Top 6 Reasons to Have a Doula at your Home Birth or Birth Center Birth

Should you hire a doula if you are planning a home birth or a birth center birth? People often ask us this. When I first began working as a midwife, I wasn’t sure what I thought. Isn’t is too many people? So much fiddling and maybe too much chit-chat for my stoic, quiet, midwestern clients? Too much fuss?

(The pictures below were sent to us by doulas with their permission and the family’s permission. We would love to include more pictures of all of you lovelies with links to your website! You can email them to please include a link to your website or page)


Doulas have always been at home births

In pretty much every historical or ancient image of birth I could find, from ancient India to medieval Europe, there is a midwife and some other women being helpful.

Well, sometimes I am slow to catch on. The more births I attend as a midwife, the more obvious it is that birth doulas are a wonderful and truly unique member of a birthing team. I love them. My favorite people are doulas! In fact, when a first time mom tells me that she has hired a doula we know and like, I have been known to chart it with one too many exclamation point.  “Client has hired Doula extraordinaire Diane!!!!” So, without further ado:

Top 6 Reasons to Have a Doula at your Home Birth or Birth Center Birth

1) They are there before we are

When I had my first baby long, long ago in 2005, my midwife almost missed it. Because she lived a million miles away in another state, my quick active labor was too much for the laws of space and time. So, I spent most of hard labor in the bathroom alone while my husband dealt with the tub. Not super fun. Then, moments after I got in the tub, just as I was feeling pressure, my midwife called. She was lost (kiddies, this was life before GPS navigation). Since my husband is challenged in this area, it fell to me, in the throes of transition, to give the midwife directions. Seriously.

Lets think. Now how could all of this - being alone, being unsure of when to call the midwife to come, filling the tub, giving directions, calming a nervous partner - been avoided?  Dear reader, you are a quicker study than me: A DOULA!

Doulas usually come to you earlier in labor than the midwife. Monitoring baby and mother is usually not medically necessary early in labor, but you might still want support.  Support can mean many things, and in early labor a doula fits right in. She can: offer suggestions, perspective and privacy. She can help with timing contractions, position changes, and help with distractions and encourage sleep.  She is an early labor angel, stepping in and out when needed. She can help you figure out when to go to the birth center or when to call the midwives to come to you.


A doula can…

help you rest in early labor so you have energy for active labor later. Pictured here, doula Elise Benoit now with MyBirth.

2) They have only one main job: to make you comfortable  

Its true. That is the doula’s main, maybe only, job especially at home or in the birth center. This can take many forms but from your perspective in labor, this is an extremely important job.


Hip Squeezes!

Almost always amazingly helpful doula magic. This is Sarah Hendricks.

It can mean bringing you water, rubbing your back, adjusting pillows, lights and music.  It can be breathing with you or walking with you or walking the dog who is whining and annoying you. It can be helping your partner help you - adjusting their hands on your back or nodding toward the cup of water to remind them to offer you a sip. Other people on your team can do these things too, but they have other jobs as well. Your partner’s job is to love you. Your midwife’s primary job is to keep you and your baby safe. But your doula, she’s got your back, literally.  


Your doula

always has your back (and shoulders, hips, forehead). This is Heidi with Heart of Virginia Doula services.


3) They provide continuous support

As midwives, our primary responsibility is the safety and well-being of the laboring person and their baby. It is super important that we are reasonably well-rested as birth gets close and in the hour or two after birth. So we sleep. We also have to chart, eat and discuss things with other providers, just like at the hospital. We can be there a lot, but we can’t usually be with you throughout the entirety of a long labor.  But YOUR DOULA CAN! (she needs rest too, so sometimes we trade out supporting you, but it is her presence that makes that continuous support possible).


a doula’s presence

makes continuous support possible. This is Emily Bruno with MyBirth.

Doulas can also provide continuity in pregnancy!  You want to change course at the end of your pregnancy? Go for it. A recent client hired us very late in the game so there wasn’t a lot of time for us to all get to know her well or to build intimacy - how delightful, then, when her doula arrived at her birth with that deep, strong, wise connection in her doula bag, ready to go. What a difference she made in this woman’s labor!  A doula can give you the confidence to switch providers, knowing that part of your team will still be with you.

4) Cultural competence

This might be number 1 for some folks and is number one on our List Of Reasons We Don’t Have Staff Doulas. Fact: there are way more doulas in our community than there are out-of-hospital midwives. This means that if you have specific, important cultural needs, you might not have a lot to choose from, midwife-wise. But you probably have tons of amazing doula options.

