Sunday, April 6, 2008


I have had several questions about home births. Mostly these are not from my friends here in San Antonio, because enough of us have done it that most everyone knows someone who has had a home birth. And I'm sure each midwife does things a little differently, so I can only give you an idea of how my midwife does it.

For the prenatal visits, things are actually very similar to seeing a doctor. There is blood work done early in the pregnancy. You see the midwife every 4 weeks until you are 28 weeks along, then you move to every two weeks. Then at 36 or 37 weeks you start seeing her every week. At each visit you are weighed (my least favorite part), blood pressure taken, they ask many questions about your health. They also listen to the baby's heartbeat and measure your tummy(to make sure the baby is growing properly). They also go over any supplements you need to be taking and answer any and all questions you might have.

The main difference at this point is that the midwives that I know are much less pushy about alot of the tests you are offered. For instance if you decide not to get the triple marker test (which tests the mother's blood for certain problems with the baby like Downs syndrome), the midwife does not pressure you like I have had doctors do. Also if certain conditions were to surface during the pregnancy (like twins are diagnosed) the midwife by law is required to hand the mother off to an OB for the remainder of her care.

When you reach the 38-39 week point, one prenatal visit is scheduled to be at the home where the birth will take place.

At this point the mother prepares the home for the birth. At the home visit, my midwife brings the "birth kit" and leaves it at the house. This has supplies in it like the bulb syringe, sterilized clamps and scissors to cut the cord, exam gloves, etc. There is also a list of things I have had to gather and have accessible in the room. We have alcohol and hydrogen peroxide, a digital thermometer, as well as a good supply of clean sheets, towels, baby clothes, diapers, and the like. We also have things for the labor, like heating pads, a birthing ball, etc. She also asks for two containers of some type - one for trash, and one for laundry - to be set up in the room.

The thing that surprised me the most at my first homebirth was that you do actually boil water! It's true! When you first go into labor, you are supposed to boil it for 30 minutes, and then just let it cool on the stove. It is used to clean the baby off after the birth. Also they ask you to have someone clean the bathroom, making sure to clear off the counter. Not the time you want hairbrushes and toothbrushes out. You also put a plastic sheet and a set of clean sheets on the bed.

Of course you have to call the midwife as soon as you know you are in labor, and she determines when she comes out. She doesn't wait to show up just to catch like most OB's do, but if you are in for a several hour labor, she will wait a while, keeping in touch by phone, to see how things go. But she has been at homes for over 24 hours before during protracted labors. In my case, I am strictly instructed to call the second I THINK I'm in labor, and they will rush right over.

After the birth, she stays at least two hours, and often longer, to monitor that all important recovery time. At that point you are left with a chart - she asks the mom or dad to take the baby's vitals (and the mom's) so many times in the next 24 hours. I love this because I can do it when the baby is already awake and nursing instead of having nurses wake us up during their rounds.

The midwife then returns after 24 hours for the first check up. This is nice because she comes to your house, no need to get out anywhere. Then you go into the office with the baby for a two week check up.

Of course, each labor and delivery is different and unique, so how she handles each of those is different. But midwives as a whole are much more into listening to the mom and her body, helping her get into comfortable positions - or at least positions that will help move things along rather than insisting you stay in bed - and making the birth as natural and stress free experience as is possible. She also does as much or as little intervention as you want. It is also so comforting to be in your own home, your own bed or bathroom versus a strange hospital.

I know it's not a situation for every mom-to-be, but it is one that I really like. I can't imagine doing it any other way now that I have had one.


Lora said...

Not to mention there isn't an incompetent person blowing your veins in the hope that they can get an IV started, a MANDATORY IV bag following delivery, silly strange people standing around making you nervous with nothing to do, people telling you not to eat or drink anything when all you want to do is dunk their head in a toilet, strange people you have never seen before popping in to ask stupid questions while you are contracting, strange, unnecessary people fussing at you because you are focused on breathing instead of them, the list goes on and on. Did I mention the strange and unnecessary people?

Sadly, the Lord has not seen fit for us to have a home birth but I sure wish we could!

Tami said...

My personal favorite is all the strange and unnecessary people who feel they have a right to come in and, er, uh, "check your progress." Often without asking or introducing themselves.

Kristen & Dave said...

What's sad to me is not the women who choose to hospital birth, its that so many choose to do so b/c they've been taught to think they "can't" birth without help, and they don't trust the birth process. The industry has vested interest in fostering this myth of needed intervention.

And how sad that the law requires a midwife to "turn over" a client for twins! The law has no business here, and that kind of decision should be up to client/midwife discussion.

So Tami...want to have your baby while I'm in town?

Tami said...

Sure. Of course, I'd rather have her before then, but I'd be thrilled to have her next weekend. Looking forward to seeing you!