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July 7, 2016

Midwife Sharon Weir explains what you need to know if you’re considering having a home birth.

At what stage in my pregnancy do I need to decide if I want to have a home birth?

It is good to start thinking about it early. Often, first-time mums don’t give it much thought because they feel that for the first time the hospital is a safer option. It may be that when they go to antenatal classes or start talking to other people and doing some research they think, “Actually, I’m a low-risk woman, why couldn’t I do it?”

There are some midwives out there who aren’t comfortable doing those though and so we might get a phone call from someone who is 32 weeks pregnant and has suddenly decided that that’s what really appeals to her.

With all my mums (and it doesn’t matter whether it’s a first or subsequent baby), it’s about remembering that birth is a dynamic situation and you have to keep an open mind about it, even on the day. I have women who plan to have a home birth and I have some women who just want to see how they feel on the day.

So is it okay to have a home birth for my first birth?

Theoretically, having a home birth with your first birth is a bit riskier, but that’s why we do antenatal care – so we can pick up most of the problems long before it gets to the labour and birth. The biggest reason why women don’t achieve a home birth with their first baby is because the labour is more painful than they thought it was going to be, or they don’t progress as fast as they would like so they want to go off to hospital and get something to help them along.

Everybody is so different. Some women have quick labours and some labour for days on end without anything happening, so you just always have to keep an open mind.

What do I need to consider if I’m not going to hospital?

The main thing is that there’s no access to drugs – but most of those who want a homebirth are in that sort of headspace anyway. We do carry equipment, but not everything: we don’t have a ventouse or forceps to pull a baby out in a hurry. We do carry resuscitation gear and pretty much everything else.

What are the positives about being at home?

The biggest thing is that you’re in your home environment. You’re not under any pressure. There’s nobody dictating what you can and can’t do. You don’t have to listen to other women being very vocal next door. You can help yourself to whatever you want to eat and drink and it’s your own bathroom.

If you’ve got other children you can have them around if you want to. It’s amazing how many women have their babies in that dawn period before their other children get up and then they wake to find baby has arrived. It’s always very lovely to watch a sleepy toddler get up and discover that Mum’s had a baby.

Then, afterwards, you’re not forced to get up and go to the toilet and shower and be out of the birthing suite because someone else needs the room.

What medical issues could prevent a homebirth?

Things like high blood pressure or gestational diabetes could be an issue, but they are things that we’d be aware of beforehand. Even gestational diabetes does not preclude a homebirth. It depends if the woman is on insulin and needs to be monitored – then it’s quite different – but if it’s just diet-controlled it can be okay.

Obviously, if a mother has a huge baby on board and it’s not in the pelvis then you’d be aware of that as a potential problem. The reality with babies like that is that they’re probably not going to progress and you’d end up going to hospital anyway. It’s more the babies that haven’t been growing well that I would worry about doing at home, because they don’t stand the stress of labour so well. You’d be very aware that that could run into trouble.

How do birth partners usually cope with home birthing?

I had someone last year who was having her fourth baby and she really wanted a home birth. Her husband didn’t want her to but eventually he came around. He agreed that it was her labour and he would support her in what she wanted. Afterwards, he thought it was so amazing. Sometimes it’s other relatives who aren’t happy about it.

What do I need to prepare in advance for a home birth?

Very, very little. In our practice, most of the women who have homebirths have water births and we supply the pools. They just have to pay for the disposable liner and we get them to buy the hose to fill the pool (because they use the same hose to drain it and the water can be pretty yuck afterwards, so you wouldn’t want that hose being used by anybody else). Then you just need something to put under the pool if it’s going on carpet, a bunch of towels and a two-litre ice cream container to put the placenta in. We supply everything else.

What if I’m feeling anxious about giving birth – should I still opt for a home birth?

If the mum is feeling anxious, then it depends on what she’s anxious about. For some women, it’s the thought of going to hospital that is scary – it’s scarier than staying home. A lot of women these days do HypnoBirthing, which can be great. It’s a shame they call it that because it’s not really hypnosis at all, it’s a bunch of powerful affirmations that help women to actually believe in themselves and that helps them overcome their fear. 


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