Home Births - Labor At Home!

There are so many cesarean sections being performed today; and research shows that most of these are unnecessary and therefore putting moms and babies at increased risk. Choosing the way you will give birth is empowering, it allows you to decide the best and most safe way to bring her newborn into the world, one of the most important and memorable events of her life.

Home births are usually accompanied by midwives (in a hospital, this would be a Certified Nurse Midwife, at home, a Direct Entry or "lay" midwife). They involve less invasive procedures such as episiotomies. There is not the stress of constant fetal monitoring which inhibits a woman's movements and makes her uncomfortable, but rather baby is monitored periodically using a hand held Doppler ultrasound device. Mother and baby never separate during water births, and in the case of home birth, the entire family can participate, not just the father.

On the flip side, check with your insurance company to ensure they cover home birth expenses, and the midwife's fees, unless you're prepared to pay out of pocket (incidentally a home birth even without insurance is often less expensive than hospital bills with insurance). A water birth at home will require the parents to file the birth certificate on their own. You may also want to rent a water birth tub, although many parents opt to use a kiddie pool for Mom to labor in.

There are many sources of information on home birth that will help you decide if it is right for you and your baby. While home births can be a wonderful experience for you as well as calming and peaceful for the child; you will have to be a low risk in order to have a home birth. If the idea of water birth makes you nervous, use the water for labor only to help ease contractions and reduce pain, and to leave the tub when you have reached the pushing stage of labor.

Photo Credit: Lobo235

I serve as the resident expert on pregnancy, birth and breastfeeding for an online forum for mums, called Mummy Madness. I received a question the other day that I thought I would share with you. One of the mothers is planning a homebirth with her second baby. But at 24 weeks, she is having a few doubts...mostly as the result of comments from other people. Having had 2 homebirths...after my 1st caesarean...and having supported clients who have had wonderful homebirths I believe that 99% of all homebirths are safe options for many women. Homebirth offers some very real advantages including:

1) Allowing you to labour and birth comfortably in your own environment
2) Reduced risk of infection because you have developed immunities to the bugs in your environment
3) Wonderful opportunity to bond with your new baby without being pocked and prodded often by nurses.

BUT before deciding upon you need to consider the following carefully:

1) Accept the miniscule risk. There are a very small number of difficulties that occur in homebirths each year. Many of the few difficulties are what is called non-emergent...in other words...not an emergency. In those cases you and the midwife have time to discuss things and make the best choice for you and your baby in your situation. These would include things like failing to progress...days and days of labour with no dilation...or going a long time after your waters break. My 2nd homebirth though demonstrates that there are real risks we must be willing to accept.

My son's head was born but his shoulders were too large to pass (called shoulder dystocia). In this situation, it is too late for a caesarean birth even in a fully equipped hospital. The midwife or doctors have about 5 to 8 minutes to get the baby out before it is too late. I had a VERY experienced midwife and she told me afterwards that my son was her closest call in over 30 years of practice. She still does not know what finally freed his shoulder. Of course, in the end my son was fine, but the truth is that was a very dangerous medical emergency that might have required infant resuscitation beyond the limits of a homebirth. So as a family you must closely examine your comfort with accepting the miniscule risk of this decision when weighed against those vast benefits listed earlier.

2) Know your history. By this I mean find out all you can about your previous birth. Were there any problems that you didn't know about? Sometimes in labour we are so focused on getting our babies out that if something isn't a major difficulty we may not even know about it. Also know about other health issues which may affect your birth...including hereditary/family problems. I had a client that opted for an elective caesarean birth because her family and her partner's had a strong history of large babies and difficult births. Also as a team with your midwife monitor this pregnancy closely. Issues such as gestational diabetes can have far greater impact upon homebirths since those babies tend to be significantly larger.

