The nitty gritty of home birth
I was overjoyed when I saw the news that the National Institute for Health and Care Excellence (NICE) are now urging that low-risk pregnant women avoid hospital births, and that 45% of births are actually ‘unsuitable’ for labour wards.
This is hopefully a step in the right direction towards changing the UK’s mindset towards labour and birth in general.
I’m a great advocate of midwife-led birthing centres, but even more so when it comes to home birth.
Before I start let me just get something clear… I’m not a hemp wearing, patchouli smelling hippy; I’m not a nouveau middle class ‘yummy mummy’ who is into her raw foods, homeopathy and reiki; I do not have hairy legs and hairy arms pits and a bush the size of Rotterdam; I am not mad (well.. OK), an idiot or naive.
I am not any of these ‘labels’ that people try to pin on you when you mention home birth – I am just a woman who did her research into birthing and labour, and made a sensible judgement based on my findings. If you were to call me a geek then we are probably getting somewhere!
I completely respect a woman’s right to choose and if home birth 100% isn’t for you then that’s great, but if you are considering it or defiantly wanting to do it, then I hope this post will help you in some way:
WHAT TO EXPECT:
So you’re thinking about a home birth?
Good for you.. You go sister. If you are having a pregnancy with no complications I can assure you that you are making a great choice for your baby and for YOU and you won’t regret it.
I cannot stress enough how what you are considering is just COMMON SENSE. For labour to happen faster and more effectively you need to be away from anything that will trigger adrenaline and in an environment that will help you produce the right hormones – hospitals with bright lights, strange smells, noises and people are a breeding ground for adrenaline.
The production of adrenaline cuts off oxytocin levels and this means a slower, more difficult and more painful birth (thus meaning drugs which slow it down even further, and then you are on the road to unnecessary medical procedures or caesarean). Home birth nurtures all those hormones you need to have a quicker, easier, less painful birth.
At around 30 weeks you will be told if you are suitable for one. You will be assessed and then the midwife will need come round to see if your home is accessible enough – a place with 12 flights of stairs and no lift is probably not going to work.
If you are given the go-ahead, firstly you need to have a think about where you will be labouring. You can do it anywhere – but for me I picked the back room in my house as it was less attached to the neighbours.
I also chose there as it was close to a loo and a shower – I had a pool in the backroom as well, but with my first I found the shower was amazing for pain relief so I wanted that close by.
I actually only ended up being in the back room/pool for about 20 minutes as I did most of my labour in the front room on a chair (one of those Chandler & Joey style TV chairs that flip up!) with my TENS machine on watching comedy shows.
If you are thinking about a home water birth too, then now is the time to start looking at booking a pool (do it as soon as you can as they are very popular – I can recommend the people over at Born At Home who are amazing).
If you are just happy to do it out of water – and this is great too – then maybe start to think about what you will be on for the final leg. Bean bag? Old duvets? Birthing ball? Futon mattress?
You’ll need to be comfortable for that final pushing stage. You also need to think about maybe getting some water proof tarpaulin (this is not essential but saves a lot of faff at the end – everything on top of it can all be bunched up and thrown away together when your birth is over – no mess and no floor cleaning required) and stocking up on a SHED load of old towels.
Now here’s where it starts to get good, and where the benefits of home birth as opposed to hospital birth start to kick-in.
When you meet your community midwives you’ll get to meet the person who is most likely to be there with you for the birth (you would NEVER get this with a hospital birth unless it was private – you are lucky to even get a midwife in most places). This is great and such an important part of the birthing journey.
In the final week the midwife will bring round a birthing box containing all sorts of bits – I won’t write what it contains here, as it differs with each district, but it contains everything she will need for the event. The gas and air comes with them on the day!
When the actual labour happens you will most likely get not one but TWO midwives. As I have already said – during a hospital birth you sometimes don’t even get ONE! This is in case something does go wrong so you have one to look after you and one to look after the baby.
If you are feeling like people are putting you off please remember these facts:
- You have less chance of complications if you choose home birth.
- Less chance of Caesarean section or a forceps/ventouse delivery.
- Your birth will be quicker and less painful.
- In Western countries where home birth is higher, neonatal morbidity rates are lower than the US.
- Birthing at home means a very low risk of contracting MRSA (for you and your baby).
- Home birth means less chance of tears, episiotomy (and the resulting infections).
- You will be given the time YOU need to give birth – not the time the NHS says you have to give birth in (so no consultant knocking on the door asking if you are done yet).
- You won’t spend your labour clock watching and wondering if you are dilated enough and ‘allowed’ to go to hospital yet, (so no trips in pain where you have to be sent back, no anxiety wondering how far along you are – the midwife will tell you in the comfort of your own home).
- No need for childcare if you have a child already.
- You maintain control over everything. Nothing is done to her without your consent.
- You are encouraged to eat, drink, walk, change positions, make noise, shower, bathe, etc.
- You can have whoever and however many people you like with you at your home.
- Your midwife does not go home because their shift has ended or because it was supposed to be their day off or because it is a holiday or because they planned something else.
- Women are supported through the hard work of labour.
