Planning a responsible home birth

When you first mention home birth, many people cringe. Does this matter to you? You must find out because one of the first steps to planning a successful and responsible home birth is discovering beforehand how the “inner you” reacts to others’ negative reactions and objections. You must be committed to this decision and informed regarding your decision; otherwise you will begin to have doubts when faced with opposition. You must do this research and make this commitment in order to merge your physical and emotional selves in preparation for the birth process. In the end, simply remember that you are this baby’s mother and you are the one that will be giving birth and you have the right to choose how and where this birth will take place.

The first step you want to take after you have “somewhat” decided you want to have a home birth is deciding who you want to assist you in the birth process. Do you want a midwife? Do you want a doula? Do you want both? Do you want your partner, your mother, your best friend, or someone else present? Or do you want all of them present? Would you prefer just one or two people? Place yourself in the situation as much as you possibly can; I realize this is difficult for first time mothers. Then envision whom you would truly feel comfortable with in this type of intimate situation. You should have at least a midwife present.

Assuming you choose a midwife to head up your home birth team, be sure that she is a certified midwife with a great deal of experience (meaning births!) behind her. I can tell you from personal experience that a good midwife can make all the difference, particularly in the case of a medical emergency. My midwife saved my life when I hemorrhaged and then my daughter’s life when she stopped breathing – all this within 15 minutes of one another. Don’t go into choosing a midwife blindly, she must be qualified and experienced. Make a list of the midwives in your area, then call them and talk to them at length. Ask questions, check backgrounds or certifications, ask about beliefs, ask opinions, but by all means, talk to them at length during your phone call and/or on your first visit. If you do not feel completely at ease with her on the phone, you should probably to the next one on your list. If you do not feel comfortable after your first visit, call another one. Remember, this woman is going to help you through the hardest work you will ever do in your life. Furthermore, she will do so without the “relief” of medications. You must have confidence in her; you will be trusting her with your life and the life of your child. By the way, for the purposes of this article, I use her to indicate midwife, however, there ARE male midwives, albeit they are rare.

Next, decide what arrangements you want to make if you already have children. You will want to choose whether to have them cared for elsewhere (or in another part of your home) or to have them present. You will need to decide so that you can begin your preparations, particularly if you want them to be present. If your children are very young, they probably shouldn’t be there, but it has been done before, but if you feel comfortable, then you should do it. If so, I would suggest that you spend time over the preceding months explaining what is going to happen in detail. I would also recommend that you have a trusted adult present that will be available to do nothing else but tend to the younger children. Should they get frightened they will then have someone they trust to turn to with their questions and fears without being a distraction to you.

Once you have your birth team chosen, then begins the lengthy and often times tedious chore of making the various preparations and other decisions. Decisions such as do you want an episiotomy? If not, your midwife should be able to instruct you on the use of olive oil to make the perineal area more elastic. If perineal massage is done consistently particularly during the last several weeks it can help tremendously in avoiding an episiotomy. Episiotomies are not a necessary evil!

Other questions will concern the environment you want to give birth in. Do you want to be in your bedroom, your bathtub, a water-birthing tub, or some other location? What personal amenities do you want available – soothing music, candlelight, dim lighting, etc? There will be a variety of items your midwife will either bring herself or tell you about so that you can be prepared. This is your opportunity to make your birthing experience just as you want it – feel free to have or do anything that will make you more comfortable and relaxed. You know better than anyone what will calm you.

No matter how close you are to your pets, you will want them completely out of the way when you give birth, particularly any cats you may own. With the blood that will be present, they will be more of a nuisance, not to mention a health risk then their presence would be worth. Start considering now where you will put them during your big event. Another benefit to having them out of the way is that some pets are so close to their owners that they might find it disturbing to have a stranger (or several) in their territory while their mistress is in obvious pain. It could be quite upsetting for them and if you have extremely territorial animals, someone could get injured, namely your midwife. Far better to keep them out of the way and introduce them to the new arrival in a more calming atmosphere.

Your midwife will also have a “To Do” list as well as a list of items that you will need to have on hand. I can tell you from experience that the list appears rather odd at first, but if you ask questions as I did, you will soon find out that the list actually makes perfect sense. Sometimes they will have you sterilize items by baking them in a paper bag in the oven for a specified length of time at a certain temperature. Your midwife will inform you of exactly what she will be bringing to your home the day or night you go into labor. She will also give you explicit instructions on when to call her and will most likely tell you that if you are in doubt, call anyway.

Your midwife should be on call to you 24 hours per day, particularly in the last trimester. If she’s not, it might be advisable to find another one. Before you are due, your midwife will make at least one visit to your home for obvious reasons; she wants to get somewhat familiar with the environment in the daytime (you might give birth at night) and it will be a practice run on the route and the length of time it takes to get to your home.

During your pregnancy, you should establish a strong relationship with your midwife and after your delivery, she will be a very special person in your life. Choose her well. Help her to help you. Midwives tend to delve into the psychological aspects of child birthing. If there is conflict in your life, they will usually want to know so that they can better assist you in your goal of giving birth naturally. Your resolve to have a natural home birth must be strong and informed; otherwise you will have so much fear and so many doubts that they will hamper your efforts, perhaps even causing distress during delivery. It would be advisable to choose a birth method that you feel comfortable with and one that your midwife is familiar with. She can usually help you in making your choices, whether it be the Bradley method, Lamaze, or another method. Follow up by taking the classes; they are worth their weight in gold, particularly to first time mothers. Remember, knowledge is power; in this case, power over your fears of the unknown.

A special note to first time mothers: I was a first-time mother and because of that fact, almost chose not to give birth at home. There are many seemingly valid reasons not to have your first child at home. However, the bottom line is that if you are healthy, not experiencing what the medical community considers a high-risk pregnancy, the baby is healthy and you are confident in your research, you will do just as well as experienced mothers. The midwife knows the signs to look for that signifies trouble – premature labor, poor positioning of the baby, toxemia, etc. A good midwife will not allow you to endanger yourself or your child – if she has any doubts she will recommend that you give birth in either a hospital or a birthing center with a doctor on call.

Speaking of birthing centers and hospitals. Many hospitals now allow midwives to deliver babies by natural means within their facilities. If you are hesitant on having a home birth yet adamant that you want your baby to be born by natural means, those are a couple of options to consider. Again, DO YOUR RESEARCH! In this case, you can never do too much researching – this is your life and your baby’s life.

There are some things about giving birth that we are simply not able to foresee, however, if you have properly planned for all else, you will be able to manage any last minute “details” without difficulty. A great resource for information on midwives is the Midwife Alliance of North America. They are currently located at www.mana.org, however this information is subject to change and cannot be corroborated by the author beyond the time of the writing of this article. From there you can find a wealth of information. Please keep in mind that some of the states have statutes that make midwifery illegal in their state. In others it is not illegal, yet there are neither statutes nor certification nor licensing requirements. Others have strictly enforced guidelines on licensing or certification. MANA has access to all of this information and more. Again, I cannot say it enough – you must be prepared. Know your facts. Take the classes, read the books, do the exercises, practice your breathing, do the planning, and know that everything else is not in your hands.

It’s important to remember that women have been giving birth without the assistance of the medical community for thousands of years. There is nothing wrong with wanting a natural birth; in fact, for each person that you find that views it with horror you will most likely find one that finds it admirable. The important fact to remember is that this is your birth, your baby, and your choice. Make sure your choice is an informed and responsible one. Good luck!