them.
A doctor/doula combo would be great too. I know two great doula’s personally in the Salt Lake area if you need a reference.
talesfromthecrib ‘at’ gmail ‘dot’ com
September 22nd, 2006 16:26
I would say to first get on your knees and find out exactly what Heavenly Father has to say about it. I knew in my first pregnancy to be packed and prepared for a premature birth. How did I know? While on my knees and through the whisperings of the Spirit. I didn’t know anything then about pregnancy or childbirth but I did have the Spirit to guide me. There are all kinds of experts we have at our disposal these days during pregnancy and childbirth who all give us so many different kinds of advice, etc, but what matters first is what the Lord wants for you and your baby. All of those other expert voices, doulas, doctors, nurses, etc, are all part of the support network that we choose while having a baby… after the Lord confirms what He wants for us. He is our Master Physician and being our Creator and our baby’s Creator, He has a plan for your baby and for you. Find out what that is. Pray about the doctor, the nurse, the midwife, the doula, etc. And listen to the Spirit to guide you.
The times when I did not obey the Spirit… I ended up with an emergency cesarean that nearly cost my baby her life. The time when I obeyed the Spirit… I planned a cesarean section even though my heart desired another homebirth. I was blessed with a beautiful natural birth anyways…my heart’s desire… due to a rapid birth and was told in a blessing that it was because of my obedience to the Lord and in giving up my will to His. I have found through giving birth 5 times and in 5 different situations that each situation is different and unique and that the Lord’s plan is different for every one and it may not even include a physical reason! :}
As for the water breaking early, take extra Vitamin C! This will keep your water bag stronger. Practice Kegels everyday… do a couple hundred a day! Also, water breaking early has to do with baby’s position and how healthy your diet is. Make sure to take a good prenatal. Then search out midwives and doulas or doctors according to recommendations and listen to the Spirit. Get blessings if you need to in order to solidfy your decision and bring direction. Some friends think I am fanatic about being so careful about childbirth decisions, but they are important. Your baby being born only happens once in this life and does bring us very close to that thin veil of life and death. :] A doula has been wonderful for me in many of my births and essential during one of my births. My husband is a wonderful doula for me. After 5 babies, he has it all figured out! LOL Of course I am one of those “natural birth types”… even foregoing the epidural while having pit labors! Fun! LOL
Above all… pray and pray some more. And get a blessing! Read and research and look into your options. It is never too late to change your mind either… until that baby is crowning anyways! :]
Stephanie
September 22nd, 2006 16:40
Stephanie,
“It is never too late to change your mind either… until that baby is crowning anyways! :]”
Hahahaha! That’s hilarious–so true, but still hilarious…
:D
September 23rd, 2006 17:01
Wow! I love all this feed back! Thanks! One thing that has come up with my husband is that he thinks a doula might “replace him” or make him feel uncomfortable since she is basically a stranger joining us in an intimate situation. Any thoughts on husbands and doula’s?
September 23rd, 2006 18:41
The doula’s job is to support you both–or, in other words to support him supporting you. She can talk to hospital staff, run to get something, etc, so that he is free to remain with you. A good doula would never remove a husband physically or emotionally from any part of the birth.
Of course you should talk about this with any doula that you interview, so that she is aware of his special sensitivity/worry on that score, but, really, it shoudl not be a problem.
I delivered both children Bradley method, and both times (with a doula and then with a midwife) my husband was right there with me, and the assistant assisted us as a team.
September 24th, 2006 13:25
I just delivered #3 this week with a midwife and an epidural. If you want a midwife, there’s no reason the posisble pitocin/epidural situation would disallow hiring one!
September 24th, 2006 15:49
My wife (somewhat forced) went with the surgeon/surgical staff approach for all three C-sections (again, more or less forced). I don’t think a midwife, doula, or gregorian chant choir would have been of much use…
September 24th, 2006 17:09
As for the doula replacing your husband, my husband was concerned with this as well. If you have a good, sensitive doula this should not be a problem. As a doula, her role would be to teach your husband how to better support you and she is like the facillitator of that. My doula was great during our last birth, even though it was a quick birth, and my husband did most of the labor support. Never at any time was I left alone and without support because I had both him and my doula.
WHen there is only one person to rely on, it makes it harder for them to leave to go to the bathroom ,etc. Near the end for our last birth, our doula took pictures while Jeff did the labor support for me. We have some absolutely beautiful, tender pictures of my husband holding me while in labor that my doula thought to take.