Pregnancy Home delivery
PREGNANCY HOME DELIVERY
HOME BIRTH: BENEFITS AND TIPS
For centuries giving birth at home was the norm. By the 1900’s increasing numbers of women started having their babies at hospitals. However, as our understanding of anatomy, modern medicine, the mechanics of childbirth, and technology have significantly increased, more women have been willing to consider the option of having a home birth.
This option involves the participation of trained midwives or nurse-midwives in cases of low-risk, healthy pregnancies. As interest in home birth increases, the number of studies will continue to grow to provide us with a greater understanding of the related risks and benefits.
The following information is designed to help women make an informed decision:
COULD HOME BIRTH BE FOR ME?
Home birth may be an option for you if:
- You are having a healthy, low-risk pregnancy
- You want to avoid an episiotomy, cesarean section, epidural and other similar interventions
- You want to share the experience with family and friends
- You want to be free to move around, change positions, take a shower, and eat or drink freely during labor
- You want to enjoy the comforts of your home and familiar surroundings
Home birth is not for you if:
- You are diabetic
- You have chronic high blood pressure, or toxemia (also known as preeclampsia)
- You have experienced preterm labor in the past, or are at risk for preterm labor now
- Your partner does not fully support your decision to give birth at home
Most midwives will bring the following with them the day of delivery:
- Oxygen for the baby if needed
- IV’s for mom if she becomes dehydrated or needs additional nutrients
- Sterile gloves, gauze pads, cotton hat for the baby, drop cloths, waterproof covers for the bed, a thermometer, a pan for sitz baths after birth
- Fetoscopes or ultrasonic stethoscopes
- Medications to slow or stop a hemorrhage
- Special herbal preparations, homeopathic remedies, massage supplies/techniques and perhaps even acupuncture needles
- Items for suturing tears
The following are some of the reasons women are transferred:
- The mother feels exhausted and does not want to continue
- Premature rupture of membranes
- High blood pressure
- No progress with labor
- Fetal distress
- Cord prolapse
For a breakdown of percentages you may refer to the following study:
TIPS WHEN CONSIDERING A HOME BIRTH
- Put together a health care team consisting of a midwife and an obstetrician
- Interview several midwives regarding their birth philosophy. You might be more comfortable with a midwife who shares your view of birth
- Write out a Plan B in case a hospital transfer is necessary
- Hire a doula
- Find out if your midwife works with a backup OB/GYN
- Find a pediatrician who will examine the baby within 24 hours of the birth
HOME BIRTH BENEFITS
Home birth may be significantly easier on your bank account. An average uncomplicated vaginal birth costs about 60% less in a home than in a hospital.
Home birth provides immediate bonding and breastfeeding. Early breastfeeding helps the mother stop bleeding, clears mucus from the baby’s nose and mouth, and transfers disease-fighting antibodies in the milk from mother to baby.
Home birth allows you to be surrounded by those you love. By including children, family, and friends in the birth process, you are provided with many helpers, and everyone involved has the opportunity for intimate and close bonding.
HOW COMMON IS EMERGENCY HOME BIRTH?
It’s uncommon for babies to be born without warning. Only about one baby in 200 babies arrives suddenly, usually at home. However, some babies are born in cars, or in the back of an ambulance, or elsewhere.
These births are described as born before arrival (BBA). Most BBAs are at home and without a midwife present, though sometimes paramedics arrive just in time for the birth.
If you’re expecting your first baby, it’s highly unlikely that he will arrive without warning. Most emergency home births happen to women who have had a baby before.
Among these positives, however, it’s important to note that there are some downsides:
You can’t get pain meds. If there’s any chance you might want an epidural or other anesthetic pain meds, you won’t be able to order those in at home. So it’s important to consider your pain threshold — and whether you think there’s a chance having the option of an epidural might be comforting to you.
