Home birth can be awesome. When I get the chance to attend a home birth with one of the two CPMs that travel to my area currently, I JUMP for joy. I love working with them and home birth is such a different energy space than going to the hospital. I love being able to be in someone’s space and all of my home birth clients so far have been the most prepared and educated people I have had the honor to work with here. I love home births so much, and the contrast when I move from a home birth client to a hospital client is so stark sometimes.

The list of things I do not have to worry about at a home birth as the doula is pretty amazing actually, not that it means I don’t worry at all. I just worry about different things. At the very top of my doula worry list at a home birth is whether or not the midwife is going to make it. I have definitely put on gloves because I was worried before that they weren’t going to make it. That could certainly happen anywhere, but where I live currently, the closest midwife is a 1.5 hour drive away. Some other things I worry about at a home birth are:

-Is there a second bathroom in case I need to go and my client prefers to labor on the toilet?

-Have they practiced setting up the birth pool & is their water heater big enough?

-Where are the extra towels that they don’t mind getting messy?

-Where are the other kids & who is wrangling them?

-What about the pets?

I see the conversation come up in doula circles all the time about only attending home births, and the Pragmatic Doulas definitely talked about it in one of their podcasts. I do not know any doulas who have been able to attend home births only with their birth doula clients and have a sustainable business. There are a whole lot of reasons for that, but I feel like the biggest factor could be the number of people that are choosing to birth at home is still small right now. While the number of home births have been on the rise in the United States for a long time, finding enough home birth clients can be a challenge to sustaining your doula business. When >95% of people are choosing to give birth in the hospital, you are seriously limiting your business if you plan to attend only home births as a birth doula.

The two big factors I see pushing doulas to want to attend only home births are how awesome and respectful home births can be and how awful hospital birth can be. This is not to attack all hospitals and completely venerate home births, as I have seen the opposite happen in both contexts, but overall as a doula, I have witnessed far more concerning things within hospital settings that have caused me secondary trauma. That secondary trauma and knowing how much better it could be, has lead me down the path of longing to only go to home births too. Here are 3 ways that I have found in my business to help me increase the number of home births I attend, and to help my clients advocate for more respectful and evidence-based care in the hospital setting.

  1. I offer an unpublished discount for home births that the local midwives know exists. I have taken the time to network with the local home birth midwives and let them know privately that I am happy to offer their clients a discount on doula services. I am not telling you to do this for your business, but I am telling you that it works for me in mine. The discount incentivizes their clients to hire me and they know that if I am there, their client will have extra support. I can give them non-medical updates while they are driving too.
  2. I try to schedule in down time when I can because hospital births wear me out for so many reasons. Even the best hospital birth wears me out from having to navigate the system and all the different personalities that we encounter along the way. Part of my self-care routine is to schedule in down time. I fully acknowledge that this is a privileged thing to be able to do, and I am so very lucky to be able to do this as my soul craves rest especially after witnessing trauma, however small.
  3. Require clients to take a childbirth class! I am not trying to double dip by requiring my clients to take MY childbirth education classes, but I have found that when doula clients take good quality childbirth education, they are MUCH better informed about all the things, including how to navigate the hospital system and what all their options are.

No matter what you decide to do about your business, I hope you find some peace with wherever you end up with your clients. Home birth clients sometimes transfer to the hospital for all kinds of reasons. Hospital clients sometimes birth at home on accident. As a childbirth professional, integrating good boundaries and encouraging clients to find a location where they are comfortable is extremely important.

What is your best recovery and coping technique after you witness trauma?

*Further Reading:

Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others by Laura van Dernoot Lipsky

Home Birth in the Hospital: Integrating Natural Childbirth with Modern Medicine by Stacie Marie Kerr

Baby Catcher: Chronicles of a Modern Midwife by Peggy Vincent

Boundaries Updated and Expanded Edition: When to Say Yes, How to Say No To Take Control of Your Life by Henry Cloud

*These are affiliate links & we may earn a small commission if you make a purchase through these links.

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