3) Prepare your body. This is true of any pregnancy. I always tell my mums that giving birth is like an iron man triathlon. By that we always hear how birth is natural and women have been doing it for millennia. That is true. But in evolutionary terms our sedentary lifestyles are far from our foremothers. In terms of the triathlon comparison, that type of physical exertion is what the human body was designed for...when we lived in caves...ran from saber tooth tigers and mammoths. But today most of us use our minds and sit on our bums. So if we are going to complete an iron man event it requires...eating right, training our bodies and good coaching. Same is exactly true for a truly natural birth. My difficulty with my son's shoulder dystocia could have easily been prevented...if I hadn't gained 40+ pounds and grown a 9 lb baby...my daughter was easily born at home without any issues...but she weighed over a pound less.

By training our bodies I don't mean the extreme exercise of a triathlete of course...but simple things like walking, swimming and yoga will help our bodies to prepare for the big event and help our babies to find good positioning in our pelvises. And of course the support of an experienced and trusted midwife...or doula is crucial to success especially in those moments when you feel that you simply can't do this. Just as with a good coach they can help us break through the wall and catch a 2nd wind...or a 15th. One big difference between labour and a triathlon though...you can't simply quit when you get tired. Once it begins...this is one race you must finish...one way or another.

4) Prepare your mind. One of the biggest impediments to any natural birth but especially a homebirth is those 2.2 pounds of gray matter between our ears. My first homebirth was following a very traumatic caesarean birth. Most of my ante-natal care was focused on my emotional recovery from that trauma. I clearly remember my first visit with my midwife lasting over 2 hours...and only 10 minutes was the medical part of blood pressure, wee and measuring. During the 3 days of labour, my midwife used her psychology skills more than her medical ones to get us through.

5) Prepare your environment. While I do mean the actual physical environment in terms of having the proper equipment, lighting and temperature, I more importantly mean those around you...the people. Without the support and faith of those people attending your birth, your journey will be significantly more difficult. One of the reasons that I did not attempt homebirths with my last two children was that their dads...going back to point #1...were simply not willing to accept that small degree of risk. They wanted the best medical care for me and the babies...and I had to respect that.

The truth is though that only YOU (plural) after carefully considering these issues can decide what is the right choice for you and your baby in your unique situation. I encourage you as early as possible in your pregnancy to explore these issues. Talk with your doctor or midwife about them. And especially discuss them openly and honestly with each other. Remember your partner too has a vested interest in this birth...it is their baby...and they love you deeply.

But for most women with no serious medical history and a 'normal' pregnancy, the advantages of homebirth can far outweigh those miniscule risks that I spoke of. I do though encourage all clients to be flexible with their birth plans, because in the end babies cannot read our carefully written plans...and even if they could...they would probably disobey...just to assert their little characters even then. And in the end the most important thing isn't how our babies are born but what happens once s/he is here.

Terri is the mother of six; 3 caesareans, 2 VBACs and an adoption. She has over fifteen years breastfeeding experience as well as peer supporter training with two organisations. Terri has completed the Childbirth Educator, Birth & Post-partum Doula certificates with Childbirth International. In addition, she also holds a BS in health education from Texas A&M University.

To sign-up for her monthly e-newsletter featuring her latest articles on pregnancy, birth, breastfeeding and parenting; visit her website:Special start Birth.

Photo Credit: Lobo235

While, in my experience, many, if not most, homebirth moms, do not get into bed until after the baby is born, it is still a great idea to have the bed made once labor begins so you are able to rest if you want to and not worry about the mattress' safety if your membranes rupture.

Below, I outline the easy way to prepare your bed so it remains clean and body fluid free. Besides saving the mattress, practical reasons for having a birth bed made will also make things easier after your baby is born.

1. Remove the bedspread or comforter and blankets off the bed. Keep the bed as clutter-free as possible; sheets and easily washable blankets only!

2. Buy an inexpensive plastic painter's drop cloth from a home improvement store, the clear and very thin types. You might also choose to use a shower curtain liner, but they tend to be far too thick. The drop cloth is thin, yet protects well because it is longer and wider.

3. Put a set of sheets (fitted and top) on the bed, a typical set that you would have on your bed for every day use.

4. Over that set of sheets, lay down the plastic painter's drop cloth.

5. On top of the plastic drop cloth, put a set of old sheets you don't mind getting messy. Some people choose to throw this set away after the birth; most wash them.

