Again, the definition of a doula:
A doula is not a midwife (unless, of course, she’s certified as both), in that she has no authority to make medical decisions, nor is she credentialed to deliver a baby. She’s not considered on the level of a nurse, either; doulas cannot administer or regulate medicine, operate monitoring devices, et cetera. In fact, a reputable doula will tell you that she doesn’t even have the authority to speak on behalf of the mother should a complication or other medical surprise surface.
But sometimes it’s the unnameable, intangible aspects of the conclusion of a pregnancy that require the most help and planning. And that’s where a doula is indispensable. In addition to the priceless knowledge and experience she brings to the laboring phase and to newborn-care assistance, she’s a wellspring of intimate emotional and physical support. A doula educates the family ahead of time; keeps the laboring mama focused and lucid; instinctively retrieves things she needs, like water or compresses; supports her body while walking through contractions; suggests different laboring positions; initiates massage and breathing patterns; reassures other labor partners; works alongside hospital staff; advocates for the mother; and, afterward, ensures that the new mommy is getting enough rest, is recovering well, and is bonding with the baby. - Divine Caroline
That said, a doula is definitely a soothing presence in all birth settings, including HOME BIRTH.
Doulas, like home birth midwives, will make home visits; or, as we call them, prenatal appointments. During these prenatal appointments, we are establishing rapport with you, getting to know your idiosyncrasies, as well as your needs and wants for your birthing time.
A planned home birth will also mean we get to know your living space: where your linens are, towels, washer and dryer, cleaning supplies, birth kit, foods and dishes, and more. We will get to know your other children, if you have already-birthed children, as well as their play/sleep spaces/routines and comfort level with attending the birth.
During labor, we normally will show up before your midwife, unless your midwife has reason to believe that you are moving toward birth quickly. Some of the things that a doula does during a homebirth:
- Doula-y stuff. Yup, we still do the normal things like massage, counterpressure, acupressure, recommendations for position changes, relaxation exercises, body work, aromatherapy, filling the birth pool, changing out your pads, cleaning up any 'oopses', encouraging you in word and actions, and overall caring for you emotionally and physically.
- We Doul-ess. Sometimes homebirths are so chill and zen we 'do' less doulaing, so we might just be there for mom, brush her hair back from her eyes, take notes for her birthing journal, offer sips of water, or make ourselves scarce in other parts of the home to do the things below.
- We make food. Yes, you read that right. We will make food for you and your birth team. This is important - you wouldn't believe how easy (and common) it is for a birth team and laboring woman to forget to eat or drink during labor, resulting in low energy or a slowed labor. Also, if a mom has a honey-do list for us, it's not uncommon that she will put on there 'in down times, please prep a casserole for the fridge for dinner in the next 24 hours. Recipe below'.
- We do household chores. We will clean up around the home, do dishes, throw some dirty laundry into the washer, tidy up the kids play space, clean up the 'mess of birthing'... whatever needs to be done. What's nicer than getting down to the business of birthing, only to get tucked into your bed with your new baby and realize (for you and your partner/spouse) that the house is completely clean?
- We take pictures. If there is a camera or video camera lying around, you bet we will take some birth pictures for you (if you want).
- We like children and pets. If you currently have either (children or pets) we can care for the pets (food, water, bathroom breaks, etc..), or your older children (play with them, help them get ready/off to school, feed them, help them know what is going on with the labor/birth, put them to bed, etc..).
- We keep watch. Sometimes, especially in longer labors, partner/spouses and midwives need to sleep so that they are fresh for the birth. You don't want a sleepy midwife at birth, and you don't want a sleep-deprived partner to miss out on the birth either! Your doula will burn the candle with you.
- We travel. In the event of a transfer to the hospital, we will go with you and offer continuity of care from the home to the hospital. This can offer unimaginable relief to a stressful situation, knowing someone is going to be with you/your partner throughout both home and hospital care.
- We Lady-Wait. After birth, while midwife is doing some initial baby vitals and daddy is loving on the newborn or calling family, we can help mom get in and out of the shower, get into fresh clothes and pads, make her bed up nice and comfy, and get her hair brushed. She feels clean and shiny when she slips under the covers, ready to love on her baby and enjoy the fruits of her labors.
- We assist. In the off chance your midwife needs an extra set of hands in a sticky situation, we can definitely do that. Midwives can be assured that many home birth doulas are well versed in how to assist a midwife with clamps, oxygen, syringes, bulbs, and more.
- We glue the bits together. I love this part of my job. We help the man of the group (usually the father of the child or the partner of the woman), the 'extraneous' member, to glue his place into the birth event. We help make sure he isn't stuck with all the grunt work, the house work, or the gopher work. We ask for his expectations as much as the birthing woman's. And, on that note...
Doulas do it at homebirths!