What to expect from a home birth

by | May 10, 2018

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Not everyone wants to bring their little one into the world under the glare of hospital lights. Natalie Nelson speaks to two midwives to find out what home births are all about.

A big congratulations on your pregnancy, mommy-to-be! Now is the best time to consider your birthing options, and being well-informed is one of the very best things that you can do for both you and your baby.

Did you know that you have options that range from birthing at home with a midwife, to birthing at a birthing centre and then finally, birthing in a hospital? Sadly, many moms believe that birthing in a hospital is the only option that they have, but if you’re a low-risk mom with no contraindications to giving birth normally, all of these options are available.

Picture this. It’s the middle of the night, a little chilly, but not freezing. You’re fast asleep, but a strong twinge wakes you up, and deep down, you simply know it’s time. You wake your partner up and joyfully smile at him and in an instant, he knows it too.

Reassured by the preparation you’ve both done with your midwife, you know that everything is happening the way it is meant to. You both try to get some sleep, but the excitement is too much. You phone your doula, who says she’ll be over shortly, as your labour has started to kick things up a notch. She arrives, and offers to make everyone an early morning cup of tea.

The sun isn’t even up yet. You’re still in your comfy, once-upon-a-time-too-big-for-me pyjamas. Your hair looks like a bird’s nest, but that’s okay, because today is the day you’re welcoming your bundle of squidginess into your lives, right here in the peace and tranquillity of your very own home.

Why give birth at home?

Sarah Jones, a private midwife practising in Johannesburg, feels that with a home birth, a mom’s emotional state is more relaxed, because she is more comfortable in her own home: more secure and not treated like a sick person. With a hospital birth, a mom has to change environments and is not necessarily in control of what happens to her.

The other thing to consider with a home birth is that moms tend to progress a lot quicker and because home births are very much hands-off in terms of interventions, they turn out to be safer than hospital births. Scientific research has proven that unnecessary medical interventions during labour may put moms and babies at risk, especially due to the potential side effects.

Elrika Knoetze, also a private midwife in Johannesburg, explains: “At a home birth we do very few internals, and there is very little monitoring: only what is absolutely necessary. We focus on a physiological birth and we have a better chance of achieving that at home than at a birthing facility.

“We are therefore in more of a supportive role, completely focusing on the mom and the birth process. We fit in with the mom’s environment and with her needs. At hospitals you fit into hospital protocols and hospital time frames: you are under the control of the ‘system’, whereas with a home birth you are under the care of the midwife.”

Precautions and “What ifs”

One question that will definitely come up when choosing to birth at home will be “What if?” What if something goes wrong? Jones reminds us that things don’t go wrong at the drop of a hat. Midwives are trained to pick up the signs before things may be going awry, and because of this, there is more than enough time to act accordingly, even if it means going to the hospital.

“Home birthing moms-to-be must always have a back-up hospital and gynaecologist in case we need to transfer in,” she says. Knoetze adds, “We make the call really early and will never leave it to the last minute. So it’s important that they (the parents-to-be) know where their back-up is and that everything is in order at the receiving facility. The back-up gynaes are always advised when mom goes into labour, so that they’re ready should they be needed.

“It also depends on how the pregnancy goes, and if any red flags are picked up during the pregnancy or early labour, we’d bypass the home birth and move straight to the back-up facility. We would not jeopardise anything in order to achieve a home birth.”

What does a homebirth look like?

Your midwife would come to you when you’re either just about in active labour, or in active labour already: the same time frame as a hospital birth, really. She would arrive with a birth pool, and a mini labour ward! All the necessary equipment to handle any emergency, including oxygen for a resuscitation, medication and drip lines to stop bleeding, a Doppler machine to measure baby’s heartbeat in utero, sutures for stitching, among other important bits and bobs. They even come with documents from Home Affairs!

Your midwife is present to support you and take care of you. Lots of chatting and encouraging takes place, as well as making tea and just simply being in the moment.

Is it a messy affair? Not always. Sarah says that often once baby is born, and things have been tidied up, it hardly looks like anything even happened. Your midwife will settle you and baby in bed, where you can cuddle and bond. While this happens, your doula and midwife turn into magical cleaning fairies and tidy the day’s event away, leaving you to bask in the glow of knowing that you gave birth to a little miracle, in your home, your way.