home ap nursing lounge education and development miscellany webrings Links Forum The Book Nook
This document discusses the option of homebirth as one of the many avenues toward a successful birth. A successful birth is one that results in a happy and healthy mom and baby. We offer this in support of education, freedom of choice, and empowerment of women and their families.
|
Homebirth...Why Homebirth?
In most cultures throughout history, women have given birth at home.
Currently, the majority of women around the world continue to deliver
their babies in non-hospital settings. This is partly due to culture and a
desire to be in a familiar, safe environment. In many areas birth is
viewed as an integral part of family life.
The advent of obstetrics in this century had a tremendous effect on childbirth customs in the United States. The birthing process became segregated from mainstream family life. Many were led to believe that the only safe birth was a hospital birth. Sadly, even today. U.S. statistics don't support this premise. The United States ranks 18th among industrialized nations for healthy births, at 10.7 infant deaths per 1000. (Data is based upon 1984 statistics from the United Nations Statistical Offfice.)
By the 1950s, most births in the United States were taking place in hospitals. Cesarean sections, epidurals, and heavy doses of pain medication became the norm. Women were denied feeling and experiencing birth through their bodies, and the drugs were having adverse effects on the babies.
In the 1960s and '70's, women began to question and challenge the way obstetricians were treating them - as though childbirth were a sickness. Women began to reclaim their power, and the homebirth movement was born.
The 1990s are a time of maternity awareness, a time when people are making the entire pregnancy and birth experience a family experience. Today, a carefully monitored homebirth, with women who have been screened to make sure they are low-risk, has been proven to be very safe and successful.
Considerations
The most important factor in choosing homebirth is that the mom have a
strong desire to birth at home. Even though a homebirth can save money,
cost is not sufficient motivation to birth at home.
The most successful homebirthers are those who have a strong commitment to it, and who trust in their body's natural ability to birth. they are often willing to devote time and energy to finding the right birth practitioner, to doing their own research, and to taking care of themselves.
For some mothers, the comfort of home and familiar surroundings can be very supportive and promote an easy birth. Others may feel uneasy that more technical medical assistance isn't at hand.
Families who choose homebirth may be confronted by family and friends, who, conditioned by a society afraid of out-of-hospital births, may challenge their decision, feeling it is both unwise and unsafe. Again, a strong inner commitment is required to stand up for the right to birth as they choose.
Practitioners
Who Assists at Homebirths?
There are several types of homebirth practitioners. They include
naturopaths,
family practitioners, nurses, physician's assistants and chiropractors.
Homebirths are generally attended by midwives. It can be said that anyone attending homebirths is also practicing midwifery. In this pamphlet, we will concentrate on having a homebirth with a midwife.
Types of Midwives
There are three basic types of midwives:
Midwifery
A Brief History of Midwifery
Midwife means "with woman." Traditionally, women have attended and
assisted other women during labor and birth. As modern medicine emerged
in the West, birth fell into the realm of the medical. Since women were
barred from attending medical schools, men became the birth
practitioners. Having never had a baby themselves, they were unable to
approach women and childbirth with the inner knowledge and experience of
a woman. Childbirth became viewed as pathological rather than natural;
unnecessary, and often dangerous or unproven, medical techniques and
interventions became commonplace.
During the 1960s and 1970s, along with the women's movement and renewed interest in homebirth, the midwifery movement rekindled. It has been growing steadily ever since. Midwives are becoming more and more involved with birthing families and have been instrumental in redefining birth as a natural event in women's lives.
Midwifery empowers women and their families with the experience of birth. Most midwives honor whatever constitutes a family for individuals, whether it be heterosexual or homosexual couples, single mothers, or any other group of people.
How to Choose a Midwife
Midwives have varying levels of expertise and styles, therefore it is
important to choose a midwife with whom you feel confident and compatible.