Thinking back, again, to my first birth… my midwife was an older, conservative, rural woman.  In many ways we didn’t speak the same language and miscommunication was common - she managed to offend me and I am sure we confused her. A doula from my own community could have been a helpful cultural bridge on my birth team. 

For example, if you are a woman of color, you might want the support of another WOC.  In fact, this can be a critical piece of you and your baby’s health and well-being. Richmond is home to so many amazing doulas of color. You can find some of them here and here and here and here.  

Families might have other cultural considerations. Maybe they would like support from someone in a specific faith community or from someone who shares a first language. Expectant families might want a doula who is queer, or trans or who has extra training or experience in issues relating to LGBTQ pregnancy and birth.

We really want all of our clients’ needs to be met - including cultural and spiritual needs. Who can help with that? A DOULA!

5) Helping people are helpful!

Out-of-hospital birth includes a lot of moving parts.  There can be pets, phones, laundry, kids, chickens, photos, videos, mail, cooking, driving - did I mention kids?  Do you need someone to make sure the chickens get cooped up at night? Or someone to help with a nervous older sister or stoke a fire on a cold day?  Ask your doula!

Also? Doulas are helpful for the midwives.  While we never want to take away from the support they provide you, we have been known to ask a doula to grab a towel or turn off a fan.  An extra set of calm, skilled hands is always welcome.

Many doulas take pictures and videos.  They might not be as skilled as some pros (also awesome additions to your team) but they can take over camera duty when your partner needs to focus on you.  


doulas can take photos

during and right after the birth, so you and your partner can focus on baby

6) More postpartum support

I’m going to tell you something else about my first birth back in the mid-aughts.  I ended up with A Bad Baby. And no support.


Young Linsey

exhausted, trying to figure it all out alone

I was blessed with one of those babies that did not sleep or nurse. He screamed. I’m grateful I was young because I somehow found the energy to figure out baby wearing (the ONLY thing my child liked), breastfeeding and most importantly, I was able to find support.

But it all would have been immeasurably easier with more knowledgable, experienced, professional support.  At RCM we check in on you a lot but to be honest, you really can’t have too much postpartum support.  A doula will visit you postpartum at least once and help you process your experience. She will have referrals, tricks and ideas to help you during those first few unbelievable weeks.

Which leads us quite naturally to a post for another day…. The amazing wonderfulness of postpartum doulas, lactation support and night nurses.  

In the meantime, check out some of Richmond’s favorite birth doulas. There are so many doulas in RVA, and there are over 50 represented in the collectives below! At River City Midwifery, we offer clients a discount when they hire a doula. Some doulas may offer you a discount if you are planning an out of hospital birth. Doulas and midwives want to work with you to make sure you have the very best birth team, for you. … happy clicking and HAPPY DOULA WEEK!

Birth In Color

My birth

Village Birth

Richmond Doulas

Birth Tub Odyssey

I considered writing this blog post in the form of an Epic Poem. This story has most of the classic Epic elements: A Hero (in this case Heroines) of Legendary Proportions, Adventures of Super Human Strength and Valor (hours staring at incredibly similar items online, hauling massive tubs up and down stairs), a vast setting (China to Richmond and back!), and multiple sites of action (whats up, Ferguson!).  But, alas, this tale does not involve supernatural forces and I’m not sure this poet can remain objective and omniscient, so this is just going to be a regular blog post.

Have you ever noticed, tooling around online, looking at birth centers, that an awful lot of them have the sort of garden tub your mom might have had in her bathroom in 1994?  


Often built in to corners, sometimes with outdated tiling, occasionally involving steps, birth center tubs seemed to us to be a design problem in otherwise beautiful birthing spaces.  Every so often you see a freestanding tub, usually appearing, in our browsing, to be way too narrow. These birth center built-ins and narrow tubes are nothing at all like the deep, wide, poofy blow-up birth tubs most homebirth midwives are used to.  

Our favorite birth tub, the LA Basseine, is a dream of cozy, sturdy functionality.

Our favorite birth tub, the LA Basseine, is a dream of cozy, sturdy functionality.

