What is a doula?

A doula provides non-medical labor support—all the good stuff like back rubs and encouraging words and suggestions for different positions to help with labor. She does not replace the father’s role, but “holds the space” for both mother and father as they take their own journeys/come into their new roles as parents. In my birth classes, I explain that I think one of the benefits of a doula is that it frees the dad up to JUST be the dad and to live his own experience/journey and not have the pressure of trying to remember all the birth “tricks” and book information.

But, why have a doula at a homebirth?

A lot of women planning homebirths do not feel as much of a need for a doula as do women in the hospital. The midwife is capable of providing many of the same functions as a doula, but she also has the monitoring tasks and baby tasks to take care of, while a doula is just there for YOU. Other things to consider when thinking about a doula for a homebirth are whether or not the midwife will be bringing an assistant and what her role will be if there is one–sometimes the assistant is available to fulfill some aspects of the doula role, other times she is observing or otherwise in training for other tasks. And, also consider how many people who want present at the birth–if you’re already having a midwife, an assistant, and say a mother or sister or friend there, adding a doula too may mean too much crowding.

A couple of months ago, I solicited feedback about doulas and homebirth for an article I was compiling for the Friends of Missouri Midwives newsletter. The full article is available here: Doulas and Homebirth. I had anticipated receiving a number of responses suggesting that doulas at homebirth are unnecessary, or redundant. After all, an emotional connection and secure trust is often the hallmark of what differentiates the midwifery model from the medical model. However, the responses I received were overwhelmingly in favor of hiring a doula for a homebirth. Personally, I very much valued the specific and customized postpartum care my doula provided to me after my last homebirth and I’ve concluded that a doula has the potential to offer something unique and precious to families, in whatever setting the birth takes place. I also think that the doula is the most likely member of the birth team to remain in contact with the family in the future. Perhaps it is because, even given the friendliness of the midwifery model, there is less of a “power differential” between mother and doula.

Personal experiences

The decision to hire a doula is a personal one, regardless of in which setting you give birth. My first baby was born at a birth center with the presence of a midwife, a doctor, my doula, a friend, my mother, and my husband. In hindsight, I felt like it had been too many people and that the doula hadn’t really been needed. For my second birth, at home, it was extremely important to me to have as few people present as possible. My husband, my mom, and my son greeted the arrival of my second son. My midwife arrived five minutes before his birth—just in time to catch! My midwife for his birth was so amazing, that I didn’t feel the need for any other professional care. I still miss her! My third baby was a second trimester miscarriage and he was born at home unassisted and just my husband present. Later, a friend who is a doula was very, very helpful to me with postpartum care/doula stuff. I really wished I had a doula there during his birth for emotional support and supportive physical care tasks (not medical support, but tea bringing and towel washing).

And, finally, with my last baby, while I liked and respected my midwife I didn’t have the same warm bond with her and really wanted to hire a doula again, precisely because I was missing some of the emotional component I value so highly in midwifery care. It is really the little things that make doula care so special (see included photo!). When planning my last birth, I chose to hire the same doula as with my third birth, with the primary purpose being immediate postpartum help (“washing the bloody towels and bringing me tea” is how I define it).

Talk Birth in Labor…

And, speaking of my doula, I’ve been meaning to share this photo for a long time. When my doula had her own baby last April, amongst the wonderful photos that our mutual friend took at the birth, I was tickled to see this picture of my doula looking at my website while in labor:
I think this could be an advertisement for my blog 😉

You can read Summer’s intense birth story here and also be moved to tears by the stunning birth awesomeness of her video slideshow here: