Hosting a home birth

Pregnancy

Aug 24

Let’s clear this up…

It's not as messy as you think!

In my years as a community midwife, I can assure you that no sofas or soft furnishings were ruined by home births! I have cleaned blood off of toilets and then done a quick once over in the kitchen to catch toast crumbs before leaving a brand new family tucked up in bed with a cup of tea (or glass of champagne!) many times - and I can tell you there is no feeling like it.

We bring absorbent pads and take any mess away with us. I always recommend asking your nearest and dearest for donations of old towels to through over chairs, or to dry off if you are in and out of a birth pool. Cheap shower curtains make great waterproof protection for your mattress or carpets (your waters could break before labour, don’t forget! If you love your mattress protect it in late pregnancy anyway).

Midwives do not need to be ‘hosted’ in your home - we are very self-sufficient (although always grateful if you don’t mind us making a 4am cup of tea in your kitchen).

Home birth is not for ‘other people’

The chances are that you, and your siblings were born in a hospital, and that most of your friends who have had babies birthed them in hospital too. Many of us become pregnant, and the only births we have ever seen are those that happen on tv dramas and movies - in clinical environments, pregnant woman/person flailing on their back like a beetle, surrounded by people in white coats and bleeping machines.

I am here to tell you that birth DOES NOT HAVE TO LOOK LIKE THAT.

If you have only ever seen birth in that uninviting environment, and never met anyone who has birthed at home, it stands to reason that the idea of a home birth seems completely other. Like it must be for a different kind of woman/person.

If this is how you feel at the suggestion of birthing your baby at home, read on!

Home birth is safe for your baby

There is clear evidence that home birth offers better outcomes compared with hospital birth.

In 2019, Hutton et al carried out a meta-analysis including 14 different pieces of research and over 500,000 intended home births. They found no statistical difference in outcomes for babies - including admission to the NICU, Apgar scores or need for resuscitation. This was the case regardless of whether this was the first baby or not. This is important as previous studies had suggested that for women and birthing people having their first baby, the risk to babies was higher. We can now be reassured that this is not true.

Home birth is safe for you

The same meta-analysis by Hutton et al, published in 2020, found that intended home birth resulted in a significant reduction in caesareans, instrumental birth (forceps or ventouse), 3rd or 4th degree tears, episiotomy, use of epidural anaesthesia, use of an oxytocin drip to augment labour, and maternal infection. Heavy blood loss following birth was either found to be less likely or did not differ in those studies that included it as an outcome.

It is important to note that these are the results of INTENDED home birth, so even those of you who may transfer to a labour ward partway through labour still benefit from planning a home birth!

Your midwife is there for you

It is easy to feel that there is a medial hierarchy in birth - that midwives are the footsoldiers carrying out the orders of doctors! But actually, midwives are autonomous practitioners who are the experts in supporting physiological birth. Midwives know birth. We know how it sounds, how it feels, how it smells, we know how women and birthing people move in labour and we know how to hold the birth space to let you and your incredible birthing body do what it needs to do.

We also know when to ask for help. Midwives are supported by doctors, and their midwifery colleagues, and paramedic crews to be able to safely transport you and your precious cargo into a labour ward, if we feel that you are veering off that expected pathway.

Your midwife and partner will stay with you in an ambulance to keep you company and help you stay relaxed. For the vast majority of transfers in, there is time to process information, to decide, to choose. Informed choice is at the heart of midwifery support in labour.