A doula for your homebirth
Gabe offers counter pressure to her client while the rest of the birth team refuels & recharges with a meal and rest.
Raleigh Birth Photography
You’ve done the research and the deep dive into what is the best location for your birth. A homebirth feels like the perfect fit for you and your family. Home is the place where you are most comfortable bringing your baby earthside. You don’t have any medical conditions that make it necessary to deliver in a hospital and your pregnancy has been healthy. You found an amazing midwife with the experience you hoped for and your values align. You’ve hired her and you are thrilled! Now what about a doula? Do you even need a doula if you are planning a home birth? Won’t your midwife fill that role?
It’s pretty common for folks to confuse the roles of midwives and doulas. Many people think having a midwife at their birth will be the only support they need. However, the roles are quite different and it is well worth taking the time to explore what type of support you will want for your birth experience. I believe a well-rounded homebirth team will be comprised of a midwife and her assistant, and a doula that you hire independently.
Your midwife will be your healthcare provider and will provide prenatal care, attend the birth, and offer postpartum followup for you and the baby. A midwife may have different levels of training, skill, and experience. She will most likely work with an assistant who helps monitor vitals for you and the baby at the birth. Both the midwife and assistant are there to assess the overall birth experience and offer assistance if needed, if anything seems to fall outside the range of normal. Most likely your midwife will be an observer who is more focused on the overall health of you and the baby. If anything comes up that needs medical assessment or attention, your midwife can help guide and/or step in.
Gabe offers grounding touch while midwife Nancy Harman, CNM checks on baby’s heartrate with the doppler.
HannaHill Photography
A doula is a trained birth companion who is not a healthcare professional and who supports families through the birth process with information, education, physical comfort measures and emotional support. The doula's sole purpose is to attend to the birthing person during the birth process. A doula will be by your side, making suggestions when needed, modeling comfort measures, reminding you of your power (affirmations and encouragement), offering touch and massage, and even laughing with you! A doula is with the birthing person and partner throughout the process of childbirth, tending to their needs and guiding them through unfamiliar terrain.
Most likely you will be spending time with your doula during your pregnancy to get better acquainted so they may understand your preferences and how to best support you during the birth. In addition to the birth itself, many birth doulas will also offer to come to your home after the birth to help process and integrate the experience and to check on your overall wellbeing. Often, your doula will make recommendations and provide you with any appropriate referrals you may need.
If you think of your birth space and team as concentric circles, your midwife would be at the outer rim observing the story as it unfolds, taking in the big picture. The birth assistant would be the next ring inside the larger circle, moving in and out, entering and exiting the personal space of the birthing person, collecting information about mom and baby. The doula would be found at the next Circle In, surrounding and “holding” the parents, tending to that most precious space and the needs of the family: guiding, comforting, reminding, informing. The birthing person is always at the center.
Each member of the birth team has their unique roles. Sankofa Birth & Women’s Care midwives Tina Braimah, CNM and her assistant Amber Rodriquez, CPM wait until they are needed, while Gabe and dad support mom as she gets closer to delivery.
Raleigh Birth Photography
A doula may very well be a valuable addition to your birth team if you answer yes to any of the following:
Is this your first time giving birth?
Is this your first homebirth?
Is this your first unmedicated birth?
Have you used a doula before and you can’t imagine going through the process without them?
Are you someone who values the presence and guidance of other women?
Are you someone who values encouragement and empathy during difficult and stressful life transitions?
Are you someone who values being educated and empowered to make choices that are right for your family?
Do you want someone to offer suggestions, insight, and comfort measures?
Do you want someone who if familiar with childbirth to remind you of where you are in the process and offer reassurance that all is well?
Do you want someone to help your partner be more involved in the process, modeling ways to support you and offering opportunities to be useful in meaningful ways?
Is it important to you to have someone who will transfer to the hospital with you if necessary? This is particularly useful if the doula is familiar with the hospital policies where you would transfer.
A doula may not be a good addition to your team if you feel strongly about the following:
You have had previous homebirths/natural births and prefer to labor alone.
You feel strongly about your ability to birth on your own terms with as few people around as possible.
You have a close friend, sister, or mother whom you trust implicitly and would feel more comfortable with them during such an intimate time.
You and your partner have been through the birth process before and your partner understands your needs, and how to best support you.
The Takeaway
After exploring and educating yourself about the benefits of adding a doula to your birth team, be sure you understand your doula’s level of experience and comfort in a homebirth setting. In addition, a doula will have their own beliefs about birth and various birth settings, so it will be important to hire a birth companion who aligns with your goals and beliefs about birth. If you have never had a homebirth before, it will be equally important to take a Childbirth Education class that has a focus on delivering at home and what to expect from a physiological, natural birth. These classes are sometimes offered by your midwife or doula.
Gabe Lazarus, CD, CPD, HCHD
Holistic Birth & Postpartum Doula
Attending homebirths since 1999
Homebirth mom 2008
Professional doula since 2014
Founder NC Homebirth Community 2016
Bengkung Belly Binding
Holistic Childbirth Education