6. Use about 10-12 safety pins and pin the entire bunch of sheets and plastic to the mattress, putting a pin every 4-6 inches around the mattress. Don't use pins if you have a water or an electric bed! Sometimes it is easier to put the pins around the "coiled" part of the mattress instead of the flatter sides of the mattress. The pins are absolutely necessary because they keep the whole shebang from slip sliding all over the place should you climb all over the bed during labor or afterwards; Sheets on plastic is slippery.

7. Have plenty of pillows available for propping and leaning; you will appreciate the added support. Use inexpensive pillows because body fluids are much more difficult to remove from them than the sheets.

While it may be tempting to make your bed before labor begins (to protect it from the possibility of the water breaking), but the plastic makes sleeping very hot. After the birth, when the top set of sheets is soiled, when mom gets up to go to the bathroom or shower, they are pulled off with the plastic and voila! a clean set of sheets is waiting for her to climb back on.

How to Get the Blood Out of the Sheets The sheets get tossed into the washer with a large bottle of hydrogen peroxide. Hydrogen peroxide is a blood removal trick everyone should know. Put this together with the regular amount of soap and that will remove the blood from sheets, towels, and washcloths. You can also use the peroxide for carpets (even colored ones), too. Pour the liquid onto the blood and allow it to sit for a few minutes. Use a towel to dab at the stain - don't rub it in. Repeat as needed.

Having a homebirth need not be a terrible mess. Learning some basic bed-making tips allows the mom to be comfortable as well as keeping things safe and clean.

Barbara E. Herrera is a Licensed and Certified Professional Midwife who assists women wanting home and water births. To learn more, click here.

Photo Credit: Swearinglibrarian

Ever wonder what a doula is and what they can do for you? The word doula is actually a Greek word that means women's servant. A doula is a non-medical assistant in childbirth. Here's how a doula can help you achieve a positive birth experience.

A doula's job depends largely on their training and what you need them to do. A doula offers assistance in one or all of the three phases of pregnancy. They can:

1. Offer support during prenatal care,
2. Offer support during childbirth
3. Be an essential support person after childbirth and during the postpartum period.

Prenatal Care Doula Assistance

Before childbirth, a doula can answer a myriad of questions a pregnant mother may have. She can also assist with nutrition guidelines and offer assistance when it comes to preparing for the actual childbirth. She may also assist the midwife with any examinations. If an expectant mother is dealing with a difficult pregnancy or is assigned to bed rest, an Antepartum Doula can provide emotional and physical support.

Childbirth Assistance

Depending on the level of training a doula has, she may attend your home labor, drive you to the hospital, and attend your birth at the hospital or birthing center.

Her primary job will be to make sure the birthing experience is as positive as possible. She may offer massage, assist with pain-relieving techniques like deep breathing exercises and she can also help facilitate the communication between husband or partner and wife. She can be invaluable for keeping everyone calm, cool, and collected.

She's the mother's and the father's advocate during the labor and delivery process.

Postpartum Doula

A postpartum doula can begin immediately after delivery and she can assist with the breastfeeding process, which can be a real challenge for many new mothers.

Postpartum doulas also facilitate the recovery period and can visit a new mother in her home. She can offer newborn care assistance and advice and in some cases, help the mother manage the household by helping with chores and tasks. Additionally, postpartum doulas can be essential for recognizing and helping mothers through postpartum depression.

Where to Go to Find a Doula

If you're interested in hiring a doula to help with any stage of your pregnancy you can visit americanpregnancy.org and search for a doula in your area. Certification is not required by law but it is available. When dealing with your health and happiness, certification is generally a good idea. You can also visit DONA, Doulas of North America to find a certified doula near you. When hiring a doula, be sure to hire one who is knowledgeable and skilled in the stage of pregnancy you need her for. Ask about training and fees, and make sure she's available when you need her.

Doulas offer expectant mothers the comfort and convenience they need at this important time in their lives. They're someone you can rely on to share information, support you emotionally and physically, and to help you manage your upcoming and new responsibilities. While they're not really a 'woman's servant' they truly are valued and a wonderful way to enhance the birth experience.