Thursday, May 20, 2010

What Happens in a Home Birth?

Many times I have people wonder what's so different about a Home Birth. How is it different than giving birth in the hospital? How is it better?

I have listed my 10 reasons for giving birth at home before (added below), but it doesn't walk you through what a Home Birth can really be like, step by step.

First of all, my prenatals usually last, on average, an hour long. I use the time to really get to know the family. Birth is such an intimate time in a family's life. If I am going to be a part of it, I want them to feel like they really know me, and vice-versa. We not only go over the clinical diagnostic that are done at an OB office (Blood pressure, fundal height, baby's heartbeat, check urine), but we also go over nutrition (which is vital in preventing things in pregnancy), as well as the emotional well being of mom. I want to make sure that any concerns or questions are fully addressed in each and every prenatal. As we get closer to 40 weeks, we will go over any specific birth wishes (candle light, waterbirth set up, music, etc) and make sure that all supplies have been gathered and are ready. We speak about when to call me in labor, and what the family wants my roll to be. Am I catching, or is dad or a sibling? I have absolutely no problems with someone else catching. And unlike some Midwives, I do not require a "three handed catch". I trust that dad will catch baby perfectly fine without my help. ;)

There are some Midwives in the area who do not "allow" clients to birth on their own bed, or "allow" clients to birth in the water. I see this as a gross violation of personal choice in birth. I am happy to catch baby (if I am even the one catching!) in whatever place mom chooses for her birth. My desire is to see women take charge of their births, and not ask me for "permission" with what they can do with their body and baby. I am simply there as a lifeguard of sorts - to make sure that labor and birth progress safely.

At the last birth I attended, I was called in the afternoon to be given a "heads up" that mom was in labor. She and her husband were going to try to go on about the day as normal, and call me when things really picked up. I got a call back at about 10pm, with a request to come soon. I gathered my supplies and headed out. When I arrived, the birthing room (in this case, the bathroom) was such a beautiful scene. Mom was laboring in her tub. Lights off, candles lit around the tub and bathroom. Dad was playing his guitar and singing to mom. It was such a sweet setting. Mom was smiling, excited for the day to have arrived. With her permission, I checked on baby's heartrate, and asked how she was doing. (In between contractions, of course.) When I knew everything was good, I retreated downstairs, telling them to call if they needed anything. They had it all under control, and wanted the intimacy of the two of them laboring alone. I only went back up every so often to check on baby, and retreated back downstairs. I don't do any vaginal exams unless I feel there is something going off that needs this tool. And it isn't often that I feel this way. ;)

At about 2am, mom decided to try to get some rest. Contractions were slowing down and she was tired. We all fell asleep for a bit, until I was woken up at about 2:50 with sounds of her starting to push. They called me back upstairs. From the time that mom's body got serious about pushing, to the time baby was born, was a mere 6 minutes. She did BEAUTIFULLY! She caught her breath, gathered up her baby, and snuggled her. I made sure baby's color and tone were good, and then didn't touch baby again for an hour. Because baby was breathing perfectly, crying quietly, and her tone was great ... I didn't need to interfere with touching baby. This was mom and dad's time, and didn't need to be interrupted. An hour after birth, I did the full newborn exam and checked mom for tears. Not ONE! :) I made sure mom and baby were nursing without any problems, cleaned up everything from the birth, and left the new family to snuggle up together and sleep.

It may not sound like I did much. I usually don't. When a mom is healthy and has had a healthy, low risk pregnancy, the best thing to do is as little as possible during labor and birth. Interrupting the process continually can hinder the birth. Vaginal exams are unnecessary the vast majority of time, and should be avoided. Unless mom and dad need the extra support, they should be given as much time as desired to be alone. They created the baby alone, they should be given the opportunity to labor alone. Now, I have had families that have wanted me more involved. I have kept mom company, rubbed many backs, and have even slow-danced in labor with mom. I am happy to fill whatever roll the family wants me in - even if that means doing nothing at all.

This is the difference of Home Birth. There aren't unknown people (nurses) walking in and out of your room without permission. There are not beeping machines or an uncomfortable bed. There aren't any IVs, or limited spaces in which dad is allowed to go. There aren't any restrictions to how/where mom births, or how many/little people in attendance. All newborn exams are done on the bed with mom, not across the room or in a separate area. Baby never leaves mom's site (unless dad is showing baby off to family that may be in another room).

