Doulas at Home Births

A majority of the women I support are giving birth in the hospital.  I've been asked recently to support a few women who are planning to give birth at home under the care of a Licensed Midwife.  As I've considered what my role might look like in the home setting vs. the hospital setting, I posed the question to a few birth focused communities that I'm a part of on Facebook.  I thoroughly enjoyed reading responses that I received and thought that sharing them here might be beneficial to other women who are considering hiring a doula for their home birth team and/ or other doulas who are asked to provide support at a home birth.  Feel free to comment below with any additional thoughts or experiences.  

Thoughts from women who've birthed at home...

M- I did have a doula, yes. Her role was "whatever needed doing." She offered emotional support to the whole family, helped filling and emptying the pool, helped care for the kids, tidied up about us. I found her really good! I would suggest having a close friendship with your doula though, because women who don't bond well with them don't find them as helpful as I did!

S- Yes. I had my partner, a doula and 2 midwives (they come in pairs for safety reasons). It was extremely helpful especially at end with my long labor and pushing phase. My partner got really exhausted so I leaned on my doula for support. She also helped by taking care of all the little things like water/hydration, birth pool water temp, food, etc., so my partner could attend to me 100%. I would definitely have doula support at my next birth as well! Very helpful! 

J- I know a lot of women that DO have doulas, even in home birth. I did not with any of mine. With my first we wanted it to just be us- private & intimate. It was perfect. With baby #2 we had more people there- my mother acted like an "assistant coach" & my husband was again in that main coach role. This worked out nice & we did have my mom back for baby #3. We did decide though to keep it private & intimate again with that birth & we are really glad that we did. I know that doulas are great & important & helpful no matter which setting you are in (hosp, home, birth center). But its ultimately a very personal choice. Don't let the $$ be the deciding factor. If you feel like you'd like that extra support, another womanly touch to the birth etc- GET A DOULA! :)

D- I've given birth at home AND I've been a home birth midwife assistant AND I'm a doula--so here's my two cents: If you have a midwife, she should have an assistant with her, maybe two. If she just has one, then a doula would be helpful. If she has two, you probably won't need another person there in a "doula" capacity.

K- I was lucky and had three midwives present for my son's arrival... The one who helped me catch him had been a doula for many years before training as a midwife, so I really had the best of both worlds! Having more than one of them there was wonderful because they were able to take turns applying counter-pressure with my intense back labor (had it with all four babies... The way I am built, unfortunately.), as well as working as a team helping me into different positions and such.... I can only say: The more: the merrier!  I'm glad all three of them were there!!
I have heard of many women who've had doulas that are also photographing their births.... If you're considering it-- go for it!! I had a friend come take pics and she did an excellent job, but I bet the pics would have been even more amazing if it hadn't been the first natural birth she'd ever witnessed and she'd known more of what to expect... Like a doula absolutely would!!

J- When I was interviewing midwives, I asked about it. One flat out said they didn't provide that type of support and I would need to hire a separate doula. The one I hired said I could if I wanted, but she and all her assistants were former doulas and they would act as both. Sure enough, I got home from work with less than an hour until birth and one was pressing into my back during contractions, instinctively. It was lovely! Now that I am a doula, I will probably ask a colleague to attend my next birth so I can get the full experience.

A- I did. I wasn't originally planning to since I'd already given birth naturally & had a (long but) fairly easy labor & since I'd have 2 midwives & my husband present. So originally, I expected her role to be more photographer than anything else. But my labor turned out to, not only be long again but also ALL back-labor. Her presence was priceless & crucial. I'm SO glad that I had her there!

J- I did and thought it was great. My doula was there for the whole labor (midwives showed up once I was in active labor). She did a little bit of everything - support for me and my husband, calling people, talked me through pain, made sure I stayed hydrated and fed. I recommend a doula to everyone!!!

B- With my first, there was just me, my hubby, my midwife and her assistant. My midwife then was very hands off, and gave me a lot of space so my husband was front and center helping me the. entire. time. He was completely exhausted at the end... of the 12 hour labor. With my second, I didn't have a doula, but my sister-in-law came to the birth to fill that role. I just wanted someone else present that could help out. She ended up being absolutely fantastic!! She helped with the tiny bit of back labor I had, she knew just what to say and when to say it when I needed encouragement, she took pictures and video, and reminded me to drink enough water. I doubt I'll ever choose to go without an additional support person again. For my husband's sake and my own.

W- I did not and I wish that I had. Filling the tub, taking care of our 3 year old and trying to support me was a bit too much for my husband to handle on his own. He could have used more support to better support me. I will have a doula and at least one other attendant for my next home birth.

M- At my HB: midwife, her assistant (training midwife), doula & hubby. Midwife & her assistant were hands off too, doula was great. Basically, hubby stayed by my face encouraging me and talking to me, doula did lots of back/neck massages and she did more with helping & encouraging me to change positions, she also did things like grab the camera and snap some first family photos & she put a freezer meal in oven for me.

I- I did. My labor was so fast that my midwife made it there before my doula because of distance only. But in theory, I would have wanted my doula there before the midwife, to be with me and support me through all the laboring part. I know my midwife would be willing to do this for me, but I felt her job was to make sure that all my physical/medical needs were met and my doula was to make sure all my emotional/comfort needs were met. I would definitely recommend a doula, regardless of where you choose to give birth.

S- No we did not have a doula. I didn't see the point. My husband was my support. But I think next time we might hire a doula so she can take pictures for us because we were unable to take pictures till after our baby was born and we were cleaned up. I wish I had a picture of right when she came out and I was holding her for the first time

H- My midwife was working with an apprentice who was a doula. Also, my two best friends are also doulas so they came as well. I was really blessed to have so much support. There were more then enough hands to take care of me, my other children, my husband and the house too & get photographs/video. I never felt alone, never worried about my other children and my husband felt supported too. Even with a full house was still a very peaceful birth because they were all so respectful of the process.

