International Doula Institute certified doulas are prepared to support birthers in every type of birth. As a professional doula, it is important to know your role in different circumstances. What does a doula do during a home birth?
While home births were the norm for much of human history, they fell out of favor in the 20th century. However, now they are growing in popularity. Many wonder if they have a midwife, do they also need a doula?
In short, a doula is a wonderful asset during a home birth. You can read on to learn exactly why.
What is a Home Birth?
A home birth is one where a person gives birth in their own home. For most people, this means giving birth with a qualified professional, typically a midwife.
In some cases, when people say home birth, they mean giving birth at home unassisted or “free birthing” with no qualified professional in attendance. For this article, we are using home birth to mean a birth at home with a qualified professional.
At the International Doula Institute, we encourage our certified doulas to only attend births with qualified professionals in attendance. This ensures a doula is not acting outside their scope and performing clinical tasks in the event of an emergency. This protects doulas from liability as well as protects safety outcomes for clients.
While there are a few physicians who might attend home births, the majority are attended by midwives. The type of midwives available to attend home births will vary based on your location.
In the US, most home births are attended by”
- Certified Professional Midwives (CPM)
- Certified Nurse Midwives or Certified Midwives (CNM and CN)
- Direct Entry Midwives
- Licensed Midwives
There are also lay midwives, which can mean a variety of things depending on the legality of different midwives in different areas. In some places, a CPM might be considered lay as they are not recognized by the state as a provider. In other areas, CPMs are not considered lay.
As an IDI certified doula, it is important clients know that as a doula you are not a midwife or an alternative for a midwife. You do not perform clinical tasks, diagnose, treat, or provide medical care to a birther or newborn.
What Does a Doula Do During a Home Birth?
As with any birth, a doula is meant to provide continuous labor support as well as assistant with the immediate postpartum period. Attending a home birth does not change that goal. However, what that looks like can vary slightly in a home birth setting versus in a hospital.
During a home birth, many birthers will call their doula to begin providing support before their midwife arrives. In the same way a doula provides support while clients labor at home before going to a birthing facility, you can provide support before the midwife attends.
For those planning a home birth, that may include additional practical support. Perhaps the client may want assistance setting up a birth tub or organizing the birth supplies their provider has requested they have on hand.
During a home birth, a doula will also provide support for:
- comfort measures
- emotional support
- positioning support
- coaching partners
- and more.
A doula will also often support a midwife in non-clinical tasks. At times, a midwife might request you grab an item, provide physical support, or assist with preparing for immediate birth.
It can be helpful to ensure both the midwife attending and the clients are aware of your scope of practice. You can discuss their expectations for you as well and ensure everyone is on the same page.
Why is it Helpful to Have a Doula at a Home Birth?
Some home birthers may assume if they are in the comfort of their own home with a midwife that they will not need additional support. While this can be true for some families, many find home births are much better with additional support.
Unlike a hospital birth, there is not the back up of additional nurses, staff, etc., if you need practical support, food, or your midwife needs an extra hand with non-clinical tasks.
Home births also lack the option for pharmacological pain relief. The most common cause for a transfer to the hospital during an out-of-hospital birth is to get pain management. Doulas are experts in providing and guiding through natural comfort measures, positioning, and emotional support.
While midwives are also experts in those areas, their primary role remains the health and safety of the birther and baby. This can mean frequent vital signs as well as needing to chart. This can limit the amount of time a midwife can provide hands on support during labor.
Continuous labor support, like that of a doula, is associated with less pain medication requests, lower risk of c-section birth, and an increased likelihood of reporting a positive birth experience.
Ready to provide support during home births? Be sure you are a certified birth doula. If you have not already started your training, be sure to register today!
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...