Birth should be a beautiful, intimate time for a family.

Ten Reasons (and there are many, many more than ten!) To Birth At Home:

10. You remain an autonomous woman throughout labor and birth. You're not treated as a sick person, you don't have to put on a hospital gown, and you're not told what to do.

9. Your husband/partner can take breaks as needed, and he's in his own home. He doesn't have to wander the halls to look for a vending machine or a cafeteria. He can even play video games. ( The big plus to my husband )

8. You can eat and drink as you wish. You are not restricted to ice chips, you are actually encouraged to eat healthy, protein-filled snacks and meals.

7. You don't have an IV. In a home birth, you drink as your source of hydration. There is no IV placed in your hand, and you are free from that cumbersome IV pole.

6. There are fewer complications at home. This is from multiple studies done over multiple decades. At home, fewer ( next to zero ) episiotomies are done. In the hospital, some have a nearly 80% episiotomy rate. At home, fewer babies need help breathing at birth ( 17 times LOWER risk at home ). At home, shoulder dystocia is less likely, even for those HUGE babies. ( even though the HUGE babies are not the ones at more risk for this, despite the myths ) At home, fewer moms hemorrhage. At home, fewer moms tear.

5. There is never a risk of mixing up babies. There is only one brand new baby at home ( well, 2 if twins ), and you know he's yours.

4. There is never a risk of mixing up medications. There are no medications, but even if there were there would be no possibility of getting someone else's meds, and dying.

3. There are no drugs. Now, this may seem like a bad thing to some women, but it's a good thing for EVERY baby. A baby born without drugs, is a healthier baby. You don't put baby at risk for drug-related conditions at birth, when there are no drugs to begin with. And without an epidural, you're not at risk for the myriad complications to both mom AND baby that come with one.

2. As many, or as few people can be in the room with you when you birth. From children to grandparents and anyone in between. And, anyone you wish can catch the baby. It makes birth what it should be - a family event.

1. You are giving your baby the greatest gift of all - a non-interventive, drug-free, peaceful, safe birth...and on your terms, not a surgeon's. There are no birth do-overs, so why not give your baby the best birth possible?


The Reluctant Crunchy Mama said...

I have one child and my experience giving birth was horrible. Since then, I have read about many studies and many beautiful home births. But this was different, very helpful, something useful to show the husband! Thank you! If I ever have another one, I am sold!

Sarah DJ said...

My husband and I are expecting our first within the next month (or two!) and planning a home birth...this might as well have been written by our midwife - her non-interventionist philosophy is so refreshing in our society.
Beautiful post, thank you!

Ray-Chill said...

I had two at the hospital before I realized that the hospital is no place to have a baby! I proceeded to have three more at home. I even got to "catch" my daughter myself. It is the most raw mortal experience a woman can have. Beautifuly written, thank you.

A NURSE said...

I am an OB RN. I have worked in L&D in 5 different hospitals in Western Canada and also 5 different hospitals in the USA. I can see why, after working in the USA why moms would want to homebirth. So would I. In Canada...all the points you make...are ok in any of the hospitals I worked in. If you are low risk that means no IVs no continuous EFM, and whatever way a mom wishes to birth...any position or with or without meds. Of course, if you wish a homebirth, that is ok also. Midwives will do either. The government supports this. I am all for as few VE's as far as I am concerned the mom is "the Queen of the room". Most RNs I worked with were mystified with the Birth Plans brought in since most of the wishes on the lists were things we already did. I had to explain to them what happens when you deliver in an american hospital.....and then they understood.

Psalms66 said...

Fabulous... the way I serve mamas too... such a beautiful way to birth! :) Giving the power back to mama and such a peaceful beginning to their family!

Besmah said...

Thank you for a lovely post, I'm so glad to have come across this! I gave birth to all three of my children at home and they were all amazing experiences. Yes, there was pain but you know what they say to feel and appreciate pleasure you must experience some pain. And it wasn't pain that I couldn't handle, I like to think of it as the pain in a marathon or working out or toughing it out through school whoever the challenge is for you. I can say however, there is nothing like experiencing it and the joy of holding your baby in your arms and the freedom of spending time with your baby for as long as you like before the midwife performs the new baby check which is done right in front of me, right beside me actually!