Hiring Our Doula

So as promised, I will continue where I left off on my previous post.

We had come to the realization during our birth class that our midwife would be very hands-off during the labor, and Hubster was overwhelmed at the idea of trying to remember everything by himself.  So we sat down with Doula P to discuss our hopes and preferences for our birth…

I feel I should also make clear why we had chosen to go with a midwife.  Before I was ever pregnant, I was exposed to the book “You.r Be.st Bi.rth” which lead to watching the documentary “The Busi.ness of Bei.ng Bo.rn” which lead to more research and more documentaries… Hubster even wrote a persuasive essay last semester for his English class about the overwhelming evidence that for a low-risk woman home birth, with a midwife, is safer, with less interventions (and their side effects) then giving birth in a hospital.  All of our research had more or less come to these general conclusions:
-Hospitals have strict protocols, that dictate how the doctor is to treat, (even if the doctor would otherwise be open minded) and how the woman is allowed to labor.  The majority of the time you must labor in bed, on your back – the most painful and unnatural position to labor and give birth in.
-Doctors are trained to look for problems.  They rarely, if ever, see a natural child birth while in school.  This is why they are so quick to intervene with interventions that are often unnecessary.  Every intervention, no matter how small, has pros and cons.  Every intervention has side effects.  There are times they are necessary, but as our Cesarean section rates are increasing we must ask if every intervention these doctors are doing is really necessary.
-Compared to other developed nations (with lower C-section rates) we have some of the highest numbers of infant and maternal mortality.  (Hubster printed out the statistics of every country in the world, it was pretty shocking to see countries that I would think of as “second” or “third world” that had better statistics than the US!)
-Midwives are trained in natural child birth.  They allow and encourage movement, and various positions to labor and deliver in.  They support water birth and other “alternative” and “progressive” birth wishes.  They are more involved in assisting during labor and delivery.
-Midwives take longer with their patients, forming close, trusting relationships.  They are less “clinical” and more personal.  They are more open, respectful and encouraging of the couple’s birth plans/hopes/wishes.

So here we are, with specific expectations and presumptions, based on a LOT of research.  And we knew, that for us, we wanted minimum interventions, no pain medication, and a water birth.  So we sit down with Doula P on Tuesday morning for our consultation.  And since she is friends with Midwife N, she was very kind and judicious, but also very straightforward about what to expect with her.  That N would:
-Not assist in labor coaching/movements/massage/pain relief.  To a certain extent, this has to do with an old injury that makes it really difficult for her to be that physical.
-Insist on breaking the back of waters at 4cm, regardless of how good my progress is.  This is so she can assist in stretching the cervix to cut labor time down.  (Which sounds cool in concept, but is extremely painful… and part of my reasons for wanting to labor without drugs is because I don’t feel that there is anything wrong with working through labor.  It is an experience that I want to experience, not hurry through.)
-Not allow a water birth.  Because bending over/reaching into the tub is physically difficult for her, and because…
-Desire that when it came time to push, N would have me on my back.  Admittedly, this is so that she could utilize some special knowledge to assist in stretching/opening my cervix (OWWW!!!) and then stretching/opening the birth canal and perineum to minimize tearing.  (Which actually sounds cool… but not worth the pain of being on my back in my opinion.)

I could feel this clenching in my chest.  On one hand, I wanted to say “Ok, this is what you’ve got ahead of you, all you can do is prepare for that.” but on the other hand it was so polar opposite of what we had envisioned, I wanted to fight it but I felt… trapped.  I mean, I’m 37 weeks pregnant for goodness sake!  Doula P was so great and calm.  She asked me to reiterate what what really important to us.  And then she suggested the possibility of changing care.  Not that Midwife N is a bad midwife – but just that she may not be the right fit for us.  And let’s be honest, how often have I written about feeling disconnected, and unsettled with her as our midwife?  We’ve never really “hit it off”.  Doula P acknowledged that finding a midwife this late wasn’t very realistic, but she has two doctors that are professional friends at the local hospital, and offered to call them and see what their availability was.

As someone who works in a (veterinary) clinic, I am fully aware of how intensely busy doctors are.  They are constantly running to and from surgery, appointments with patients, trying to get through writing up charts, calling patients with lab results, and a million other types of paperwork.  They are rarely available at the time you call, and it’s always a few hours before they have a free moment to call anyone back.  So I thought perhaps Doula P would speak with their assistants or leave messages and we would find out more later in the week.

