Hilary Duff says the final days of her fourth pregnancy were 'so awful': 'The most miserable I’ve ever been in my life'

The 36-year-old mother-of-four detailed her intense pregnancy pains in a new interview with Dr. Elliot Berlin.

NEW YORK, NEW YORK - MAY 17: Hilary Duff attends the 2022 ABC Disney Upfront at Basketball City - Pier 36 - South Street on May 17, 2022 in New York City. (Photo by Dia Dipasupil/Getty Images,)
Hilary Duff shared details of her "fast" labour with daughter Townes. (Photo by Dia Dipasupil/Getty Images,)

Hilary Duff's home birth with daughter Townes did not go as planned. The 36-year-old actress spoke to Dr. Elliot Berlin on the "Informed Pregnancy Podcast" about the speedy arrival of her youngest child in a candid conversation about pregnancy and childbirth.

From pregnancy pains to family planning with husband Matthew Koma, no topic was off limits for the "How I Met Your Father" actress. Here's everything we learned from the interview.


Duff is mom to 12-year-old son Luca Cruz Comrie (who she shares with ex-husband, Mike Comrie) and 5-year-old daughter Banks Violet Bair and 3-year-old Mae James Bair with Koma (his legal surname is Bair). Although Duff called her home "busy" with three children, the actress told Berlin that she and Koma knew they wanted to have a fourth child.

"You can't really ask sympathy from people —[that's what] I noticed when you go in for baby number four," Duff said. "When you're like, 'Oh my God, our life is crazy. Oh, this is nuts.' You're like, you knew it was nuts at three, and then you went in for number four. So this is your choice.”

Duff said she was not sure if she was done having children after giving birth to Mae in 2018.

"Luckily it was really easy for us [to get pregnant]. And you know, there's two lines on the stick and you're like, oh, there's two lines on the stick, and you're like 'Oh sh-t," she joked.


Koma opted for a vasectomy three weeks before Duff gave birth to daughter Townes Meadow Bair on May 3. Knowing this is their last baby has made the newborn process bittersweet.

"It's hard when you're in that stage with a new baby and you realize how fast it's going. Like the Townes is already six weeks old and it's so yummy," she said. “She’s holding up her neck, she’s smiling at us…the first few weeks are so hard, and you’re like God, of course I love my baby — but this is brutal, right? Then you get a smile and you’re like,” Oh that’s what we do this for. You know those little moments of like, just — you can’t even put words to it. And we’re like, ‘This is the last one.’”


"The end of my pregnancy was so awful this time around," Duff said, adding that she knew she would "never do this again."

The "Younger" star said she was impatient once she reached 37 weeks, but she experienced 'a lot of pain' during the final weeks of her pregnancy. Duff said she experienced back and rib pain, insomnia and a 'patch of burning skin' on her ribcage.

In addition, the weight of Townes, who at 8lbs 13 oz. was her biggest baby, caused her to experience sharp, sudden pains in her vagina and pelvis known as "lightning crotch." Some pregnant women experience lightning crotch in their third trimester as the baby moves down into the pelvis.

The physical symptoms caused Duff to feel isolated to "hunker down" and finish the pregnancy.

Berlin said he recalls Duff feeling "under water" and "not available" to the outside world.

"I think maybe the most miserable I've ever been in my life," Duff said. "I wouldn't say I was like depressed, but I was just like, I felt super buried.”

Duff said having her fourth child was much different than when she gave birth to her son when she was 24 and "figuring things out by herself." This time, she's more comfortable setting limits on herself with her other children, even though she admits she "still feels guilty all the time" for not being able to meet all of their needs when she's feeding Townes.


"First of all, you're huge," Duff told Berlin. "I was huge, I still feel huge. My body was like, 'Oh yeah, we know what to do. We got this!' From a week and a half to two weeks pregnant, not a single thing in my closet fit.”

Although Duff was told it was unlikely that she would make it full term to 40 weeks, Duff delivered Townes at 40 weeks and 3 days.

Once she reached full term, Duff said she tried everything to try and induce labour, including asking her midwife for membrane sweeps to loosen the amniotic sac from the uterus.

BEVERLY HILLS, CALIFORNIA - MARCH 12: 2023 Hilary Duff, Matthew Koma arrives at the Vanity Fair Oscar Party Hosted By Radhika Jones at Wallis Annenberg Center for the Performing Arts on March 12, 2023 in Beverly Hills, California. (Photo by Steve Granitz/FilmMagic)
Matthew Koma and Hilary Duff welcomed their daughter, Townes Meadow, in May 2024. (Photo by Steve Granitz/FilmMagic)

Duff said she received "aggressive" sweeps that left her in tears, but failed to induce labour. She drank what she called a castor-oil based "witch's brew," also known as a midwives brew to help jump-start labour and completed the Miles Circuit, a 90 minute series of stretches which some believe helps the baby move into the ideal alignment for birth.

Although many people use sex to induce labour, Duff said she "was not interested in sex at all."

"Anytime anyone mentioned sex to me, I was like, you can go get out of here. Absolutely not. You can go sex yourself," she said. The actress added, "I don't like my body like this. And so I'm not gonna do one other thing for one other person that I have to. Even though everyone was like, this will help you.”


Although she gave birth to Luca with pain medication in a hospital, Banks, Mae and Townes were all born at home without pain relief.

Duff was in bed when she experienced "the most monster contraction of all time" to signal the beginning of her "fast and furious" labour. Although Duff had been experiencing false labour pains (Braxton Hicks) in the final weeks of her pregnancy, the actress and her husband knew these powerful contractions were different than before.

Duff's birth team and her friend and personal assistant Lauren, arrived to find her on the floor of her entryway labouring. Duff said her water broke in her hallway, and although she feared she would deliver in her foyer, she powered upstairs to her birthing tub.

"I was not down to have the baby outside of water," she said. Duff added, "I had maybe two, maybe, maybe three contractions in the water, and then her head was like barreling through my body. And then it was one push, her head was out. And then I didn't get a contraction for two and a half minutes.”

Because newborns don't breathe until they are out of the water, Duff had to wait until her next contraction to deliver the rest of her baby. The entire birthing experience, from first contraction to delivery, took less than two hours.


Choosing a baby name is a tough job. The actress said she liked the idea of giving surnames as first names to her children, but Koma disagreed with her first choice, which was Ford.

"Then Townes came about, and it was not really from anything. A lot of people are like, oh, [the singer] Townes Van Zandt," she recalled. "I don't know too much about Townes Van Zandt, but obviously I know his name and I know where he came from and stuff. I guess maybe that's the only place I've heard that name. But just liking the sound of it.”

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