January 18, 2017

All About Birth Settings: Giving Birth at Home

By: Cara Terreri, LCCE, CD(DONA) | 0 Comments

home birth pic If you're following our new, short little series, we're sharing the ins and outs of different birth settings. Last week, we shared about hospital birth and today we talk about home birth -- what to expect and what's important to know.

Giving Birth at Home

Like the name implies, a home birth offers certain creature comforts and freedoms that aren't easily duplicated in the hospital. Additionally, and more importantly to some, is the type of care provided, like less routine medical interventions, at a home birth attended by a midwife. When planning a home birth, it's more relevant to learn about how to specially prepare your home for the event (although, nothing too elaborate is necessary) than it is to learn about the specifics of the environment and routines, though we will touch on both below.

What to Know About the Environment for Birth at Home

Not too much to unusual to know here -- it's your own home! And while you likely know your house like the back of your hand, it will be helpful before your birth to consider how you might use its different features and furniture for labor and birth. If you plan to rent a birth tub, where do you want it located for birth? What areas of the house do you think you'll feel most comfortable for labor? Of course, the beauty of home birth is that you don't have to make these decisions in advance -- you can do what feels best in the moment. You may never imagine laboring in the kitchen, but it might be where you end up for half your labor! Be sure to appoint someone on your birth team to help you manage your environment for optimal comfort, like adjusting the temperature in the house, drawing/opening curtains, and manning the door.

What to Know About Who's Present at a Home Birth

In general at a home birth, the only people present are those you personally invite, including your midwife or midwifery team. Other attendees could include your partner, friends and/or family, your other children, your pets, and a doula. Your midwife may work alone or have an assistant present, which should be clarified with you during prenatal visits. Consider carefully who you would like to attend your home birth -- just because visitors are not limited like they are in the hospital, it's important for you to think about how many people you want in close quarters during a very momentous and intimate time.

Home births are mostly attended by Certified Professional Midwives (CPM), independent midwifery practitioners who meet the standards for certification (which include formal training as well as demonstrated clinical skills) and are knowledgeable and skilled in providing the Midwives Model of Care.

What to Know About Routines and Procedures During Home Birth

One of the benefits of home birth is one-on-one, personalized care, which means fewer interventions and non-medically necessary routines. There won't be copious paperwork to fill out when you begin or are in labor. You will not need to be triaged to assess if you are in labor -- much of that can be done over the phone with your midwife, or during her arrival. Cervical checks are optional (though do be sure to ask -- some midwives perform these routinely as well). Monitoring is intermittent and can be done anywhere in your home, with you in virtually any position. Routine IVs are not used, though most all midwives carry IV equipment if needed. Medicinal pain relief is very limited. Midwives are equipped to handle common birth-related complications and know when to transfer to a hospital if needed. It will be important for you to discuss with your midwife what a transfer to hospital would involve, just in case one is needed.

During a home birth, it's common for parents to be more directly involved with the birth of their baby (Dad/Partner to catch? No problem!), and to have longer uninterrupted skin-to-skin time with baby after birth. Nearly all of baby's assessments can and are done while in arms.

Many who are unfamiliar with home birth are often concerned about the mess and clean up after a home birth. Many experienced home birth families will tell you that it was not an issue -- those on your birth team will clean up swiftly after birth and you would never know anything "messy" took place.

For a home birth, different than a hospital birth, you are responsible for providing many of the birthing supplies, like chux pads, postpartum pads, peri bottle, plastic bed protector, gauze pads, cord clamp, etc. Be sure to check with your midwife on the supplies that she recommends, as they may differ and she may recommend purchasing a kit from a supplier she uses.

Ways to Make Your Home Birth Uniquely Your Own

Because your home is so personally yours, a home birth by nature will be very uniquely "yours." Of course, you can implement special touches to make it more personal, like a music playlist, candles, diffusing essential oils, and hanging up motivational images, affirmations, or blessingway birth flags, for example. Who you have in attendance at your birth will also make it more personal and memorable (take extra consideration over who and how many people you choose!).