We asked mothers and midwives to tell us what their most frequently asked questions were around home birth.
We have listed them here with our own answers.
If you would like to contribute a frequently asked question around home birth, please send it to us via our Contact Form
–Is a birth plan necessary for a home birth?
– Isn’t a home birth unhygienic and who cleans up the mess?
We’ve been made to believe that birth needs to be a sterile procedure and that a sterile environment can only be maintained in a hospital setting. The release of a recent groundbreaking documentary MICROBIRTH has just provided evidence that the way in which births are being conducted these days (in hospitals – and the high caesarean section rate) are actually to our disadvantage.
The baby, during its incubation period has been repeatedly exposed via the mother to the habitat in which it will eventually live – the home. It is “colonised” for the bacteria and germs that make up that specific environment.
The birth of the baby through the vagina is a protective mechanism for the baby, providing a unique introduction to healthy bacillae that will multiply and immunise the baby. Further facilitation of uninterrupted skin to skin contact with the mother and then the introduction of the first sips of colostrum as well as delaying the 1st bath so that the baby’s skin absorbs it’s vernix.
The baby who is born into the environment in which it’s been colonised to, is better off than a baby exposed to bacteria and germs for which it has absolutely no immunity to.
Yes, there is a bit of blood around the time of the birth but midwives will make use of linen savers to prevent any soiling of bedding, floors, etc and births that happen in water are much easier to clean as all the birth goo gets drained away when emptying the bath.
It is useful to have a black bag handy for soiled linens that are easily washed in your washing machine and another bag for the soiled linen savers that can be discarded into household waste.
Any medical waste eg. Needles, syringes, etc. will be discarded into portable medical waster containers which the midwives carry.
Generally, most midwives and doulas pride themselves on how “clean” things look afterwards so that the new mother has one less chore to tend to!
– Lana, home birth mother of 2
Women who choose home birth are very much considering their baby’s health and well being. They are strong advocates for their babies and choose home birth to prevent a potential cascade of interventions and procedures that may be unwarranted or harmful to themselves and the baby. When a woman is birthing in a space that is her own, both she and her partner can “let their guard down” knowing that the midwife attending them, will not do anything without the parents’ consent or be pressured into unwanted procedures or interventions, such as:
- routine suctioning of the airways
- immediate clamping and cutting of the cord,
- immediate vaccinations,
- immediate bathing with harsh chemicals
- not being allowed skin to skin contact with the baby so that assessments can be done
- the baby being offered alternate feeding methods other than breastmilk
- mandatory observation in an incubator as per hospital protocol even if there’s no indication
In fact many midwives and doulas have observed that when the mother is the primary focus of optimal care and autonomous decision making during pregnancy, labour and birth, she will be highly in tune with her baby and it’s needs and able to trust her instinct in caring for her baby beyond the birth.
– Lana, doula and home birth mother of 2
– What if something goes wrong?
Your antenatal visits during your pregnancy with your midwife are a process of eliminating any risk factors that would make a home birth unsuitable. Examples of these would be things like high blood pressure, diabetes, multiple pregnancy,etc.
You will also consult with a doctor at your back up hospital at least once during your pregnancy so that should the need for transfer for you or the baby be required, you are already in their system and access to emergency care would be quick and easy.
Midwives who attend home births are highly skilled and bring along equipment for the most common obstetric emergencies such as drip sets, catheters and medication for bleeding. Oxygen and other resuscitation equipment to provide immediate medical care and stabilise both mother and baby in the home until transfer to your pre-booked hospital can be done. During labour the midwife is constantly assessing the normal progress of labour by observing the mother – who she has gotten to know very well during the antenatal period, and able to feedback to her any concerns and recommendations if continuing a home birth is no longer suitable.
– Lana, doula and home birth mother of 2
– What happens to the placenta after the birth?