The following questions may help the pregnant woman to select a midwife who is well suited to her and her family:
Determine if the midwife's answers to your questions agree with your desires. If your heart trusts her, you have found your midwife.
Prenatals
Prenatal visits may take place at the midwife's home or clinic or at the
family's home. The latter is especially comforting for the family as they
are in their own surroundings and may be less hesitant to ask questions
and get involved. Prenatal visits are also a time for the midwife to get
to know the family and friends, neighbors, or other children who plan to
be present at the birth.
Prenatal care for the pregnant woman includes discussion of nutrition, exercise and overall physical and emotional well-being, as well as overseeing the healthy development of the fetus.
Midwives include the family during prenatal care, inviting them to ask questions and to listen to the baby's heartbeat. Intimate involvement of the family throughout the pregnancy allows for early bonding of the newly emerging family unit.
The midwife and family will often discuss the mechanics of birth. The more people know what's going to happen, the more comfortable they may be while awaiting the birth.
The midwife interviews the pregnant woman to determine if a exists (homebirth may not be a viable option for everyone). A high risk woman has certain medical conditions or special needs. She may have diabetes or blood disorders or be carrying twins or a breech baby.
If they do determine that a high risk situation exists or may develop, the midwife and family decide whether a homebirth is practical. This process is especially important for those families in rural areas many miles from a hospital. As midwives have varying levels of experience, some are more comfortable handling higher risk situations than others.
During this time the midwife helps the family to prepare for the birth. The family may want to have a birth plan. This includes a list of what will occur during the birth: special music, candles, special religious or cultural rituals, who will be in attendance, which room in the home will be the birthing room, what kind of support the mom desires, etc. These steps enable the family to create the atmosphere they want.
Birth is a well designed process, and most women can give birth easily by trusting in themselves and in their practitioner.
Labor
When the mother's labor begins, she calls the midwife. The midwife may be intimately
involved right from the beginning of labor or may be there in more of a
peripheral sense. She is there to serve the family.
At homebirths, family and friends frequently join together in support of the birthing family. Husbands or partners may be very important to the birthing mom during this time. The midwife can help fill the primary support role if other support is not available to a single mom.
Usually someone other than the mom or her partner assumes responsibility for any children who are present, freeing mom to focus on birthing. Another adult may be the designated photographer.
The midwife helps to calm people who are present at the birth. Tension in a room can slow down or stop a labor. The midwife handles these situations so the mom and her partner can continue to focus on the birthing process.
Because homebirth families are well prepared, the birthing process can feel quite natural. They can let go of any fear surrounding birth and trust the process instead. If difficulties occur along the way, they are calmly resolved.
During labor the partner and family nurture the mom. The midwife is watchful for any complications or signs of distress in either the mom or baby. Throughout labor, the midwife asks permission to perform any procedure and explains to the mom and family what she is doing and why.
The birthing process is allowed to take its own course and set its own pace. The general philosophy is that any interventions (administering drugs or trying to hurry things along), can create more harm than good.
In the safety and security of her own home, the mom is likely to be less inhibited about trying different labor positions and locations. She can sit on the toilet or go for a walk outside. She can eat or drink whatever she wants. She writes her own script. When it's time to deliver, she can often try whatever position she wants: on her side, squatting, sitting or kneeling.
Complications
Occasionally, there will be complications during labor. The midwife is
trained to recognize the early stages of complications and to take
necessary action. Transport to the hospital during the course of the
birthing process may be necessary for the health of either the mother or
baby. To promote a smooth transition in this situation, some midwives
have their pregnant moms pre-register at a nearby hospital.
The rate of cesarean deliveries is very low for midwives and homebirths, compared to hospital births. Part of the reason for this low rate is the fact that most homebirths are not high risk. But more importantly, midwives aren't in a hurry. They want to take time with their families. And, it has never been shown that shorter labors are safer than longer ones. Labor and childbirth are a natural process and, unless distress to the mother or baby is indicated, this process is not interfered with through drugs, medical equipment or cesarean intervention.
