10 things to know about home birth

A mom who has given birth at home twice discusses home births, including what to expect and who it is suitable for.

By Katja Wulfers

10 things to know about home birth
©iStockphoto.com/AtnoYdur
When my husband and I considered midwifery care for our first pregnancy, we were curious about the process of delivering our child at home. The idea of being at home,
surrounded by the people I trusted most, made me feel safe and as though I could truly tackle pushing out a baby.

With our second pregnancy, there was no question where she'd be born.

While we embraced our home birth experience, the process is certainly not for everyone. Wendy Murko, a registered nurse and midwife with the Community Midwives of Halton, shares 10 things you should consider before making any decisions about where you give birth to your child.


1. Women often choose home births so they can be in their own space

"The desire to be in her own space, where she controls who attends, is the primary reason a woman chooses a home birth," explains Murko.

Many women also hope that by staying at home they won't be tempted by optional medical interventions that are only available in hospitals.

2. Healthy women with low-risk pregnancies are the ideal candidates for home birth

The ideal candidate for home birth is a healthy woman with a low-risk pregnancy that is progressing normally. The mother-to-be should feel safe at home and have a supportive partner.

As labour begins, some women choose to switch from home birth to hospital birth for non-emergency reasons, explains Murko. Likewise, a woman who planned on having a hospital birth can make a last-minute decision to stay at home, as long as time allows and there are no medical contraindications.

Invariably, what the decision comes down to is that the mother-to-be feels comfortable with her choice and knows that she can change her mind.

3. Home birth is not for everyone
Women who have had significant post-partum hemorrhaging or more than one Caesarean procedure in previous deliveries should not have home births. Nor should women who have elevated blood pressure, women who are at less than 37 weeks or more than 43 weeks gestation or women who are carrying twins. Finally, if the baby is in a breech position the mother-to-be is not a candidate for home birth.

4. Home birth safety and emergency procedures

Two recent Canadian studies, the first conducted in British Columbia and the second in Ontario, examined the outcomes for planned home and hospital births and concluded there were fewer interventions with low-risk planned home births than with low-risk hospital births.

Registered midwives are trained to respond to any delivery-related emergency. They undergo yearly recertification for neonatal resuscitation and biyearly recertification of emergency skills. While in certain circumstances paramedics may be called to transport the mother-to-be to hospital, the most common reason this happens is for pain relief and because the labour is progressing slowly, explains Murko. (If you're looking to have a natural birth, have a look at our 10 tips for natural birth piece.)

5. Midwives come equipped with medical equipment
Midwives attend home births with the same equipment that is found in hospital labour rooms, with the exception of epidurals. The Colleges of Midwives in regulated provinces issue a list of essential equipment, which includes fetal Dopplers, stethoscopes, blood pressure cuffs, oxygen tanks, bags and masks for resuscitation, drugs to stop hemorrhaging, IV bags to treat bleeding, and medication should stitches be required. (Not sure if you should consult a doctor, obstetrician or midwife? Have a look at our article and find out which health practitioner is right for your pregnancy.)

6. Home birth rates vary by practice
Home birth rates vary by province and practice, but in Ontario approximately 20 per cent of midwife clients choose to have home births, notes Murko.

7. Preparing for the big day at home
A home birth includes home visits by the midwife prior to the due date. "We conduct a prenatal visit to see where the birth will take place and how we'll set up our equipment," explains Murko.

Parents receive an information package with a list of items to gather before labour. These are easily sourced items such as plastic to protect the mattress, garbage bags and washcloths.

8. Having a baby at home is not messy
Home birth is all about planning. "If the couple is prepared, the mess is minimal," says Murko.

For our home births we put a plastic sheet under the bedding on our mattress and did the same with our pillows. It was easy and effective. Once the baby is delivered the midwives strip the bed and put soiled linen in prepped garbage bags.

9. The mother-to-be chooses who can attend the birth
The primary midwife arrives first and the backup is called when pushing starts. Many practices have student midwives as part of their team; the mother-to-be can decide whether or not to have a student present. Beyond that, anyone the woman chooses can be present, whether a doula, friend, sister or children. (Wondering who to invite to your home birth? Read up on our article about who to invite to the birth of your baby.)

10. After the birth it's time to care for mom and baby
After the baby has been delivered, he or she is placed on the mother's tummy and dried off. After the placenta is delivered, the midwife takes a quick look to see if stitches are needed and then the tidying begins. While one midwife cleans up, the other completes the neonatal checks.

The new mother can start breastfeeding as soon as she's ready and the midwives are there to help with any questions or difficulties. They stay for a few hours to make
sure that everyone is well and then leave to allow the family to get acquainted.

A planned home birth is based on the mother's health and the parents' comfort. My husband and I received all of the information we needed to make the decision together and it was the best decision we've made. I delivered healthy babies in the peace of my home and then toasted with a pint.

A woman's body not only goes through many changes while she is pregnant and also after she has delivered a child. To know more, read over a our tour of your post-partum body article.

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