Dog Doulas
Jules Ballard 
Dogs as birth companions
I worked as a nurse and midwife in the NHS for 37 years, the last 26 of these as a community midwife in a rural area. I always felt privileged to share such an intimate time with families, especially being part of their birthing experience. During home visits to complete their ‘birth plan’, I would meet many animals; dogs, cats, mice, rats, gerbils, hamsters, birds, rabbits, lizards, iguanas, water dragons, snakes, tarantulas, goats, chickens, pigs, and llamas to name a few. I always preferred to call this their ‘birth preferences’ as it was a rare occurrence that any birth went exactly to plan! Women had 3 choices for their place of birth; home, a low-risk birthing unit or hospital. As a full-time community midwife in the rural South West of England I was on 24 hour call, 2-3 times a week to cover a geographical area of 900 square miles.
The national average for homebirths in the UK remains low at 1-2%, though our community team’s rate was quite high in comparison at 7-9%. We offered homebirth as a realistic option and many women would opt for this as they wished to labour without the constraints of hospital policy. Women should be able to have whoever they wish with them for support, whether this be multiple humans or animals, but this would be impractical in hospital due to space. Some women chose homebirth to increase their autonomy and have a free choice of birthing partners. I would always ask women what prompted their choice for place of birth and for many, their animals played a major part in their decision making.
One reason was they didn’t want to leave them home alone or use boarding facilities when they went into hospital, but for the majority it was because they saw their animals as a source of support and wanted them with them for labour. In some cases, this led to women who were high risk medically choosing homebirths that potentially decreased their safety and that of their babies. As midwives we had a duty of care to attend all births, even if a woman was putting herself at risk, but also to meet with these women to discuss those risks, devise an individualised plan and allow her to make an informed choice. Being a guardian who does consider her dogs to be family members, I could understand their predicament and as one said ‘being forced to make a choice between their family members’. I would always explain that as a midwifery professional it was not my job to force them to do anything, just give them information.
In the UK, 80-90% of guardians consider their dogs to be family members (Bradshaw, 2017). Viewing pets as family members has also been shown to improve wellbeing and have a beneficial effect on physical and psychological health (Wells, 2009). For many guardians, their dogs provide emotional support, companionship, and protection, whilst satisfying human needs for inclusion, affection, and respect. However, society on the whole, does not consider them to be family members, with dogs (except assistance dogs) still being forbidden from going to many places such as shops, museums, theatres, hospitals, beaches and parks, where other family members can freely go.
Recent press coverage of a woman with autism and PTSD having her Maltese assistance dog present during her labour to help with her anxiety implies having dogs in hospital is a recent phenomenon, however it has been happening for at least 15 years. I supported a blind woman, at our hospital to have her assistance dog on labour ward, though this necessitated writing a guideline and protocol. This was followed by a woman who had a hearing assistance dog a few years later. But, where does this leave able-bodied women who wish to have their dogs with them for support and are not protected by the Equality Law Act 2010. For them, home birth is their only option.
Every home birth is lovely, whatever happens, women feel a huge sense of empowerment at having achieved their home birth, with minimal pain relief, being able to adopt whatever position feels right at the time and being able to share the experience with as many people or animals as they choose to.
At one home birth I was teaching a colleague how to suture and I thought she is so close to me I can feel her breath on my neck, I turned around to tell her she didn’t need to be quite so close and I was immediately licked by a black Labrador! who then proceeded to rest her head on my shoulder whilst I continued suturing (I did maintain sterility)! It is often difficult to obtain complete pain relief when using only local anaesthetic, but this woman derived enormous comfort from looking at her dog and using her, as a point of focus. These experiences were special and a world apart from hospital experiences.
In most cases it was cats and dogs that women requested to be with them for support. The other animals were just there in the vicinity, as we were in their home. I always discussed the safety aspects of animals, pregnancy and babies, never leaving them alone together, washing hands and using gloves to clean (particularly cat litter trays), not kissing animals or holding them near to their face and the importance of being aware of their pet’s body language. In the case of cats and dogs, I could provide them with my own leaflets about dog body language and discuss what I observed when meeting their dog.
With other animals it was a case of directing them to relevant websites and providing generic safety advice about hygiene and specific zoonotic diseases.
I have heard numerous stories from women of how their dogs realised they were going into labour before they did, coming closer to them and being reluctant to leave their side. It is theorised that dogs are able to do this by recognising scent changes, as well as subtle changes in human behaviour, though it has not been shown definitively. The fact that dogs can detect cancer, diabetic hypoglycaemia and epileptic seizures, it does not take much imagination to believe they can also sense labour.
When a woman first mentions homebirth and having her dogs present, I always discussed how important choice is for the dogs too. Birth is rarely a silent event and is complete with loud groans, grunts, screams and curses. This could potentially increase their dog’s anxiety or add to their stress. As long as the dog is free to leave, they are exercising choice, however in my experience most dogs chose to stay. Maybe, what appears to be stressful or dramatic for the woman, does not appear so for dogs. Despite labour being tiring and painful, in the majority of cases there is a lot of positive energy as women look forward to welcoming a new family member. Maybe that positive energy resonates with the dogs.
Home births are about creating a natural environment that is calm and relaxing and enables a woman to actively participate in her birthing experience. Reassurance and support are integral to ensure that experience is positive. Being surrounded by the calming presence of their dogs can facilitate this. Contemporaneous documentation remains, but as many women decline to be examined there is no way of knowing what stage they are at in their labour, so labour progress charts that must be rigidly adhered to in hospital, are impossible to complete. A midwife must have patience, stamina and rely on her clinical skills of experience and observation, similar to those skills required to be a dog behaviourist. I retired from midwifery 3 years ago to focus on my work with animals. I had a wonderful career and the skills I learnt I continue to apply to dog behavioural management and animal wellness.