Provided by Trina Stacey
Despite the fact that home birth is on the rise, with the number of home births tripling in the United States since the late 1980’s, details of what prenatal care from a midwife and home birth actually looks like are difficult to come by. While births are as different as the children who result from them, there are at least some experiences most home-birth parents have in common.
Before You Call the Midwife
If you're considering having a home birth, research your state and city ordinances early in you pregnancy. Laws about who can birth at home and under what circumstances vary greatly by state. Some states only allow women to attend births in birthing centers that meet a set of established criteria.
Pre-Birth Prep and Prenatal Care
Prenatal care for a home birth looks a lot like the prenatal care you’d get from an OB in preparation for a hospital birth. Women have monthly appointments in the early months, which increase in frequency as their due date gets closer. Appointments can last up to an hour, and often cover everything baby’s health and growth to mom’s overall physical and mental health. According to San Diego midwife Darynée Blount, despite the similarities in prenatal care some women choose to maintain dual care with an obstetrician in case they need to be transferred to a hospital for conditions such as preeclampsia, or inductions or during labor due to complications.
In the last few weeks leading up to birth, midwives meet with the mothers-to-be to create a birth plan and talk about possible circumstances that might occur during the birth. Trina Stacey, whose daughter was born at her home in 2011, said her birth team went over “various birthing options available [such as] water birth if I wanted it which I did, possible interventions that may need to be carried out how they would be managed, transition to hospital if it was needed.”
Labor and Delivery
When contractions are consistently coming every four to five minutes apart and lasting for at least one minute, the midwife will make her way to the selected birth location. Upon arrival she’ll check the baby’s heart rate as well as take mom’s blood pressure. Birth coaching tends to be gentle and encourages women to move into positions that are most comfortable and feel most natural.
Ashley McAdam had her daughter at home in 2012. Before she was in labor she had never considered a water birth due to her general discomfort around water but when her midwife recommended she try a warm bath to soothe the tension from contractions she ended up delivering her baby in the tub.
Besides assuring women of their birthing abilities and keeping an eye on vitals such as heart rate and blood pressure, midwives coach women through the difficulty of transition and the pushing phase to avoid any unnecessary tearing or injury.
Mindy Wood birthed her second daughter at her New Hampshire home and considered the midwives trust and hands off approach one of the most powerful components of the overall experience: “The midwives were just quietly waiting, other than checking baby's heartrate and my blood pressure every so often, until I started pushing which was when they were needed to catch the baby. Since everything was going normally I was allowed to labor the way that made sense to me.”
Baring any complications, babies are placed right in their mother’s arms and new moms are encouraged to nurse if they are planning on breastfeeding. Often infants will stay with their parents for at least at hour before being cleaned off, measured and weighed. Midwives stay for a number of hours to monitor both mama and baby, clean up anything birth related, and sometimes even cook a meal to help boost the new mother’s energy after laboring. This also allows the mother’s body to deliver the placenta without force.
In the days and weeks following the birth, midwives make house calls to check on the baby’s growth and mothers healing. Midwife student Nikki Helm said “We see our families continuously throughout the first 6 weeks of baby's life and Mama's postpartum recovery. We see our families at home for the first few visits, so that parents don't have to take their new babies outside of the house and recovering Mamas don't have to leave home. We are considered to be primary care providers, so we are able to care for both Mama and baby for those first 6 weeks. We monitor baby for weight gain and illness, we check Mama's perineum and monitor her for healing and postpartum depression and assist with breastfeeding issues.”
In Case of an Emergency
If there is an emergency that requires mom and baby to be transferred to a hospital the midwife will travel with the family and often stays on to act as an advocate and birth coach after medical care has been transferred to the hospital staff.