Jess has joined us before on RMS and so we’re thrilled that today she takes up one of our Monday afternoon additional family related posts.
At 35 weeks pregnant it is probably a bit late to be deciding whether or not I want to hire a Doula but it didn’t really occur to me until I looked into both my situation regarding birth and how a Doula can assist. A bit of background story: I gave birth to my daughter almost two and a half years ago. I didn’t go into labour naturally and therefore was induced which ended in basically every intervention you can name, culminating in an emergency c-section when she got stuck.
Fast forward to 20 weeks pregnant this time around and I met the consultant who basically told me that he thinks I’m a great candidate for VBAC (vaginal birth after caesarian) and that the only thing that makes me “high risk” is the potential of scar rupture (this occurs in 1 for every 200 births) but that he believes it should be fine. A few more weeks go by, I’m happy – it’s agreed I’m having a vaginal birth and I won’t be induced again: wonderful. But then I start looking through my maternity notes and looking up some of the acronyms and comments that the consultant has written down. CEFM he has written means that I will have “continual fetal electrical monitoring”.
I remember from my first birth that this means two rather large bands around my waist that connect to a machine telling me the baby’s heart rate throughout labour, I also realise this doesn’t make me very mobile and will probably mean I’m more restricted to the bed (the same as last time). He has also written “cannula on admission” and I’m told this is a precautionary measure in case I end up needing a c-section. I’m also advised (as last time) that I shouldn’t eat or drink during labour in the event that I have to have general anesthetic and another emergency c-section. I started to feel worried about how good my chances of actually having a vaginal birth would be. For someone who had told me that I have a very good chance of VBAC, everyone seemed awfully well prepared for my failure.
And so that is how I found myself head deep in research learning some very interesting things (such as the fact that continual electrical fetal monitoring is more likely to end in a caesarian and has a 60% false positive reading of saying something is wrong when it isn’t.) I also found out that some of what was being advised was more about policy than safety. I began to realise my second birth experience might end up not much better than my first if I didn’t arm myself with the knowledge and support to ensure a better experience.
Where I live in Cornwall there is a well known and highly regarded Doula called Gilly Nevin who runs amazing workshops preparing couples for birth. I got in touch with Gilly and met her for tea and to find out more about hiring her as a Doula. I am fairly new to the idea of a Doula but here is how it works. A Doula is not a medical professional such as a Midwife, she is a strong, supportive woman, helping the mother throughout the labour process. So like a friend, right? Yes but a friend with immense knowledge. After meeting Gilly for only an hour I understood what kind of knowledge I had been lacking. She told me that I could have managed without an epidural. She reminded me that I had made it to 6cm completely alone with no husband present, no midwife and in a strange environment. She told me that the attitude and language used by my midwife could have negatively affected my birth – my midwife had asked what pain relief I had wanted and when I had asked for none she had told me “they all say that, you’ll crack.” I did indeed crack, fearing what she knew that I didn’t and I took the epidural. I didn’t know that being on my back would reduce my pelvis size by 30% not to mention the fact that I would be working against gravity and reducing oxygen to the baby, I didn’t know the potential issues that could be caused by artificial rupture of membranes, I never questioned why I couldn’t eat or found out how Syntocinon would affect my labour and my baby. It’s safe to say I was clueless.
After one hour with Gilly I felt much more informed and also very sad at how things could have been different if I had been equipped with this knowledge the first time around. Gilly couldn’t support us as our Doula because she has a busy schedule and is completing an MA at the time we are expecting. But she did agree to do a private one-to-one workshop with Jake and I and to hold something called a “Birth Art” session.
When I pulled up in her drive ready for my birth art I couldn’t help but think that it was crazy that I was spending £50 on drawing some pictures, I haven’t drawn in years and I was never particularly good at it. Gilly took me to her barn and I sat down on cushions and beanbags. She left me to make some tea and during that time I just sat and listened to the birdsong with the sun on my face. Already I felt more relaxed and less stressed than I had felt throughout my entire pregnancy. Gilly returned with freshly brewed tea and a tin of small chocolate biscuits and then she left me to draw. I was expected to firstly draw a map of my birth followed by individual pictures of my experience using pastels. I sat there, mind blank not knowing what to do. So I ate a biscuit. Then another, then another. And then I picked up the chalk and out it came.
I don’t really remember much after that but at the end of it I looked down at my drawings and realised how much my negative birth experience had affected me. How all of my memories involved machines and strip lighting and a faceless cold midwifery team (I did have one very good midwife but not until I had been there 24 hours). Talking over the pictures with Gilly and opening up to my experience I allowed myself to feel all of the feelings: disappointment, upset, guilt, anger… and a grief for the birth experience I never had. Following this we had the workshops with Gilly which taught us about how the body works during birth, the importance of Oxytocin and different techniques for labour.
However, one thing was clear. That having a consistent voice who believes in you, someone who champions you during labour is key and that this can make all of the difference to a birth experience. I knew I would have Jake (and he is much more clued up this time) but would it help me to have some added support in the form of a Doula? Doulas range in price but the two I know of in Cornwall both charge around the £1,000 mark which is quite an investment. But people invest double that and more without even blinking for just the photographer alone at their wedding, someone to capture the memories. Surely it’s worth £1,000 for someone who could help to shape your memories and make it a more positive experience for you. After all, you never forget the birth of a child. And yet, not only had I not yet convinced my husband on the expense, I also hadn’t found the “right” Doula who was either a fit for us (and confident with VBAC) or someone that was available, as was the case with Gilly.
So my question is… to Doula or not to Doula? Would I benefit from having one? Did you have one? Did it help you? Time is running low for me with only 5 weeks or so until D day. Is a Doula an unnecessary expense or an important investment for a second time (in all honesty terrified) mother?