Homebirth is a great option for low-risk healthy women. What does that actually mean?
Determining an appropriate client care provider: Per LM Practice Guidelines. Pregnancy-related conditions that require care by a hospital-based physician or Nurse-Midwife:
1) Chronic Medical Conditions:
Cardiac disease (Class II or greater) Diabetes Mellitus (DM) Type I Diabetes Mellitus Type II not well controlled on diet (consultation required) Hemoglobinopathies (carrier or disease, not trait) Renal disease (chronic, diagnosed; not UTIs) History of pulmonary embolism or deep vein thrombosis Current chronic condition not well controlled: hyperthyroidism, seizures, lupus Active tuberculosis Active syphilis infection Active gonorrhea infection at onset of labor Positive HIV status or AIDS Smoking Any other condition at midwife’s discretion
2) Current Pregnancy (antepartum) Related Conditions:
Ectopic pregnancy or hydatidiform mole/molar pregnancy (suspected or confirmed) Preeclampsia with or without severe features, HELLP syndrome, eclampsia Placenta previa at onset of labor Placental abruption Primary genital/anal herpes simplex infection in the third trimester Active genital/anal herpes simplex outbreak at onset of labor or at ROM Positive Zika infection Gestational diabetes not controlled by diet (on medication, consultation required) Preterm labor or preterm premature rupture of membranes (PPROM) defined as <37 weeks gestation per verified EDD by LMP date, ultrasound assessment, and/or physical exam Fetus in any presentation other than vertex (head down) at onset of labor Signs and symptoms of uterine rupture Multiple gestation Any other condition at midwife’s discretion
(3) Previous Obstetrical History: Previous Rh sensitization Previous cesarean with vertical uterine incision, inverted T uterine incision, or extension of the incision into the contractile portion of the uterus Previous cesarean birth less than 18 months prior to EDD of current pregnancy Two or more cesareans Any other condition at midwife’s discretion
Questions to ask yourself when deciding if a homebirth is the right option for you;
Why do you desire a homebirth?
How do you feel about undisturbed, physiological birth?
What do you believe to be true about birth? (i.e. is it a medical condition that needs to be managed, or is it a natural process that sometimes needs intervention?)
Do you fully trust the birth process? your body's ability to give birth naturally?
Are you committed, and have a strong desire to having a natural, unmedicated birth?
Are you prepared to manage labour without access to medication? (epidural, nitrous oxide/gas & air, IV pain meds etc)
Willing to research and educate yourself on various topics and tests that are available to you and your baby?
Willing to work towards maintaining and improving your health throughout pregnancy, birth and beyond?
Do you feel safe, confident and comfortable when envisioning birthing at home?
Is your partner supportive? How about your other family members?
Feel you can communicate openly and honestly with sharing past medical history and/or risk factors related to your health and current pregnancy?
Do you take responsibility for your health and well-being? Exercise frequently and eat well?
Feel you can ask questions and communicate openly with us should you not understand or need further clarification of any aspect of your care?
How far is the nearest hospital from your house in case of transfer?
Women share their reasons in choosing a Homebirth:
"1. I wanted to be in the comfort of my own home. People go to hospitals when something is wrong. Giving birth is a natural phenomenon. That being said 2. I did not want to be in a position that I felt I needed drugs to give birth. I love the all natural approach to home births with herbs. 3. You stayed by my side the whole time and remained clam. THANK YOU FOR EVERYTHING." T.N 3 homebirths
"I had all three of my babies at home and wouldn’t have it any other way. Here are some of my reasons: - if you’re planning on having a natural birth, there’s really no reason to be anywhere other than home... especially with the epidemic going on now. I feel like you’re more likely to get sick in the hospital. - not having a drive anywhere during labor (that just sounds like hell) - With a home birth YOU are in control. In control of your surroundings, who is there (you can have the support you want), your movements, and what you feel comfortable with. - I never felt pressured to do anything I do not want to do, but always have options and have those options discussed with me (let’s hear it for medical freedom!) - Trust! I have a real relationship with my midwife, during our meetings leading up to the birth I get to know them and they get to know me on an individual level. Not like a 10 min check up with a nurse. Birth is intimate, so you should know and be comfortable with those there intimately. I trust my midwife with my life and my baby’s life. Hope this helps some mamas with choosing how and where to birth their babies" J.H 3 homebirths
"Birthing at home was the best because I was in my own dirt in my own house my own everything. My cat cruising around . My food. My towels. My shower. My toilet. Some of the best parts after the baby's born you do not leave your house because the Midwife comes back to your house to check the baby the next day and for the other check-ups within the first couple of weeks. You never have to take your beautiful fresh perfect baby out." N.G 1 Homebirth
"Well it’s very convenient if you end up having a half-hour-long labor! Never would’ve made it to the hospital!" A.D. 2 homebirths
")Creating my own calming atmosphere was the most important for me 2)No one poking and prodding 3) No change of care! Its the same loving midwife/midwives from start to finish". K.L. 2 Homebirths
"I have so many reasons I birthed at home!! But, here are my top three: 1. I felt so much more comfortable, safe, and confident in of my own familiar space. 2. The experience was empowering and liberating; I felt free to make my own choices and physically strong and capable. 3. The individualized care, attention, and all the extra time I got with my midwife (not only did this help me trust her 100% at the birth but it created a lasting friendship too!). M.M 1 homebirth
"1 homebirth = statistically safer 2 homebirth midwife’s provide a much more comprehensive, personalized form of care throughout pregnancy, birth, and postpartum. 3 the last thing I wanted to do in labor - or after giving birth- was have to drive somewhere! 4 I knew I’d be more free and empowered to do whatever I needed to do give birth if I was at home 5 I was scared of being pressured towards pitocin, drugs, etc. and wanted autonomy. homebirth is wonderful!!" A.K 1 homebirth
"1) Personalized care 2) Didn’t want to leave my older child with anyone, we’re *always* together 3) I wanted a family experience 4) I wanted to sleep in my own bed 5) I wanted the safety of a midwife without out the cascade of dangerous unneeded interventions I would get at the hospital" R.S 1 homebirth
"I choose home birth because: 1. It’s where I feel safe 2. I’m more likely to have a vaginal birth with no interventions 3. My family and friends can support me without any rules or regulations 4. By far Cleaner 5. I am already home after birth and can rest in my bed immediately after 6. I have access to healthy food 7. I know my feelings will be supported and I won’t be scared or shamed into interventions 8. I have the loving support of a midwife whom I have a relationship with not just whoever is on call at the hospital that day." M.S 2 Homebirths
"I chose a homebirth for both of my babies because 1.) home is where i feel most safe and comfortable 2.) i knew there would be less chances of interventions and disturbances to my body’s natural birth responses 3.) i could be in my bed with mg baby immediately after giving birth (no drive to or from the hospital) 4.) i didn’t need to make special arrangements for my dogs. 5.) i don’t consider birth a medical event that would require the use of a hospital." D.P 2 Homebirths