You may end up at the hospital anyway. The risk of needing hospital transport is relatively high with home birth: If it’s your first pregnancy, there’s a 25 to 37 percent chance you’ll need to be transferred to the hospital mid-labor. Transports occur for a variety of reasons, including a lack of progress in labor, non-reassuring fetal status (or fetal distress), need for pain relief, hypertension, bleeding and fetal malposition.
There’s an increased risk of neonatal death. Although perinatal mortality rates (that is, babies who die during or shortly after birth) are similar among planned home births and planned hospital births, planned home births are associated with a two- to three-times increased risk of neonatal death (death within the first month of a baby’s life) — though the risks are still low, at two in 1,000. This is because if complications do arise during labor and moms don’t live close to a hospital, they may not make it in time to get their babies the treatment they need.
HOW CAN I GET THROUGH EARLY LABOUR AT HOME?
When you feel the first twinges of labour, you’ll be excited, daunted and keen to get some reassurance that all is well. However, your midwife will encourage you to stay at home for as long as you can. This will be the case whether you’re having your baby at a birth centre or at a hospital. It’s fine for you to stay at home, as long as you’re healthy and your waters haven’t broken.
That doesn’t mean you won’t feel a bit anxious. You may worry about being on your own, or feel unsure about when it’s the best time to leave for hospital or the birth centre. If you’re having a home birth, you may wonder when the time is right to call your midwife and get her to come to you. Read our article on how to know when you’re in labour for guidance.
Remember that birth is rarely like it is on TV. First-time labours are usually slow and even a little boring at times! Early labour can take hours, even days. But there is plenty you can do to help yourself. And don’t forget that a midwife is only a phone call away if you need reassurance.
Staying at home in early labour gives you a better chance of having a shorter and more positive experience of active labour. You’re less likely to need medical interventions in the form of drugs to speed up your labour, or to help you give birth. This makes sense when you realise that it’s much easier to rest and relax in your own home. You’ll be able to save your energy for the hard work that’s to come.
Early labour may feel like backache, aching in your lower tummy, cramps, or low-intensity contractions. Try the following tips to ease you through this stage:
- Try sleeping or resting. You could be in labour for some time, and the more energy you can save, the better. If contractions make it uncomfortable to lie down, try leaning over cushions or on a birth ball with a blanket over you.
- Have a bath or shower. Warm water can help relax you and ease the pain of contractions. Ask your partner to get the bath ready. Try lying on your side on towels or a non-slip bath mat. Ask your partner to cover you with a towel, and then pour warm water over you.
- Have something to eat or drink. Slow-release, carbohydrate-rich foods are best. These include bread, potatoes and pasta. If you’re not feeling hungry try a smoothie, a banana, or anything you fancy!
- Distract yourself. You could go for a gentle walk, potter around the house, play with your other children, or sit on a birth ball watching a DVD. Be careful not to wear yourself out, though.
- Warm those tender spots. Use a hot water bottle or a wheat bag heated in a microwave on your lower back or tummy.
Doing all these things can help early labour to move on to active labour. Listen to your body. Experiment with positions that you find comfortable and do what feels right, whether it’s getting rest or moving around.
Your midwife may also suggest taking paracetamol to ease any discomfort. There’s not a lot of evidence to suggest that paracetamol is effective at reducing early labour pain, but some women may find it helpful.
You can think of labour as running a marathon. You need to prepare yourself in advance, pace yourself early on, and have calories and fluids to keep up your energy. You may want to be on your own and zone out from normal life, or you may need someone to encourage you. It could be a doula or a friend who has had a positive experience of birth. She should also be able to help your partner to help you.
Your birth partner can support you by:
- Just being there to keep you company, hold your hand, talk to you, calm and reassure you.
- Helping you to breathe through your contractions.
- Putting pads for a TENS machine on for you.
- Looking after your other children.
- Making you something to eat.
- Timing your contractions.
- Running a bath for you.
- Giving you a massage.