The Basics About Home Births October 19, 2012 12:11

Today, home births are considered unconventional and many people find them scary. Before I had my first child (who was born in a hospital), I felt strongly that they were unsafe and irresponsible. Education and an open mind led me to soon believe otherwise, and with my second pregnancy, we sought care from a professional midwife and began to consider (and ultimately plan for) a home birth.

After having experienced a home birth with natural delivery and a hospital birth with pain medication, I would recommend that every pregnant woman with a low-risk (that’s most women) pregnancy seriously look into the option of a midwife over an OB. When there’s a healthy mom and a healthy baby, midwifery care is a great and very safe way to go. There have been recent studies that have even concluded that in the case of a healthy mom and baby, midwifery care can often be the safer option over obstetrical care.

Just a few points to compare and contrast OB care and hospital birth versus midwife care and home birth, since I’ve now experienced both.

Home Birth/Midwifery Care

·      Midwives by practice give moms much more hands on care and attention; typical midwifery practice is to schedule every prenatal visit for one hour, allowing enough time for the parents to get questions answered and spend time getting to know the person(s) who will be attending the birth

·      When you have a midwife, your options are much greater for the type of labor and birth you want to have; home, birth center and hospital are all available options, and you can choose to deliver your baby in the water, standing up, in a bed, or any other scenario that is comfortable (and deemed safe) for you

·      Medical interventions such as the use of drug-induced labor, IV, epidural, forceps/vacuum extraction, episiotomy, cesarean, etc., are off the table unless absolutely medically necessary, in which case you would be transferred to a hospital and OB care (however, midwifes are licensed to administer IV and select medications if the mother needs it during or after the birth; for example, if pitocin is needed to help the uterus contract after delivery, the midwife can provide that)

·      Your midwife stays with you throughout the labor from the moment she arrives until hours after your baby’s delivery; she’s there monitoring the process and being as involved in supporting the laboring mom as needed and wanted

·      At home, there is no post-partum nurse, so the birth partner (usually dad or a friend/family member) is typically responsible for caring for the mother’s immediate needs for the recovery period; the midwife will visit at regular intervals from the day after birth through the six week post partum milestone to ensure everyone is doing well, but if the mother spends her first few days after delivery on bed rest (which is recommended), someone at home must be around to meet her needs

·      When the baby arrives, he is not taken away from mom at all; his first hour or so is spent cuddled right up at the breast, bonding and being comforted as he adjusts to his new world; the midwife monitors the baby all from the comfort of his mother’s arms and when the time is right, the midwife will do a gentle newborn exam right there on the bed next to his parents

Hospital/OB care

·      If you find a good OB, he/she will provide you with quality medical care and answer your questions and concerns as they arise, and your OB will (hopefully) respect and honor your wishes for the baby’s birth plan

·      OBs are surgeons, and therefore on a demanding on-call schedule when deliveries and cesarean’s take place; this means you may spend long waiting times for your prenatal visits, or get only a brief time speaking with your OB at each appointment; this varies greatly depending on the doctor you choose

·      Another variable is who will deliver your baby; most of the time, your baby is delivered by the doctor on-call at the hospital when you are in labor—this may or may not end up being your chosen OB

·      Hospitals have a bad reputation for pushing medical intervention during labor to speed women through the process; if you choose to have your baby in a hospital, be prepared to stand up for any specific wishes you have, and ask a lot of questions if nurses/doctors begin recommending any form of intervention

·      In my experience having my first child at the hospital, I felt that the care was excellent, and I was very happy with the team of people who assisted us; we did have a few interventions, but I still believe they may have been unavoidable regardless of where we were; given the circumstances and how prolonged the labor was, we were in a sense ‘lucky’ that the OB on call at the time did not push for a cesarean

·      Standard practice in hospitals is to take the baby across the room as soon as he is delivered, to clean him up and examine him; he is handed to the mother after he has been washed and swaddled—if you wish to have your baby put on your chest right away, skin on skin, you will need to make this very evident and constantly remind the staff not to take him immediately away

·      Voicing your wishes is paramount in a hospital; if you do not, the staff will go along with their standard practices, which may or may not be aligned with what you want

·      The postpartum care in hospitals is really helpful for new parents—provided that you have a nurse that you like—they do all of the heavy lifting with the baby, and guide you through the first overwhelming 24-48 hours of your baby’s life

Whatever route you choose, take some time during pregnancy to figure out what you want for your birth experience and anything you really want to avoid during labor and delivery. Everyone is different, but most women do have specific thoughts about what is important to them; but when those wishes aren’t known to the people attending the birth, some women end up feeling disappointed or regretful of the overall experience. Welcoming a child into the world is the most fulfilling and life-changing time in everyone’s life, so starting off on the right foot with a good birth experience only makes the family feel more able to make the big adjustment.

-Ashley