J- Yes, her role was to be photographer and help with bigger kids. My doulas didn't make it to either of my home births though (nor did my midwife)... next time we'll try again. In fact, I just may keep having babies until my photographer and midwife make it to one.

A- I had two friends serving as doulas and they were invaluable. One documented a lot for us via photos and videos and did a lot of running around the apartment gathering things (supplies for the mw, water refills for me, etc.). The other was a primary physical support when my partner needed a break or, at the end, when he left my head space to catch our daughter.

E- Yes, she blended right in to the fabric of my birth experience in a very positive way. Not usurping anyone's role but offering patient and intuitive support. She was so respectful of the intimacy of our home birth.

M- I didn't have a doula but if I could go back and make any changes to our birth & preparation for birth, it would definitely be to hire a doula.

K- Yes! My doula was so wonderfully supportive, wise, and loving. She helped my husband with counter-pressure and hip squeezes, suggested position changes, and all the usual awesomeness that doulas do... but mostly, she was a solid, positive, reassuring presence. I HBAC'd, so it was also neat that my doula is the ICAN president!

E- I can't recommend a doula enough, especially for a first birth. My labor was very long and unpredictable. When my husband needed to rest, the doula could support me and vice versa. She was the quiet calm we needed in an unpredictable labor and delivery.

K- Yes I did. She was extremely helpful! She helped my husband, helped me with positioning, pressure, massages, drinks, cold and hot rags. She was invaluable!!!

K- I had a friend come and be a doula for me and I'm so glad! She didn't at all take the place of my husband for labor support-- I needed them both! The birth was a little complicated (face presentation!) and I was very grateful to have my wonderful midwife, husband AND doula-friend helping me at the end!

P- Yes I did. I invited a student doula to my home birth because I know how hard it can be starting out to get experience. She was also there to take some of the role of supporting me off my mother and husband. I wanted to have a nice tight team of people with different jobs so no felt overwhelmed (especially me). All I needed to do is sit back and birth my baby and feel every sensation of it. Having my doula and other team members there afforded me that ability. She was also charged with the task of taking pictures and she rocked it at it. She got great pictures

K- Yes, for a precipitous freight-train birth, and she was amazing. We converted to home birth while I was in early labor, and she and my husband cleaned my whole bedroom and turned it into a birth suite while I bounced on a birth ball and ate a sandwich. Then, after my water was broken and I went IMMEDIATELY into transition, she was right there with me, pouring her energy into me to keep me capable of keeping my head above water. I would not have managed that experience half as well without her. While I was pushing, I began to come unglued just a little bit, and she physically turned my head towards my husband so I could join his focus. She was amazing and I'm so grateful.

R- Yes, she was amazing. She was with us for 24 hours and the midwife for the last 12 hours or so. Will definitely have a doula for #2, too!

N- I had 2 midwives and 3 doulas. One doula was my photographer, one was my best friend and guide throughout my journey of birth and being a birth professional and one was a new friend in birth and was about to give birth herself (turned out to be 9 days later) They were all wonderful and I am so very grateful that I had them ♥

Thoughts from doulas who've given support at home births... 
C- Doulas should be at every birth! I feel doulas allow the midwives a break - they don't have to spend as much time at the birthplace, allowing them to sleep and keeping it more intimate for the parents. The more undisturbed you can keep the birth, the better for the hormones to work and baby to slide out! :) I still come when mom needs me and do the same as I would at any other birthplace. I tidy up and assist the midwives as needed and have always worked as a team with them. Home births are so soft and safe for the parents. I look forward to the day when we attend more births here than at the hospital!

A- My goal and passion is to be involved in home births. I'm just patiently waiting for the awesome opportunity!

A- I loved my doulas when I was a home birth midwife! I got to show up while the moms were in transition or pushing, feeling ready to handle anything, having eaten & slept.

R- I have attended just one home birth and it was a fast one. I arrived before the midwives. When I arrived it gave dad the freedom to heat water for the tub. When the mw arrived they were busy setting up shop and paperwork, etc. I was comforting mom and heating up the rice pack, fetching drinks, taking pictures. After the very fast birth it was the same mw were attending to baby and paperwork. They actually commented, "how did you find a photographer who is also a doula? You are so lucky!" And I think they said that because they saw I was the only one designated for verbal/emotional encouragement, completely focused on mom. Grandparents were focused on food prep and childcare, etc. I was wondering if my doula role would be unneeded and I would just assume the photographer role but my doula role was huge. Especially during pregnancy. I am so grateful for the experience and look forward to my own home birth some day!

J- I'm going to be attending my first home birth in early Sept. I can't wait! Like CM said doulas should be at every birth. I expect I will get there before the mw but I'll let you know how it goes..

J- Yeah! More home births! Love being a doula in the home ♥

J- I'm doulaing at a home birth next month. I will do whatever she needs me to. Her 2 year old will be there and he knows me so I may just end up being his watcher for a while, I love doing pictures so I would do that too if needed. This is mama's 2nd home birth so I think she'd do great w/out me, but her needs are different this time w/ little guy there and new town, etc.

B- The difference between home and hospital birth is like night and day... night on earth and day in Euphoria, but *please* remember the masses of women who *need* doulas in the hospital. 99%. I encourage you to take what you learn at home and find a way to recreate the atmosphere for the 99%, begging you to please not abandon hospital birth like so many doulas who get a taste for home birth do.

N- I've only supported a few home births but have felt useful at every one. I have found that it's less common to just hire a doula for a home birth but it's more about picking people that have something specific to offer. I always feel an even deeper appreciation for being able to attend when I'm asked to witness a birth at home.