Usually, women who choose to birth at home will choose a physiological third stage , which means that they would like to birth their placentas on their own and with no or as little assistance as possible. It is a good idea to discuss this with your midwife beforehand to be sure that you are both on the same page as to what you are wanting and how you would like to have this stage of the birth to be managed. Some midwives may practice active management of third stage, which means that you will receive a shot of synthetic oxytocin into your thigh and the midwife will then actively deliver the placenta. This is standard practice in hospital and it is what is recommended to prevent post partum haemhorage but most home birth midwives know that women choosing to birth at home would like to do so with no, or as little intervention as possible.
It is recommended, that once the placenta is birthed, that the cord be left until it has finished pulsating. Usually the cord is clamped and cut then, although some midwives may leave the cord for up to an hour or more so as not to disturb that early bonding and breastfeeding between mother and baby. Some parents may choose a lotus birth and not cut the cord at all.
Parents can choose what they would like to do with their baby’s placenta. Firstly, your midwife may show you how the placenta was implanted in the womb and which part housed the baby. This is always very fascinating for new parents. Some parents choose to dispose of the placenta. This is fine and your midwife will take it to your local hospital where it will be incinerated. Most home birthing parents choose to do something special with their placentas. Some parents may choose to plant their baby’s placenta under a tree. Some mothers choose to eat it either by having small pieces in a smoothie or by having the placenta encapsulated. You can also make a tincture from the placenta. There are apparently many health benefits to consuming the placenta. But at the end of the day it is a personal preference and totally up to you!
If you are unsure as to what to do with your placenta, it is fine to keep it in the freezer until you have decided. On your home birth supply list you will probably be asked to provide a 2l ice cream container for the placenta. The placenta will then be stored in your freezer until you are ready to deal with it. It may be a good idea to clearly mark the container as containing placenta. Some people have been known to keep their placentas in their freezers for a number of years and have even moved house with them!
– Ruth Ehrhardt, midwife and home birth mother of 4
– How do I prepare my older child (children) in attending my home birth?
I talked to my then 2 year old son, explaining in terms he would understand about what to expect. Mommy might roar like a lion. We watched some YouTube videos of homebirths. The midwife was amazing as she would allow my son to listen to the heartbeat and really included him in the antenatal check-ups – this really helped alot.
– Helen Behm, Cape Town, Home Birth mother of 2
–Is a birth plan necessary for a homebirth?
Chatting to couples who’ve chosen homebirth as an option, many of them agreed that the need for a birth plan was more and exercise in asserting their wishes for their ideal birth scenario and to make all parties attending the birth clear on what their expectation were.
Most midwives and doulas agreed that women choosing homebirth generally have similar ideologies around birth. Eg, freedom of movement, nourishment, mother-led labour support, use of water for pain relief and or birth, gentle birth practices, uncoached second stage, physiological third stage, delayed cord clamping, skin to skin, delayed newborn checks and weighing, etc.
Women reported having ample opportunity to discuss their “birth plans” with their midwives during the antenatal period and most felt confident that just by having the discussion and getting a sense of the midwife’s practice-style, they could negate putting things in black and white.
However, most agreed that a written birth plan was essential should the need for transfer to secondary level care at a hospital arise.
Here were some of the points mentioned for home to hospital transfers;
– No separation from birthing partners – women felt that the need for the birthing partner/s of their choice became even more essential to help them advocate and negotiate their wishes in the hospital.
– Most requested that medical caregivers in hospital include them in all decision making around their expectant care and respect their right to informed consent AND refusal.They requested that hospital staff respect that for them, needing to be in hospital could be a traumatic experience in itself and that they (the mother or couple) not be treated as irresponsible or idealistic for having chosen to birth at home.
– They requested that hospital staff respect that for them, needing to be in hospital could be a traumatic experience in itself and that they (the mother or couple) not be treated as irresponsible or idealistic for having chosen to birth at home.Most couples expressed the need for gentle, mindful care of their baby while in
– Most couples expressed the need for gentle, mindful care of their baby while in hospital including no rough handling by staff, delayed cord clamping, skin to skin, support for breastfeeding, delayed bathing.
Essentially, most women felt as though their midwife had a good idea of what they wanted for their birth and most felt confident in expressing those wishes with some reporting their midwives encouraging them to bring along a proposed birth plan to one of their antenatal appointments for discussion.