As a doula, it is important you be familiar with a variety of birth location options in your area. You are likely to get clients inquiring about their options. You might also be able to educate clients about options if they express dissatisfaction with their current plan.
Options can vary geographically, but many have access to hospital births, home births, and freestanding birth centers. The last option can vary significantly but has been growing in popularity. As a birth professional, it is important to familiarize yourself with options in your area.
Hospital Birth
Most US women give birth in a hospital. This was not always the case, but it is the most common birth location in the US and many other countries.
As a doula, it is helpful for you to learn about birth outcomes, statistics, and patient satisfaction with birth, at your area hospitals. You cannot tell a client where they should give birth, neither should you tell them not to give birth at a certain facility. However, you can provide information, non-identifying anecdotal experiences (do not ever share information about clients to other clients), etc.
You can help clients learn about hospitals and which have midwifery practices, only OB practices, c-section rates, etc. Help clients understand the implications of baby friendly facilities, which hospitals have open nurseries, and which do not.
It can be helpful to find out which facilities have NICUs and which level NICU. Some hospitals partner with private practices or other hospitals for well-baby care and NICUs.
Ask a client about their ideal birth experience. Help them sort through which facilities may be more likely to make that possible (while understanding the many variables involved in birth).
Parents choose hospital birth for a variety of reasons including:
- Feeling it is safest
- Risking out of other types of care
- Not being aware of other options
- Familiar with that hospital’s health system
- Recommendations from friends and family
- Good marketing and ads
As a doula, your role is to simply ensure they are aware of their options and how to make an informed decision. From there, you simply support them with evidenced based care before, during, and after their birth.
Birth Location Options – Home Birth
Many families are unaware that home birth is a safe option in many situations. They also may not be aware of the options in their area.
Some people associate home birth with free birthing, or unassisted birth, but that is not the case for the majority of home births.
Free birthing is when one gives birth without a qualified professional in attendance. At the International Doula Institute, we do not encourage our doulas to attend these types of birth. While free birth is an option for families, as a doula, it can be easy to step outside your scope of practice during a free birth.
Most home births are attended by qualified midwives. Research shows that these births are as safe, and in some cases safer, for low-risk women within 15 minutes of a hospital with obstetrical care. This is when a qualified birth attendant is present such as a certified nurse midwife, certified professional midwife, or skilled direct entry midwife.
As a doula, being aware of home birth providers means you can provide clients with understanding of birth options in their area. You should not encourage nor discourage home birth as that is outside your scope of practice. Provide clients with information so they can make an informed decision for themselves alongside the aid of a qualified birth professional.
You can remind clients of their rights, options, and aid in finding reputable resources.
Freestanding Birth Center
A freestanding birth center offers similar benefits and care as a home birth. However, it is in a freestanding building, often close to a hospital. It provides a home like feel for low-risk families seeking midwifery care.
Some choose a freestanding center as they aren’t comfortable with a homebirth, for geographical reasons, or there are not homebirth providers in their area. Others prefer the option of birthing in a facility but are not comfortable with a hospital.
If there is a freestanding birth center in your area, it is helpful to become familiar with it and the providers. You can help your clients learn about all their birthing options including birth centers.
Wherever your clients give birth, the most important thing is that you provide ongoing support. You can help prepare them for birth by ensuring they are aware of options and are making informed decisions.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...