Home birth midwifery is newly legal in the state of Alabama, y'all!* I'm a huge fan of home birth, having birthed my two youngest children with a midwife in a home. Now that accessing home birth midwifery care is becoming easier, thanks to legislation in Alabama changing, I've come across more families seeking to birth in their own homes.
When I began my journey to home birth, I had never even heard of a doula, nor could I imagine why I might need one. I figured any support I'd need would come directly from my midwives, who were wonderful. Now that I've had two home births, both with doula support, I can say truthfully that I would never birth without a doula, whether birthing at home or in the hospital. Midwives are awesome and play a vital role in a positive birth experience, but doulas do as well, just in different ways.
My Own Experience with Home Birth + Doula Support
I couldn't imagine my last birth without my midwives Karen and Wetawnya - but I also couldn't imagine my last birth without my doula, Hannah. I had a lot of anxiety during my pregnancy and a huge amount of fear about giving birth again, only 12 months after the birth of my older son. I spend countless hours talking to Hannah about what had been difficult about my previous birth, what I wanted to be different with this birth, and what kind of support I thought I might need from her.
Hannah spent my early labor with me because she knew I needed the emotional support, as I told her, "I don't want to do this! Can I just go to the hospital and get an epidural?!" She walked me through my fears and through that dark valley into a truly glorious, joyful, spiritual birth experience. Right before I pushed my baby out, I said to her and my midwives and husband, "I feel so safe and loved." I believe that doula care was such a key component to that birth being the birth of my dreams.
What Support Do Doulas Offer in Home Birth?
Basically everything we offer in hospital births! Yes, usually home birth settings are much more relaxed and calming naturally. You have a lot more access to comfort measures - you're in your own home with access to whatever you might need to help cope with the intensity of labor, which is wonderful. You have access to water labor and birth, if you'd like. You've got the support of a midwife who you trust to keep you and your baby safe.
Midwives are incredible and Alabama needs more of them. The focus of a midwife in birth is to ensure the medical safety of the birthing person and the baby. They have a lot of clinical tasks (blood pressure checks, monitoring fetal heart rate, charting, etc.) to keep up with as they monitor the health of mother/baby.
Midwives often do offer some emotional and physical support during labor, but it isn't always continual, as they have to stay fresh so they're able to manage any complications that might come up.
This is how doulas are so beautifully complimentary to midwives - as doulas, we don't have to focus on the health of mother/baby (since we aren't medical professionals) so we're able to be fully attuned to the emotional and physical needs of the birthing person. This covers everything from emotional support to physical comfort measures to partner support - I'm simply here to make you feel safe and supported, whatever that looks like.
Emotional Support
For me, whether at a home birth or a hospital birth, emotional support is vital. Birth is an intense, extremely emotional transformative experience -- and most people going through it are going to freak out at some point. And that is okay and totally normal - but it's worth preparing for, to have a presence whose sole purpose is to connect with you emotionally and offer whatever support you need in that moment.
Connecting with a family emotionally is really important to me and is the reason I meet prenatally several times throughout pregnancy and am also available via phone / text for check ins on how you're doing both physically and emotionally. It's important to me that you feel safe and comfortable with me and that you feel like I'm on your team. This connection comes in super handy during birth, when things have gotten intense and may feel overwhelming - just being reassured that you're okay, that you're doing a great job, can be enough to help you keep going on your journey of labor.
Physical Comfort Measures
This is what doulas do best! Hip squeezes, counterpressure on the lower back, rebozo work, position suggestions, back rubs, all of that. Birth can be intense and any physical support to help you feel more comfortable is vital.
I also focus on the basic physical needs of the birthing person - are you staying hydrated? Are you peeing often enough? Are you resting between contractions when you need to? Are you eating to keep your energy up? These simple things are often not in the forefront of a laboring person's mind, so I keep up with what you need when so you've got the stamina to continue moving forward.
Non-judgmental Support in Decision-making
When you have a care provider - whether a midwife or a doctor or an L&D nurse - they will have opinions about what they believe is best for your care. That's great, you've hired them for their professional opinion! But when it comes down to it, what your care provider suggests may not be something you're comfortable with.
That's where doula support kicks in, creating a safe space for you to make any decisions that may come up about your care both prenatally and during birth. As a doula, it's important to me to help you look at all angles of a decision (pros, cons, risks, benefits, alternative options) and to then support you in whatever you choose. I can help with whatever you need as far as informational support and looking at all the information you may need to make your decisions.
I don't have a stake in whether you opt for a cervical check or decide to forego them altogether. You can stay home or transfer to the hospital for an epidural, it's all good with me! My goal is to help you feel like YOU are the one making decisions in your birth and that you feel empowered in that.
Supporting the Partner
Partners need doula support, too! I love working with partners that want to be active participants in birth and it's important to me that the partner feels positive about the birth as well, because this is a life-changing moment for them too - getting to meet their new baby.
Whether your labor is 4 hours or 24 hours, your partner is going to need a break at some point - to eat, to drink, to pee, to take a nap, just to have a break from hip squeezes. Having a doula in the birth space enables your partner to fully focus on you and be present in the moment, but also takes pressure off the partner to be EVERYTHING for you - because they know the doula has their back, too. I also love getting to help partners prepare prenatally to help their birthing partner feel comfortable and supported. One of my favorite ways to empower partners is by teaching them how to use the rebozo, which is a woven fabric that's part of Mexican heritage. The rebozo can be used to increase comfort both during pregnancy as well as labor. Many partners appreciate having a tangible way to support the birthing person and be more involved in the labor process.
Interested in Doula Support?
I offer free consultations with any families considering doula support. I love chatting with folks who are planning home birth or hospital birth. Whatever your journey to birth, having the support of a doula can be valuable. I also offer discounted rates to families considering home birth in the Huntsville area who would like to have doula support.
*Current midwifery legislation restricts VBAC moms, as well as those pregnant with twins or breech babies, from accessing home birth care. Hopefully this will change in the future and home birth midwifery will be available to ALL mothers seeking respectful, safe in home care.