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  • Writer's pictureHannah Burba, CPM


Only if you want to!

But it is not required.

Many of my clients enjoy having the physical presence of an extra support person at their home birth.

For a first-time labor and birth, Doulas are often helpful as they can show up when a client is in early labor (contractions still spaced out and fairly short) before the midwife and birth assistant arrive in later- during active labor.

Doulas are wonderful (usually) with providing hip-squeezes and counter-pressure, and often provide a nice break for a partner to have an extra set of hands to physically support a laboring person so a partner can take a nap, eat some food, and stay hydrated through a long labor.

I recommend getting clear with a prospective doula as to what their experience is working with home birth clients and home birth providers, as it’s a different scene than a hospital birth and doulas need to bring a different set of skills.

At home, we are offering collaborative care- midwives and birthing families are making decisions about their care together. There is a continuity of care, and the same providers present through the duration of the labor. Instead of needing to, perhaps vehemently, advocate for the desires and “birth plan” of a client and family, a home birth doula is often asked to remain present and responsive to what the client’s needs are (not the desires of the doula). Again, those hip squeezes throughout a long night of labor are clutch. Often doulas show up as an extra pair of hands in filling (or refilling with hotter water) the birth tub and bringing the birthing person fortifications throughout their labor- they are valued and appreciated at a home birth.

Doulas are really helpful when we transfer from a planned home birth to a hospital setting. The most common reason this happens in my practice is when a laboring person elects to get an epidural and *hopefully* some sleep. Doulas will accompany a family to the hospital and advocate for their new “birth plan,” and support them through the hospital protocols that present themselves. Often, by the time we are transferring, a birthing family is exhausted, and the presence and support of an experienced doula is appreciated.

It is the choice of the family who they invite to their birth. It is the role of the midwife to support those choices.

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