# Doulas pre-hospital... do they "check your cervix"?



## alexsam (May 10, 2005)

OK- I'm totally ignorant on this and where else to go with these questions than MDC, right







?

I am planning on a VBAC with and OB in the hospital (I know, I know... but I really think with this doctor and a good team this will be a good thing). I would like to labor as much as possible at home before hand. I will have a doula. I was wondering... I know doulas are not midwives and don't "deliver" babies, but I was hoping they might be able to give be some basic indications about "when to head over". Do they?


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## April422 (Nov 28, 2007)

Quote:


Originally Posted by *alexsam* 
OK- I'm totally ignorant on this and where else to go with these questions than MDC, right







?

I am planning on a VBAC with and OB in the hospital (I know, I know... but I really think with this doctor and a good team this will be a good thing). I would like to labor as much as possible at home before hand. I will have a doula. I was wondering... I know doulas are not midwives and don't "deliver" babies, but I was hoping they might be able to give be some basic indications about "when to head over". Do they?

As a doula it is outside my scope of practice to do cervical exams.

However years of experience has led me to be fairly accurate at interpreting what stage of labor a woman is at by watching and listening to her.

If the goal is to get there before pushing but well into active labor or close to transition, a good/skilled doula can assist you with that.


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## sapphire_chan (May 2, 2005)

Would a doula even need to check the cervix to determine where a woman was in labor? I thought external signs were more reliable than dilation anyway.

ETA: Oh, April422 already covered that.


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## joandchris18 (Jul 28, 2006)

I second that. We do not do checks, however a montrice can. So If you just really want that look into one, but a good doula knows and there is less risk of infection not doing checks.


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## soso-lynn (Dec 11, 2007)

I agree that cervical check are risky and mostly unnecessary but if you really feel the need to check before heading to the hospital, you can probably manage to do it yourself or get your DP to do it.


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## alexsam (May 10, 2005)

I guess the thing that I am "worried" about was that my very large son was not in a good position and so I had something like 15 hours of labor and only dilated 2cm. Damn. It hurt. But because of an early membrane rupture, we were in the hospital and then with "no progression" because of his lousy position, things start taking a turn for the medical... This time, barring the early rupture or anything like that, I'd like to do all I can at home. I guess I just don't want to be like "Right! I've been in labor for hours and hours! Time to go to the hospital!" and then "Yup! Your in labor! Dilated 3cm! How about pitocin?" ya know?


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## SublimeBirthGirl (Sep 9, 2005)

A doula can help you decide when to go to the hospital, but she'll do it by watching what matters: the big picture. What is your emotional state? How talkative are you? Etc. You can go from 0-10 in no time, or be 9 cm for hours. Dilation isn't a good indicator of how much time you have left, and exams are unnecessary and often detrimental even when done by a midwife, nurse, or doctor.

If you have a doula who also practices as a midwife, or an L&D nurse, she may be able to do an exam but it's not within the normal scope of doula work.


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## Mamato3wild ponnie (Jan 6, 2007)

I also had a 2 week early membrane rupture with my last birth which ended up being pit induced and no epidural. My son was very large and was not moving down. What that was is, the baby was not ready to come yet. And more than likely your first water sac ruptured. So we might of had a smoother labor if we would of stayed at home longer. This go round i am planning a homebirth and my midwife explained that we have 2 water sacs and that she would of told me to keep up with my temperatures and not read to far into the ruputure. So staying at home no matter what for as long as you can will ensure you a better chance at VBAC. A very good doula will also recognize this and support you in this. Just find one who is comfortable with this type of situation.


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## chpiper (Jul 2, 2007)

I totally agree with what others have posted...just wanted to add that some women find it beneficial to hire a midwife to stay at home with, then when they go to the hospital the midwife takes the role of a doula...

Certainly wouldn't work for everyone, just thought I'd toss it in there...


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## wombatclay (Sep 4, 2005)

I also wanted to chime in with my own experience with a hospital vbac...

With dd1 I dilated fast but stopped at 7cm... her wonky positioning and my sPROM meant that 32 hrs later I had a c/s. With my vbac I consulted with my doula (and myself!) and arrived at the hospital feeling pretty good about where I was. I allowed one cervical check and was only at a 2-3cm! However, my dd2 was born via vbac without any labor augmentation/drugs less than 9 hours later (and that includes the 4 hrs of pushing). So I dilated from a 2-3cm to 10cm in about 4-5 hours without a huge increase in the birth sensations (I didn't even notice transition







).

So I guess what I'm saying is that even if you do get to your birth site "early" as long as you have a good support team in place you can avoid a lot of the "medical stuff" and still have a great birth. I know I wanted to show up pushing but in the end everything was fine... so trust yourself and your birth!

happy birthing!


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