When we set out on this Grand Birth Center Adventure, we naively and offensively assumed these tubs were a failure in taste among our midwife sisters.  Perhaps birth center midwives and designers had just not gotten the memo about Beautiful, Round Freestanding Tubs. Perhaps they had forgotten how nice it is during home water births that to be able to reach a client from all sides of the tub. Maybe they’d never watched HGTV?

The truth is that we had heard whispered tales about birth tub woes before. Through the grapevine we heard about a hospital labor-tub program where all of the expensive tubs were returned not once, but TWICE.  We heard from students who spent hours cleaning jetted tubs after messy water births because, their preceptors told them, they literally had no other tub options. We remembered hearing that tubs were delivered with jets when none were asked for and that plumbing was always, always an issue.  Another midwife had mentioned ominously, in passing, “good luck finding a freestanding tub, we tried”.

So we were smug then, when a quick search in google, lead us to Wayfair. On Wayfair, there seemed to be a plethora of tubs that appeared perfect for water birth. They looked fine, were strangely affordable, and about the right height and size. We wondered, “have midwives never been to Wayfair before?”  We felt worldly and wise, and in the middle of about 49 other renovations, a lake of paint, and the business of starting a new health care business, we didn’t look too carefully at the specs (actually we didn’t know there were specs) and clicked “proceed to checkout”.

Screen Shot 2018-10-26 at 8.37.27 AM.png

Our new tub began its journey to us from China.  

An Epic Adventure

some of the perils on the journey

some of the perils on the journey

While we waited, we added plumbing to a bedroom where no plumbing was before.  To be clear, the amazing and patient Matt at New Day Mechanical installed the plumbing.  He worked like a surgeon performing reverse laparoscopic surgery. One small incision in the wall here, another two there, and one to let out the gas over there (there was no actual gas involved). Look inside, thread the plumbing in and voila!  

Our ceiling, to this day

Our ceiling, to this day

The Tub arrived. Adrianna and Marinda muscled and rolled it up the stairs, all by themselves!  I was not there, but I imagine they felt very pleased with themselves (and possibly annoyed with me) as they set it in to place.  But…….it was not right. Bafflingly shallow. We texted each other pictures of ourselves in various labor positions and declared that “it had to work”.

The most common labor position in water tubs

The most common labor position in water tubs

At some point, most people do this too

At some point, most people do this too

Then we went back to painting a second or third coat on some trim. We had it plumbed in, and it looked beautiful. I posted a picture of the tub (in black and white because the walls were still the color of baby amoxicillin) on Instagram and it was a VERY popular post (for us, I don’t really understand IG). Okay, we thought, the tub is good.  It has to work.

A moment in the spotlight, Instagram Fame

A moment in the spotlight, Instagram Fame

Paint trim, rip out flooring, imagine that all future clients will be 4’11”.  

That night, I took a bath in it.

You guys. It was AWFUL, and I wasn’t even remotely in labor.  Hard, slippery, so, so shallow. The combination of shallowness and largeness made it feel like I was just sitting naked on the floor in a vast puddle, which, well, I was.  The hard and narrow sides hit a strange part of my back and leaning over the edge in hands and knees - the most common water labor position - was a comedy of errors and bruising.  

Another time, my toddler had a great bath in it.  He declared it a “Great BIG BIG pool-bath!”. So there you have it. Thumbs-up from the under 3 set.



It was with great sadness that the three of us convened the next morning and admitted to ourselves and each other that it had to go.  We had thirty days to return it.

And thus began The Great Tub Search.  We wanted a tub that was:

  1. Freestanding

  2. Water depth of at least 19 inches

  3. Circular or at least roundish

  4. Interior width of at least 36 inches

  5. Can fit in the building

This seemed like a reasonable list.  We learned more about bathtubs than we ever imagined was possible to know.  We learned that the Standard Depth of a tub in the USA is 14-17 inches. This, of course, is too shallow for anyone who is not a baby.  We learned that a “European depth” is 18 inches and that “Japanese or Greek depth” was 22 or more inches. We studied websites and we learned the listed measurements were often wrong.  So, we downloaded and studied the specs.

Now, we understand that people not concerned about humans emerging from bodies might not have the same sense of urgency over these few inches, but it was frustrating how difficult it was to determine “how deep is the tub”.  

You guys, there are thousands of freestanding tubs on the market. Who knew? They are mostly variations on the theme of “Banana Split Boat”.

Exactly like this

Exactly like this

Or sometimes they are shaped like shoes or horse troughs. We kept searching.  

