HOMEBIRTH: DO I NEED A DOULA?

I’M HAVING A HOMEBIRTH! COULD A DOULA BENEFIT ME?

A common question I get is whether a doula is redundant at a homebirth. While doulas and midwives tend to overlap in their understanding of continuous care and emotional support as elemental components of birth, our roles are still quite different. Below is an FAQ to explore the complementary care of doulas at homebirths. You can also check out my corresponding post Is a Doula Like a Midwife?


REMIND ME, WHAT IS A DOULA? AND IS IT LIKE A MIDWIFE?

A doula is an expert in labor support. Support is a broad term, and a doula’s skillset is equally broad in order to meet the differing needs of each family. These are the general areas in which doulas focus their support. Together they facilitate an easier birth:

  • Emotional and psychological preparation, guidance, and ease.

  • Physical comfort, positioning, and nurturing touch.

  • Supporting you in your confidence, decision-making, learning, and information-gathering.

Doulas and midwives are often similar in that they both value these components as part of a satisfying birth. Doulas, however, focus only and primarily on these things. For midwives, clinical care and safety take the front seat. One of the unpredictabilities of birth is whether the circumstances will allow your midwife to provide all these components of care. Midwives also vary in the degree to which they enjoy and are skilled at this type of care. Having a doula ensures this is part of your experience.

SO, IF I HAVE A HOMEBIRTH, I COULD STILL USE A DOULA?

Yes! And you get even more focused doula support at home. This is because your doula is not also tending to the hospital environment, so there is more bandwidth available for helping you cope and navigate the path of labor. Your doula will also likely arrive before your midwife. Additionally, in many labors, there is a point where it’s wise for your midwife to rest, helping her stay mentally alert to assess safety and medical aspects. Your doula is in a different brain-space--their cognitive brain not activated by providing medical care. A doula stays with you, helping to guide you and your partner from beginning to end. When labor hits its peak of intensity, two needs are present: sustained, present support, and preparations for baby’s arrival. The midwife cannot always do both at once. Your doula stays focused on your emotional experience throughout all labor’s ebbs and flows.

Doulas help you clarify your vision and preferences for birth. As your midwife appointments are packed with information, your doula visits create the space for you to talk about leftover questions and, from there, develop strategies unique to you. By bringing your developed vision to your midwife, she can then help facilitate that vision for you.

AND, ABOUT THAT “THING” I HOPE WON’T HAPPEN...

If you transport to a hospital, a doula will be invaluable continuity. The benefit in this situation is that doulas who also practice in hospitals have experience with interventions used in positive ways, with positive outcomes. Doulas are uniquely poised to facilitate the best transport and hospital experience possible. Though your midwife will also likely accompany you in a transport, their job is to help bridge the gap clinically. Doulas bridge the physical, emotional, and informational gaps for families.

MY PARTNER AND I WANT TO DO THIS TOGETHER. WILL A DOULA MAKE MY PARTNER OBSOLETE?

Doulas and partners make for a support dynamo! Doulas know birth; partners know the laboring person. Combined, doulas and partners provide deeply robust care. And doulas facilitate a closer bond between a laboring person and her partner. A partner can have a pretty big role put on their plate: being the emotional rock, the physical rock, remembering what was learned prenatally, applying all the techniques at the right time, determining what the laboring person is experiencing, knowing if it is all normal...and having their own emotional experience as well. A doula can guide the partner, suggest or model what to do and say, be a reference point and encyclopedia. A doula allows a partner to find ease in whatever their role is. The doula can take care of the details so that the partner can focus solely on the laboring person. The doula can be more hands-on, facilitating the partner being the photographer, or taking a break to eat. It is a collaborative team that best serves everyone involved. Bottom line: Doulas enhance, not replace, the partner. They can also help with older siblings who will be present or nearby during birth.  

AND WE MEET THE DOULA BEFORE BIRTH, RIGHT?

Oh yes! A personal relationship is the cornerstone of doula support. Working together prenatally helps you to have personally-tailored preparation. It builds your toolkit for birthing. A doula who gets to know you prenatally knows the ins and outs of what you want, what strengths you bring, and how to utilize those things in labor. The one-on-one preparation and education gives you gems of knowledge that aren’t able to grow out of a group dynamic. A doula who knows you personally is equipped to sync up with you in labor and birth and help you have the kind of experience you are aiming for. Having a doula on your birth team creates a cohesive and authentic experience--one rooted in the uniqueness of each family.

THEN...WHAT ABOUT AFTER THE BIRTH?

Doulas visit the family again after birth--often twice. They reflect on and process the birth experience with you, having witnessed your amazing powers in birth. Doulas also focus on helping the family adjust and care for each other, recognizing both the joys and challenges of the early parenting experience. A doula fills in the gaps of what you know, helps you understand what to expect and what is normal, and assists you in building connection and confidence. Having a doula that is skilled in breastfeeding support is a huge asset, as the learning curve to that relationship can often come with challenges and questions. A doula is an expert in what she knows and doesn’t know--she assesses and refers for challenges outside her body of expertise.

PRENATALLY, IN LABOR, AND POSTPARTUM, YOUR DOULA TUNES INTO YOUR INDIVIDUAL CIRCUMSTANCE AND SUPPORTS YOU IN FINDING YOUR OWN WAY WITH CONFIDENCE AND JOY. HAVING THIS ATTENTION AND SUPPORT IS A RICH COMPLEMENT TO
YOUR MIDWIFERY CARE.