She calls up Dr.B, and gets his personal voicemail (I can only assume she has his direct line or cell phone number?) and she leaves him a message that she has a client interested in switching care providers  wants a water birth, and is he available for my due date of Decemeber 30th?  Then she calls up Dr.J – and he answers his phone!  When she says her name he very warmly says “Oh hey!  How are you?” It’s evident that there is a great deal of mutual respect, as for a peer or colleague.  Unfortunately, he is out of town until January, but said that if I was a little late he could be available, and advises she try Dr.B.  As they are talking her phone beeps – it’s Dr.B calling her back!   (Totally unheard of!)  He is very enthusiastic and easy going about the idea of a last-minute patient, and a water birth.  “Anything for you!” was his attitude.  Again – I was blown away by the obvious respect these doctors have for Doula P.  It made me not only feel confident that we had made the right decision to hire her as our doula, but it also gave me the confidence that if we switched to a hospital birth, with a doctor, that we would be respected and our wishes and hopes would be honored as much as possible.  Doula P told us not to feel any pressure to change, but that at least we knew we had options, to go home, sleep on it, and let her know.  But in the span of the 15 minute car ride home, Hubster and I had gone from “considering” to realizing that was what we wanted.

Us.  In a hospital.  With a doctor.

Say what?!?!

But it’s true.  I instantly felt more at ease.  I felt like we had a great team, a great support system.  As ironic as it sounds, we just could not get over the fact that we had more freedom, more options, more chances of our desired birth experience at a hospital with a doctor (and doula!) than we would have had outside of the hospital with a midwife!  At least, in this specific circumstance.  I can’t deny that we live in a pretty liberal, “progressive” area of the country that has doctors and hospitals that welcome changes in the birth industry.  When we lived in Colorado, none of the three hospitals in our proximity allowed water births, period, end of discussion.  And I also think that Midwife N is something of an anomaly of the midwife profession in that she is so set in her ways and does things SO routinely.

I think that what made such a difference was this: Hubster has a saying from being in the fire service.  “A patient doesn’t care home much you know, until they know how much you care.”  With Midwife N, I always knew she had a lot of knowledge, but I never felt that she really connected with me.  Regardless of multiple visits over several months.  But in the course of a 2 day birth class I had absolute conviction that Doula P genuinely CARES about her students/clients.  I felt a connection with her and I felt that she would absolutely stick to keeping our best interests on the forefront.  So that I have a significant amount of trust in her – so much trust that this “die-hard stay-out-of-hospitals” woman has agreed to change to a hospital – and I feel peace about it.  Actually, I feel excited!  I feel like I finally know what to expect, I feel prepared.  Midwife N would never go into specifics on her protocols or preferences… probably a well-intentioned attempt to sooth and calm.  But I would so much rather have it handed to me straight.  And we have that now.

Other amazing points:

We discussed breastfeeding.  Midwife N had just told me to look up the La Leche League for classes, but I’m busy and never got around to it… Doula P grabs her phone and starts making calls and comes up with a list of classes and support groups!  I’ve had some concerns that my right nipple is a little wonky, and may impact my ability to breastfeed.  The woman at the WIC lactation consultation waved away my concern without asking to see the anatomy in question, and said if I had any problems, they would be addressed postpartum with a lactation consultant.  Midwife N basically did the same thing.  Doula P was the FIRST person to say “would it be ok if I looked?” so I whipped ’em out (ok, I actually was tactful and discrete) and she compared right to left, had me do some breast massage to stimulate the nipples, and agreed my right nipple IS in fact a little flat and may need a nipple shield, but that she believes with the right tools and assistance we will be ok.  It was actually nice to feel affirmed that I’m not going crazy or paranoid, and to be validated.  To be taken seriously.

We talked about my history of panic attacks, and how that is why I came to desire a water birth/labor.  We talked about my symptoms of an impending panic attack and how I’ve handled them without medication in the past, and how she and Hubster can help me if I start to feel them coming on during labor.  Since numb hands is a big part of my symptoms, she went over various hand massage/pressure points (Which felt amazing!  Oooo, hand massage…)

We talked about my concerns about my parents being overly zealous about wanting to be there as soon as I’ve delivered, and how to tactfully tell them that I wont know how I will feel, and we will have to see on the day of what all happens.  (Also, at a hospital, they can hang out in the waiting room until I’m feeling ready, and then when I start to feel done, I can utilize the hospital staff to play “bad guy” and direct them out – harder to do if they come to my home after we are all done at a birth center with a midwife.)  I want to honor my parent’s enthusiasm – as I’m on the verge of “official” motherhood, I’m more empathetic of how I would feel if my daughter turned me away.  But I also wont deny that this birth, and the time right afterward, is powerful, emotional bonding time for Hubster, myself and Seedling as a family.  And we genuinely just may not feel “up” for visitors.  (Another perk at the hospital?  They want us to stay overnight – so I get an extra day of recovery before having to come home and handle the dogs and cats etc.)