Screen Shot 2018-10-26 at 1.04.35 PM.png

Japanese soaking tubs, we learned, were deep and round, but far too narrow for baby having. Like big buckets. We learned that those Friends-era built in garden tubs, usually jetted, offered the best depth, but we couldn’t and didn’t want to tile a tub in to the simple little 1930s bedroom that we loved. And NO JETS EWWW.  So we looked, and looked.

Late at night, loopy, I even tossed hilarious hospital birth tubs like this in to the ring.


Some of them are actually pretty cool, but mostly not available in the US (of course) or hospital-budget friendly not low-debt birth center budget friendly.

I mean, this could be cool.

I mean, this could be cool.

And, no post about waterbirth tubs would be complete without this:

I’ve always wanted to be a spaceship pilot!

I’ve always wanted to be a spaceship pilot!

or this

Someone actually made this.

Someone actually made this.

At this point, we considered scratching the whole birth center idea and opening a birth tub manufacturing company instead…

At this point, we considered scratching the whole birth center idea and opening a birth tub manufacturing company instead…

We did find one tub that was kind of perfect.  I present to you: The Aquatica Pamela.

Yes,  Aquatica , this tub is perfect for our next birth suite! Construction starts soon!  hint, hint

Yes, Aquatica, this tub is perfect for our next birth suite! Construction starts soon! hint, hint

She wasn’t the prettiest tub at the prom, but she fit every single criteria. Except one. She wouldn’t fit in the birth center, up the stairs or in the room.  We contemplated removing doors, windows, trim, hiring a crane, and/or changing the entire layout of the birth center. She was also way out of budget. So we got special tub financing.

However, before clicking “buy now”, this time, like a pack of geniuses who learn from their mistakes, we made a template from an old sheet and laid it in the room.  No. No way. Way too big. Would be like a cereal bowl in a dollhouse.

We vowed to get Pamela for our next birth suite, because in all other ways, she is kind of perfect. At least we won’t have to go through this again in a few months.  

Finally, in an act of desperation we did what countless people before 2017 have done.  We went to a store.

These still exist!

These still exist!

Now, I had been to another Ferguson the previous week and found a tub that would more or less work, but it wasn’t perfect.  Let’s call this tub “Barnabus”. Here, my husband and child demonstrate “how to make showroom workers uncomfortable”.


At the time, convinced there was a perfect option, we dismissed Barnabus out of hand.

Back at Ferguson, this time, we scoured not just the internet but the dark web of shopping: industry catalogs.  We learned about the world of Very Expensive Tubs which included copper (the metal) and Solid Surface (the rock) and other rare elements.  We added “must not weigh more than 300 pounds” to our list. Armed with The List and a mountain of catalogs, Marinda and our wonderful sales worker Teresa McClellan, found us a short list of acceptable, or nearly acceptable, candidates.  With names like “Olivia”, “Elise” and “Adriann”, they were fancy versions of the banana split boat. Mostly they were too narrow, too heavy, and had a several week wait time. And were over five thousand dollars.  

Back to the Aquatica Pamela?  We did some more measuring and contemplated our life choices. Maybe we could make it work. MAYBE IF WE GAVE UP AND STARTED FROM SCRATCH.  Did we all cry? I’m not saying.

Enter, stage left. Barnabus. In a sea of almost-right Olivias and Pamelas, we had looked right past the almost-right Barnabus. There he was on my photo roll, comfortably accommodating a giant adult human and a small 10yo. His edges were wide enough to lean over, he was deep enough. He looked alright.

See, looks almost right!

See, looks almost right!

We ordered him.

When he arrived from across town, we visited him at the Fergeson showroom.  He was good. A little underwhelming among all the shiny copper pennies and cold, hard rocks, but we took him home. (I mean, some strong workers brought him to the birth center).  

And here he is!  

He fits in very nicely, we think, even without IG filters

He fits in very nicely, we think, even without IG filters

I have to say, he looks great!  So deep and cozy, lovely, freestanding.  We can get to all sides, he fit in the door.  

Toddler contemplates life as a tub model

Toddler contemplates life as a tub model

Now, we just have to get Matt here to move the drain over three inches….

Stay tuned for reports on Barnabas in action!

(but seriously, we think this will be a wonderful place to labor and have a baby. It is deep and wider than it seems. One end is sloped for comfortable learning back or side-lying, and the other is straight, making hands and knees easier. The bottom is textured and not slippery and the sides are wide and easy to drape over without armpit bruises. We especially love how deep it is, so everyone, even tall people, can give birth in any position that makes sense for them.)

