What Is Homebirth, Anyway?
By Erin Kaspar-Frett, midwife
I’ll start by telling you what homebirth is not. It is not a substitute for a hospital when one is needed. It also is not a chanting hippy fest, nor “extreme birth,” nor many of the other labels assigned to it. It is just that; a birth that happens in the home instead of hospital. There are many myths surrounding homebirth, and I thought I would take time to discuss them.
► Myth 1: All homebirthers will stay home no matter what.Truth: We transport when need arises. In fact we monitor mom and baby and transport (during labor) or transfer care (prenatally) when there are signs to do so.
► Myth 2: Midwives are untrained. Truth: Midwives are usually fully trained care providers, training that takes years to complete. Many of us have degrees related to our schooling, and all of us have a protocol to follow. Be aware that not everyone that uses the title “midwife” has the same training or procedures. But trained midwives recognize when we need more help than we can provide at home. We are skilled in how to handle situations such as: shoulder dystocia, resuscitation, maternal bleeding, meconium in the amniotic fluid etc. More importantly, we monitor to make sure all vitals and signs of health are maintained, in order to avoid late emergencies.
► Myth 3: Homebirth is unsafe.Truth: Research says no. Research has shown planned home birth for low-risk pregnant people with a skilled and trained care provider is as safe for mothers as hospital birth but carries less interventions and their coinciding risks. Homebirth is also as safe for babies as hospital birth as long as the care provider is trained and certifie in neonatal resuscitation and carries equipment.
► Myth 4: Midwives do not bring anything with them to the birth.Truth: We bring a lot. For example, we bring many bags with us, including oxygen, anti-hemorrhagic medications, basic vital equipment, scale, resuscitation equipment, etc. In fact, we carry equipment and supplies to handle the most complications.
► Myth 5: Birth is messier at home.Truth: While birth does carry with it some fluids and ourbodies are involved, it is no messier at home than in the hospital. We provide a list of things to gather around your house and set up to minimize the “mess” but also clean up for you before we go. Our goal is to have your house the same or better than when we came.
► Myth 6: Homebirth is unsterile.Truth: With the exception of surgical birth (we don’t do that at home), birth is not sterile, no matter where birth occurs (think about where the baby comes out). Birth should not be sterile. Our bodies carry good bacteria all the time. We want to share that with babies so their immune systems can be as strong as possible. That said, midwives understand the need for cleanliness and hand-washing and keep the area as clean as possible.
What does homebirth look like?
First, let’s talk about the prenatal appointments. We hold appointments at the same schedule and testing (if parents want it) as the clinic. By the time baby is coming, they should have a good understanding of the midwife’s practice and expectations. When labor starts, the midwife is alerted. They may not come right away. Midwife and parents will decide that together. When it is time for the midwife to come, they will show up with the bags and set up inside. They will listen to baby intermittently as long as everything continues to look good. They will take the birthing person’s vitals every few hours and set up the area for birth. Mostly, the midwife will leave them to fin their own internal rhythm, although styles do differ, and we are there to help in the event that it’s needed.
The birthing family decides what the lighting will be, who will be at their birth, the amount of talking, and what they eat, even who catches the baby. Trained midwives will stay at the house long enough to do a newborn exam, check the birthing person’s bottom, make sure everyone has eaten and is stable and cleans up. This usually takes between four and six hours. And then we return for visits in the post-partum period, or families come back to the midwife office This relationship may last a year or a lifetime.
The thing is that we are human. That means we have a hormonal system that reacts when we are worried or afraid or something (or someone) unexpected walks into the room. That is never more obvious as when giving birth. Adrenaline (the hormone released when stress occurs) blocks the endorphines’ (nature’s pain reliever) receptor sites in the body. So if a birthing person is startled or afraid or is uncomfortable with the environment in which they’re birthing, the birth could be more painful. That isn’t to say that homebirth is painless, far from it. It is still childbirth, and everyone experiences that differently. However, it is able to function more efficiently and with more ease when the birthing person is relaxed and in an environment in which they are comfortable. That does not mean homebirth is for everyone! High-risk pregnancies are not candidates for home birth. For low-risk pregnancies, it is a personal choice, and a human right to choose.
Erin Kaspar-Frett is a licensed, certified Pofessional Midwife with a master’s of science in Midwifery from the Midwives College of Utah. She lives with her family in Knapp, Wisconsin, and serves a geographical area within a 1.5 hour radius of her home. She can be reached at 612-801-9967 or firstname.lastname@example.org. For more information about Erin and the safety of homebirth please visit www.earthmothermidwife.com.