- Your midwife tends to be ‘a certain type’ and you wont get some miserable, insenstive cow who to be frank shouldn’t be working in such a profession!
- Bonding is enhanced.
- No visiting hours, cold aircon, toilets down the hall, buttons to push for pain relief/help, screaming babies (except your own!) or other crying/screaming/distressed mothers.
- Pregnancy and birth are viewed as normal, natural body functions and not as an illness or disease.
- After birth you can have a hot shower in YOUR home, get your pyjamas on and hold your baby while someone brings you tea and toast in YOUR bed. You can then sit there like the frickin holy Goddess that you are and revel in your absolutely mind-blowingly, off the scale JOY (in your own home)!
For the sake of a balanced argument here they are:
- If you require more pain relief then gas and air or pethidine then you will have to be transferred. In my experience most women I know who had home birth (me included) didn’t even get to pethidine stage and did it either with no pain relief or very little – your progress is so much quicker and your body is able to produce its own pain relief so you are more likely not to need other drugs.
- You need a thick skin as society will still view you as ‘weird’ or ‘nuts’ for choosing home birth over a hospital – be prepared for lots of opinions on your choice.
- The mess – its not for everyone, but rest assured the team of midwives clear everything up – they bag up all the towels, mess etc. They take things like the placenta away. Mine even cleaned the floor for us! The only thing they wont do is clean the pool if you have a water birth – this is your responsibility.
- The noise – in some situations if you have very thin walls and are worrying about the noise you will make and the neighbours this may make you more anxious. I made less noise in my home birth as it was less painful. FACT!
- I honestly can’t think of any more.
WHAT YOU’LL HEAR:
As I stated above – please be warned if you do choose homebirth you have to be prepared for a lot of people calling you ‘brave’ or ‘silly’ or some downright rude people saying you are irresponsible and endangering your baby’s life (no seriously, be prepared).
I know if you have chosen home birth as an option you are a very level headed and strong minded woman – which is good. Trust me you will have to be in order to not let people put you off but I know you lady *wags finger* and I know you can handle that no problem.
You will hear things like:
“I/my baby would’ve DIED if I’d had a homebirth! Because XYZ went wrong and thank god I was in hospital”
Lets look at this statement…
(a) How do they know they would have died?
(b) Nine out of ten times the complications they suffered were a result of them BEING in hospital in the first place (i.e being in that environment interfered with birth – slowed it down, made it more difficult OR the hospital wanted the bed and so started giving them drugs, medical procedures to hurry them up etc etc)
(c) If they had underlying problems they wouldn’t have been accepted to have a home birth anyway.
You will also hear people saying that NICE has recommended home birth as a cost cutting measure for the NHS – please rest assured NICE is an independent body outside of the NHS and Government and advises them based on hard facts and evidence based studies.
You’ll hear people saying there will be loads of mess. Don’t worry about this – that is the least of your problems and the midwife team clean up after you anyway.
Please see this quote from a midwife on home birth:
“I want to reassure you that as a midwife I often deal with emergencies. Midwives are highly skilled, we can give emergency medicines to stop bleeding, resuscitate mums and babies, deliver babies when their shoulders are stuck. All following exactly the same steps that a doctor would take. Even a ventouse can often be averted using a ‘supported squat’ position
“The only thing we cannot do is a Caesarean section or a hysterectomy. However, even the most urgent of caesareans are ‘aim to deliver within 30 minutes’. In four years I have seen one case where a woman’s baby needed to be born in less than this, and it was a known unwell baby and she had an epidural and syntocinon drip (both are risk factors that reduce oxygen to the baby – hence why women are more closely monitored with them).
“This woman would have given birth in a hospital anyway, so it is important not to automatically think: ‘If this had happened at home, the baby would have died’, because such women would be strongly advised against birthing at home.”
WHAT YOU WILL NEED:
A month before:
- Think about ordering a pool if you wish to have a water birth.
- Get your TENS machine ordered in – I cannot recommend these more highly as a means of pain relief. We got a package with our pool which included a TENS machine.
- Start packing stuff away in the area where you want to give birth (do it now and get it out the way).
- A few weeks/week before (we never know when they are going to show now do we?!):
- Think about who you want to be there with you.
- Choose some funny videos to watch in the early stages of labour (no I really mean this – watching comedy in the early stages makes you produce the right hormones and it will speed you up like no-one’s business.. My labour was five hours! Its also a massive distraction).
- Choose some nice music and get a CD or playlist sorted – whatever you fancy.
- Get some candles in – try to choose some that have a scent that helps in labour.
- Get the pool up and running if it’s one with a pump (use it as a hot tub in the weeks leading up and get your money’s worth)! Or do a trial run if it’s an inflatable.
- If you are not having a water birth – think about getting something comfy to lie on for the pushing stage – a bean bag, birthing ball, old duvet, futon mattress, chair etc.
- Start stockpiling old towels and buy yourself a big piece of tarpaulin – as I already said this is handy at the end as the midwife can just bunch it up and whack it straight into a big bin bag with all the towels etc. inside.
Pack a hospital bag for you and your baby, (you wont need it but just in case – you don’t want to be faffing about with all that in that scenario).
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