Well Person Care Extravaganza!

Its pap time! 10/08/18

duck bill.jpg

Many of our friends, clients and family members are not getting pap smears regularly.  We are not getting screened regularly.  It is easy to forget, or put it off. When the CDC changed the guidelines for most people to screen every 3 years instead of every year (yay!) it became even easier to put it off until the next visit.

Sometimes people get pap smears at the beginning of pregnancy care, but midwives often want to wait since those early tests have a higher false positive rate and are uncomfortable. Sometimes it’s just nice for those early appointments to be about building a relationship before more invasive procedures. Paps sometimes happen at the end of pregnancy care, but are not included in maternity billing so it is easy to put those off as well.  

Sometimes we avoid pap smears because we have had experiences that make them difficult.

Sometimes those experiences have been with providers.

Sometimes other things have happened in our lives that make pelvic exams hard.  

Some of us have experiences with provider bias.

On the best day, pelvic exams are NOT FUN.

We get it!

Yours truly (Linsey) had a very traumatic experience with a physician 20 years ago. I went nearly 10 years without a pap smear. Prior to this year, my last pap was in midwifery school when we practiced on each other. I am happy to say, however, that my pap a couple months ago with our very own Erin Parish-Gibson was great.

So, we were inspired to start our first annual event - a low key, low-cost, low stress well-person day!  This day only we are offering pap smears *at our cost*. If you can’t afford that, let us know and we will figure it out.  JUST COME ON IN! Of course we offer all of these services every month, but this is a low cost, fun (as fun as we can make it!) event.  We want to make it as easy as possible for you. We will have chocolate, tea, mimosas for adults and snacks and toys for kiddos. All four midwives will be here to help with your kids and chat with you.

Call us at 804-601-6992 or email  Or you know where to find us on social media.  

Here are more details:

  • Pap smear/HPV at cost $30.00 NO STIRRUPS

  • Birth Control consult $15.00

  • IUD removal - free

  • IUD consults and insertions (let us know in advance, this is priced out per device and can go through insurance)

  • Herbal Consults $20.00

  • STI testing at cost (inquire about specifics)


Door Prizes!  Tea and Coffee! Mimosas!  Chocolate! Music! Kid friendly! No Stirrups!

Birth Center Week 2 Update

Week 2

Baby Ephraim helping!

Baby Ephraim helping!

I want to start this week 2 update by sharing that we have been humbled by and are so appreciative of the outpouring of support from the community. Your words of encouragement and support mean so much to us. Starting a new business is perhaps a little bit like having a baby, and small words of encouragement help get us through that last coat of paint, the last coding error on the website or hiccup with legal paperwork. Thank you! We want this birth center to be centered in community and connection, and look forward to giving back and serving the community for years to come.

So, we are 12 days in to the lease on our new space, and things are moving right along. We open for clinic in 10 days! So far, Marinda, Adrianna and I plus family and community members have been here every day working very hard. We have been painting. Did you all know that Adrianna used to work on a painting crew? She is an amazing painter! What do you think of these colors? Imagine art on the walls and colorful but simple mid century furniture.

New paint colors, obligatory accent wall 

New paint colors, obligatory accent wall 

We have pulled up three rooms of carpet, carpet padding and approximately 30575038 staples. Currently we are getting bids for floor refinishing. We hoped a buff and coat would do the job but it looks like a full sanding is necessary.

Marinda pulling staples

Marinda pulling staples

And then we need furniture. We are hoping to eventually transition to fully mid-century antiques, but the market is so high for them right now. If you happen to have any mid century beauties laying around that you'd like to sell to us, please let me know! We are in the market for shelves, a credenza (or nice low dresser), a couple couches and 4 chairs. For pieces we can't afford used (haha!) we are waiting for a sweet baby girl to come earthside, and then plan to drive to DC for some IKEA furniture.

Business updates: we have several clients in care already, and have tours planned for early September. I built the website in record speed, but our SEO is terrible. We know that takes time. If you have a website, you know link-backs are so helpful. We would definitely appreciate and reciprocate links.

We have a few very exciting projects and community partnerships in the works. We can't wait to tell you about them! Stay tuned!

Do you have any questions for us? Email us or post in the comments <3


Random vintage find in our building

Random vintage find in our building