What happens at a home birth

The question so many people ask when it comes to home birth is how does it all work? As midwives we love homebirths, and maybe that makes us a bit biased, but once you’ve experienced the simplicity of it all, I’m sure you will agree with us! Really the only thing that changes is the venue. Instead of going into a hospital for your birth, the midwives travel to your home for the birth. We believe that this is what makes home birth so successful. All the driving becomes our responsibility and one less thing for you to think about. One of our beliefs is that the first intervention in birth is getting into the car and driving to the hospital. If we can keep you at home then we don’t disrupt the hormone levels and the body is allowed to progress the labour in a safe and secure environment.

In terms of logistics, in early labour, we highly recommend the use of a doula who will come to you at home and help you with the early stages of labour. She is in contact with us at all times. Early stages of labour don’t require medical monitoring as the contractions are still mild and allow enough rest in between for mom and baby. Once labour progresses to active labour then we make our way to your home. On arrival, we will most likely set up all our equipment and the birth pool. We will listen to baby’s heart rate using a Doppler and observe the labour and contractions. If necessary we will do an internal exam to see how far dilated the cervix is. 

“Do we have all the necessary equipment?” We have all equipment necessary to stabilize mom and baby in an emergency while we wait for an ambulance or transfer to hospital. This includes oxygen and suctioning. In terms of medication, we only carry medication for emergencies to stop bleeding. We do not carry any pain medications, as this is seen as an intervention and therefore could require further management not fit for a homebirth.  

Once we have done our initial assessment, we fall into your space and birth. We allow the labour to progress as needed and really sit in your environment and wait for baby to arrive. This does not mean that we sit and stare at you for hours. We make ourselves comfortable and are merely present for advise, encouragement and support. 

When baby is born, all initial assessments are done and completed at home. The placenta is delivered at home. The perineum is examined for the need for stitching. If stitching is required, this is also done at home. Assistance with the first feed is done and all equipment is packed up and that which needs to be tidied up, is also done so. 

“Is it not a messy procedure?” Another question we often get. Before you go into labour, we issue you with a list of things to get. This is not complicated and includes things like linen savers and black bags. We use all of this to protect any linen or flooring. Once the birth is done and equipment is removed, it’s as if nothing happened in the room. The only difference is the addition of a new member in the household.

We then leave you in the comfort of your own bed once everyone is stable. We are then available on our phones for any questions and we do a postnatal visit the next day and then twice more as needed. 

Homebirths are for low risk pregnancies and labours. Therefore if any red flags come up in the pregnancy then we will advise a change to the birth plan if a hospital would be safer. And in the labour, if any red flags come up then we will arrange transfer to the hospital as soon as possible to avoid waiting too long and having an emergency at home. The transfer to the hospital will either be done by ambulance or in your own car depending on the reason for transfer. Currently, 54% of our practice chooses homebirths and we haven’t had any transfers from home. Homebirths are beautiful and sacred and we hope more people look into this option for low risk pregnancies.

Header image supplied by Sam Schröder Photography.