If you’re considering a planned home birth and wondering if this option is the right one for you, you probably have many questions surrounding the safety, practicality, and legalities of home births in your area. If you choose a planned home birth you will give birth vaginally in your home, assisted by a trained, experienced midwife. It is important to seek as much information as you can about the options surrounding home birth in your area. Where would you feel most safe? Who would you prefer to be your support people, and would you prefer a hospital or home setting?
Why have a planned home birth?
If you choose to have a planned home birth, and this option is available to you in your area, it is recommended that you have continuity of care with a midwife, who will provide your antenatal, labour and birth, and postnatal care. It is a well-known fact that the midwifery continuity of care model has improved health outcomes for mother and baby (41). Women can build an open, honest relationship with their midwife, helping women feel safe and supported during their child-bearing journey, and improving their outcomes.
During your labour and birth at home, your midwife will stay with you and support and encourage you, while monitoring the wellbeing of you and your baby. Birthing at home allows you to move freely in the comfort of your home, supported by anyone you desire. Being in a familiar, safe, protected place may allow you to relax more during your labour and birth. Studies comparing home vs hospital birth found that many women felt more empowered during their planned home birth, with satisfaction rates increased for those women who had a planned home birth compared with hospital birth (41).
Is planned home birth safe?
Studies from around the world conclude that for healthy women with uncomplicated pregnancies at full term, home birth is a safe option for mother and baby. In fact, no study has shown that hospital birth is any safer! A large examination of 16,924 women planning a home birth in the US between 2004-2009 found decreased rates of medical interventions such as caesarean section, episiotomy, and vacuum/forceps delivery. The study also found that neonatal outcomes were improved, and babies born at home were less likely to be admitted to a special care nursery for infection and breathing difficulties (41).
Your midwife will also bring with her safety equipment in case of emergency. This includes drugs used for excessive bleeding after birth (postpartum haemorrhage), oxygen, and sterile equipment. Your midwife will also work with your nearest hospital so that in the case of an emergency transportation and referral systems are in place to ensure the safety of you and your baby. Discuss your back up plan with your midwife, where is the closest hospital, what transportation method will you use, and who will go with you to hospital… (Packing a ‘just in case bag’ is a good idea).
When is a planned home birth not recommended?
During your pregnancy, your midwife will discuss your medical and antenatal history to identify any conditions that may compromise a home birth. Some of these may include:
- high blood pressure problems
- abnormal placental position
- there’s more than one baby in there,
- your baby may require paediatric care,
- you labour before 37 weeks, or
- your pregnancy goes past 42 weeks.
Other conditions or situations that will affect your ability to have a planned home birth will be identified and discussed with you by your midwife, and/or doctor. During your labour and birth, there may also be situations where a hospital transfer is required.
Some of these include:
- no labour progress (no, or very slow dilation of your cervix),
- increased persistent blood pressure or temperature,
- your baby is showing signs of distress (abnormal foetal heart rate),
- cord prolapse (where the umbilical cord presents first through your cervix or vagina),
- your baby does a poo, and the amniotic fluid becomes a greenish/yellowish colour,
- you request pain relief not available at home, and
- any abnormal bleeding.
After the birth of your baby, you may also require a hospital transfer if the baby is having breathing difficulties. It is also recommended if you are bleeding excessively, or if all or part of your placenta does not separate after giving birth.
How to prepare
If you have decided on planned home birth, there are lots of things to consider. Be sure you have chosen a trained midwife who practices home birthing and has access rights to a hospital near you. If you are unsure of suitable midwives in your area, please consider contacting an organisation that supports home birth to get further advice. Once you have chosen your midwife, it is a great idea to discuss a birth plan with her and your support people.
Things you could consider are;
- where you would like to labour and give birth in your home?
- will you make a sacred room, or use your whole house?
- what sort of lighting will you have?
- will you have music?
- who will your support people be?
- what coping mechanisms will you use to help you through your labour and birth?
- how do you want to give birth?
Essential oils and diffusers can be pivotal in setting the scene for your home birth. However, some essential oils have medicinal properties that can help your labour along, as well as help you relax. You can find a great range of essential oils at Eco Modern Essentials, and a beautiful range of scented candles and diffusers at dusk. Just click the links to explore their products.
Many women give birth in birthing pools in their home. You can discuss this with your midwife and find out information on where to hire or purchase a birthing pool. You could also consider arranging a waterproof cover to protect your mattress, flooring or furniture. And lastly, it is important to discuss with your midwife your hospital back up plan. It pays to prepare yourself physically and emotionally for a hospital transfer in the event an emergency does arise.
After the birth of your baby
Immediately following the birth your midwife will assess the well-being of you and your baby ensuring there are no complications. You will be able to bond with your baby for as long as you like, supported by your midwife with skin to skin and breastfeeding. Evidence suggests that homebirth increases breastfeeding success rates (42). After a few hours and once you and your baby are settled, your midwife will leave. They will visit you over the next few weeks to provide postnatal care to you and your baby.
Planned home birth is a safe option for you and your baby if;
- your maternity care system supports and facilitates planned home birth, and
- you have a low (or normal) risk pregnancy
The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists support planned home birth. They state that there is no reason why this option should not be offered to all women at low risks of complications (42).
Jacinta Reid (BMid) Registered Midwife
Photo by Pixel-Shot used under license from Shutterstock.com