doula vs. midwife

[NotUrsula]

To further comment on the issue of L&D nurses -- IMO this counts more than ANYTHING else when you are choosing a hospital for delivery.

Forget the birthing balls, and the decor of the labor suites, and the quality of the cuisine. The experience of the nursing staff and their attitudes toward you and your situation are THE most crucial aspect of a hospital delivery. Your doctor can go anywhere where he/she has privileges and will probably only be present for an hour or two, but the nursing staff will be there for the entire stay, and if they are not supportive, you will be miserable.

When my first child was born I had a young nurse tell me patronizingly that I was reacting too loudly to my unmedicated precipitous labor, and that I was "just going to have to do better than that." Honestly, I nearly swung at her with the IV stand! DH demanded that they get her off my case, and after a great deal of argument from the charge nurse, they found me someone else. (It was a holiday weekend.)

A few years ago I lost a child to a severe fetal malformation. It was detected fairly early, and we had some difficult choices to confront. I was hugely dismayed at the attitudes of the nursing staff at my OB's "home" hospital where the testing was done; to a woman, they all failed to hide disdain for me when they discovered that we were even considering a termination. Their unprofessional behaviour absolutely guaranteed that when I was (successfully) pregnant again two years later, I would choose to deliver elsewhere. My OB wasn't happy with me because she had to deal with major road construction to get to the other hospital, but I wasn't backing down. I'm *so* glad that I didn't. The nurses at the hospital where I did deliver DD were so much more supportive of me than the nurses at the other hospital ever had been; in any department that I'd ever dealt with there, not just Womens Health Services.

Go take the tour even if you've been there before, and ask questions about medical statistics. Even if the nurses cannot answer them for whatever reason, note that HOW they deal with the question will tell you a great deal about how they will deal with communicating with you when you are a patient there. If they talk down to you or tell you that the issue is not important, it's not a good sign.

Also, take the tour in the evening late in the week if possible, and note how many beds are occupied. A place that has essentially no patients in L&D in the evening has a good chance of being a place that does a lot of inductions and scheduled C-sections. At one very "busy" hospital I took the tour at 7 pm on a Thursday, and only one bed was occupied -- at a hospital that delivered 900 babies a year. When I commented to the nurse about how deserted the place was, she said that most of the moms had gone home that afternoon, as usual. "As usual?" The explanation was that the normal stay for a C-section was 72 hours, thus the people who had had scheduled C's on Monday morning had all gone home on Thursday afternoon. Same deal with the inductions; those people delivered on Tuesday and also went home on Thursday. On being questioned, my OB admitted that that particular hospital put a lot of pressure on physicians to turn each L&D suite in no more than 14 hours.

 

[paper1225]

I just had to add a huge for choosing to use a doula or midwife! I am a labor and delivery nurse at a hospital and I know most nurses stress when a doula walks in, but I absolutely love it!!! Birth is such a natural happening and I know at our hospital most of the dr's I work with keep the choices from the mothers. I live in Missouri, and would love to become a midwife, but really to get a good job that would allow me to do the job to the fullest potential and to have protection for myself and the mother-I would have to move.........now moving closer to disney would be good.

For the original OP, if you already have a dr, then you want to find yourself a doula.......check though, we have a CNM (certified nurse midwife) that works our floor as a nurse practitioner and she also works in a dr's office offering what services she can here! Make calls and interview!!

 

[PoohHappens]

Another L&D nurse here. Yes there are some lousey nurses, there are also some really bad doctors and there are some midwifes that are downright unsafe. Now that being said there are some really really great supportive nurses, docs and midwifes. Yes induction, cesarean, and epidurals are all at a high rate these days. But not all of that is coming because the caregiver is making or suggesting these are necessary. Much of this is coming from the patients themselves. We have many many patients demanding these things, sometimes even outside what would be medically indicated. Like complaining that they want to be induced at 36-38 weeks because they are uncomfortable. Most of the moms here who have posted, that is not the case. Most sound like they were happy to carry their babies to term, and would like the least medical interventions possible for their delivery. I commend them for this and many nurses are supportive of this as well. At the same time though, OB docs are one of the highest litigated professions. It is awful that many have had to go to practicing basically to protect themselves rather than care for the patient as a person. But it is reality.

To the OP, a doula sounds like what you may be looking for. I am not sure what your doctor meant about working with a midwife though. Unless he is willing to transfer your care to a midwife and be the physician back up. Good luck with your birth and I hope that is is a positive experience for you and your family. Good luck with accomplishing your VBAC.

 

[amberg@eastlink.ca]

we had a doula with our second child. our first, dd- her labour was horrific, and i wish i had been better prepared by haivng a doula or midwife. the only reason we choose a doula over a midwife- it wasnt covered when i was pg the last time- and went on a sliding scale in accordance with your income- upwards of 2000 dollars. the doula was free- and wonderful!!!!

thankfully now its been changed and we have a province covered midwife!!! yeah go us- were finally in the 21 century!!! wahoo!!!

my doula met with me a few times before birth and had me shape out a birth plan, nothing rigid, bf'ing within an hr, clean off the baby first, no forceps/vaccum extraction. she was wonderful. after my bad first experience i wasnt going in unpreparred. i went in to be induced, she met us after i had the gel placed about half an hour or so later. she gave me advice on not to squinch up my face as it can make it more painful, helped by running the tub, having me focus on breathing , rubbing my back. talking me through the contractions, helping time them as we paced the halls etc. i knew with ds i wanted to see him being born since i didnt have thah option with dd. i remember screaming out the mirror- since he came out fast and she was off to get it! she took all the pics once he was born and a few during labour and several after i was all nice and sparkly again.

she followed up with a visit the next day , a home visit to check on us, and gifts! then she came back and baby sat the two about 2 weeks later so we could have an hr to ourselves! oh and she prepared his birthstory- makes me teary every time i read it!! best of all she is a life long friend!