Birth
Homebirth allows for full participation of family members. Under the
guidance and assistance of the midwife, the opportunity is available for
husbands or partners to "catch" their child as it is born. These moments
can be very powerful and transformational in the lives of the new parents.
At homebirths, babies are usually immediately placed on the mom's stomach or breast, providing security, warmth and immediate bonding between mom and baby. This contact provides security for both mom and baby.
In the rare case when the baby has difficulty breathing on its own, midwives are fully trained in infant CPR. Usually, putting the baby right to the breast and having mom talk to her baby will encourage it to take those first breaths.
Putting the baby immediately to the breast helps reduce any bleeding the mom may have. The sucking action stimulates the uterus and causes it to contract. This closes off blood vessels and reduces bleeding.
After a hospital birth, things can get very busy, with bright lights and so many people doing things to the baby. This can cause a baby to shut down or shy away from people. At home there is an opportunity for everyone to relax. There's time to be quiet, calm and peaceful.
Those first moments are a sacred time, a time to be honored. This is baby's special bonding time with its parents and all the family and friends present. When a baby is born, all that baby wants is to be loved and taken care of. This early bonding allows them to relax and feel secure.
The mother's milk supply usually comes on the third or fourth day after birth. Prior to that, the baby is drinking a substance called colostrum, which has many antibodies to help fight bacteria and build up the baby's immune system. It is also rich in vitamins and protein. The midwife will offer counseling and support in getting started and continuing to successfully breastfeed.
Some members of the medical community have recently acknowledged that having a homebirth decreases the mother's and baby's chances of contracting an infection. The mother is used to the bacteria in her own environment and has built up immunities to it. This is passed on to the baby through the colostrum. Even when women are segregated in maternity wards, infections are much more commonplace after hospital births than homebirths.
One of the benefits of homebirth is that after the birth and special bonding time, mom and baby can be tucked into their own bed in the comfort of their home to rest and sleep. The husband or partner sometimes joins them for rest and deeper bonding.
After the baby is born, the midwife doesn't go away. She is still
accessible for information and support. This can be of great comfort
during the postpartum period when moms have questions or problems. The
midwife will continue to check in on the mother, baby and family for a
usual time frame of six weeks, although some midwives will continue to
get calls for much longer. Some families and midwives form lasting
friendships based on the joy and trust they shared at birth.
Resources
There are many educational resources available which offer detailed
information on birthing and homebirth. These are just a few of our
favorites.
Heart and Hands by Elizabeth Davis Celestial Arts PO Box 7327 Berkeley CA 94707 US Midwifery Today magazine PO Box 2672-350 Eugene OR 97402 US Midwifery@aol.com Mothering Magazine PO Box 1690 Santa Fe NM 87504 US Spiritual Midwifery by Ina May Gaskin 42 The Farm Summertown, TN 38483 US
Jill Cohen lives and practices midwifery in the Eugene, Oregon area. She is associate editor of Midwifery Today, and senior editor of The Birthkit.
Copyright 1994, Midwifery Today, Inc.
Midwifery Today, Inc.
PO Box 2672-350
Eugene OR 97402
541-344-7438
1-800-743-0974
Fax: 541-344-1422
Permission is granted to reproduce this item in electronic form and distribute it freely, as long as: This permission and the authorship of the article are retained in any additional publication of the article. The content of the article is not changed in any way. You do not charge for the article, other than the cost of download and/or connect time, or photocopying costs, in the case of a printed version.
(Parentingweb note: Please obtain copies from the Midwifery Today
website)
To the Miscellany Index
home ap nursing lounge education and development miscellany webrings Links Forum The Book Nook
(Links to all other areas can be found by following the link to "home")
© 1998 -
2006 Tamalyn and parentingweb.com (except as noted)
Disclaimer: The contents of Parentingweb is for informational purposes only
and should not replace medical care from a doctor or lactation consultant.