So after all of that, I had to notify Midwife N that we are transferring care without outing her friend.  I sent her an email, just explaining that the birth class brought a lot of concerns and fears to light, and that Hubster and I realized we would feel better in a hospital setting.  She actually took it really well and sent a very nice reply.  Then I called up Dr.B’s office and made an appointment – next Wednesday at 9:30am!  Oh, and of course I need to tour this hospital I’ve never been to!  Doula P actually leads tours on occasion, and is giving one Tuesday evening at 5pm.  So now I’m just working on getting done with the last of my “check list” stuff… we wrote up a birth preference letter for the day we go into labor, I need to gather/pack a bag… oh, and get the stupid car seat installed!  That was supposed to be on Scott’s plate BUT – this week he started a new job!  It’s in a welding shop, so it’s in his field of study, and will offer some income while I’m on maternity leave, all great and amazing things, but it means he is gone from 5:30am to 10pm between work and school… so I’m thinking it’s up to me, on my days off, to get these last things taken care of.

Oh, and did I mention that last night I *might* have had some braxton hicks?  It wasn’t like my entire abdomen went hard, but I would feel pressure on one said (usually my left) and the it would roll across the front of my abdomen to the other side… it could have just been Seedling running out of room, but all I could think last night was “I’m excited for labor, but we’re not quite ready yet!!!  AHHHH!!!!!!!!!!!  Don’t come, don’t come, don’t come just quite yet Seedling!” and then I woke up at 3:30 this morning just… awake.  I tried to fall back asleep but when Hubster got up for work at 4:30 I figured I might as well too.  So I’ve been up, walked dogs, fed pets, made breakfast, made egg salad, started filling in the baby book, and typed up a long-ass blog post, all before I would normally be awake.  Could  this be the surge of energy/nesting women get right before labor?!?!  Oh, I hope not, I’m so not ready…. I’d like to at least MEET this new doctor before we go into labor!  And the car seat!  Oh, and we need to get Doula P the rest of her payment (since we’re doing this so last minute we were able to make a deposit, but have to pull the rest out of the savings trust and that could take a few days to a week…)  AHHHH, so much to do, and I’m excited and stressed… and now that it’s time for me to be waking up, I’m suddenly exhausted.

 

Advertisements

6 responses to this post.

  1. Wow, so many wonderful changes! I’m glad you found a plan and a team that makes you feel at peace and safe. That is so very important! I’m from a very conservative area of the country… and all of the hospitals here have a birthing bath INSIDE every labor/delivery room, I can’t imagine any hospital not allowing it??? That’s just plain crazy! Overall, I think you have the best of everything there… doula in a hospital with a doctor who’s open to your wishes… freedom and security. I love the idea of birthing in a hospital, because in that documentary you named (the Riki Lake one) I remember watching the lady in labor trying to get into a cab and make a ride to the hospital when things went wrong. LOL. Yeah, that’s not what I think would be ideal. Haha. Anyway, I hope you can get some sleep and check some stuff off your list… but really, I’m excited for your post of “I’m in labor!” or “meet my baby!” !!! Can’t wait!

    Reply

    • To be fair, the scene where they are hailing a cab is because she went into super early labor and had nothing to do with a normal labor needing to transfer. But yes, it is nice to know that if we need an OR we don’t have to think about the logistics of transferring.

      I’m excited too 🙂 I didn’t get nearly as much done today as I wanted/needed, but that seems to be the way every day goes these days…

      Reply

  2. Posted by Babycrazykiwi on December 13, 2012 at 3:51 pm

    It’s interesting to hear about how birth goes for other people around the world. Most people here use midwives as their first option. And many smaller towns have maternity ‘homes’ which are set up for whatever birth you want. Unsure about larger places though. One day when I finally get to do this I will know a whole lot more lol. All the best for the next few weeks.

    Reply

  3. This sounds so perfect!!! I really wanted a home waterbirth, but since my husband wasn’t comfortable with it, I did a midwife assisted hospital birth, and it was PERFECT. I really think that having a good support system around you is more important than where you are – and your doula and the doc she recommended sound great. YAY!!!

    Reply

  4. […] Hiring Our Doula « Bleeding Tulip […]

    Reply

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: