Home Birth

By Liz McSporran

Giving birth at home is the choice of a growing number of women. This choice is supported as far as possible by Warwick's community midwives, who are all experienced in supporting those having home births.

If you are considering a home birth, do talk to your midwife, even if you originally chose to have a hospital birth but now feel differently. There are some situations which may lead her to recommend giving birth in hospital, if she considers this to be safer for you or your baby. Raised blood pressure in pregnancy or particular difficulties in previous labours are examples of where a hospital environment may be safer. However, most women with no previous problems or pre-existing health issues, and who remain well during pregnancy can safely plan to give birth at home.

Advantages of labour and birth at home include:

	being in a familiar, comfortable and private environment
	having family members around
	including other children in the birth of a new family member
	feeling more in control - not having to adapt to a hospital routine, and being able to move around as wished
	continuity of care

There are some perceived disadvantages, such as limited pain relief choices. In fact, it is only epidural anaesthesia which is not available; midwives bring entonox (gas and air) with them, and pethidine can be prescribed beforehand by GPs for use in labour. Non-pharmacological methods of analgesia are also available for use at home -TENS machines can be hired, warm baths can ease pain (and should you wish to have a waterbirth, pools can be hired to set up in the home). Keeping mobile in labour not only promotes good progress in labour but also helps with pain, and of course being relaxed in comfortable, familiar surroundings helps too.

Another concern is that should there be a problem there would be need for transfer to hospital. This does occasionally happen and is most usually because labour is not progressing as we would expect. Partners of women wishing to give birth at home may be anxious about safety; often they are helped by talking to someone else whose partner has had a home birth and who can discuss anxieties. Current research is starting to show that well planned home births are associated with fewer complications than those in hospital.

When the time approaches to give birth at home some preparations will need to be made:

	make sure there is reasonable light and a source of heating in the room where the baby will be born
	arrangements for other children; even if they are to be involved in the birth it is best to have another adult (other than birthing partner) who can care for and support the children should they be disturbed or anxious about their mother's condition
	clear area in which the labouring woman can move around easily
	equipment to assist with labour, eg birthing ball, mat, bean bag
	plastic sheeting to protect mattress or carpeting in the place where the birth will take place
	towels, clothes, blankets for the baby

If you have planned a home birth your midwife will give you information on what to do once you think you are in labour. A midwife - if not your own, usually one from the same team- will then come to see you and assess if labour is under way. Once labour is established she will stay with you until the baby is born. A second midwife will join her as labour progresses and she will also stay with you until after the baby is born. They will ensure that you and the baby are well, comfortable and that the baby has had opportunity to feed before leaving. According to the time of day, your midwife will visit either later the same day or the following day. Post-natal care then proceeds as for all mothers and babies, the midwife visiting as necessary for the next 10-28 days.

The baby will be examined at birth by the midwife, and a medical examination organised for him or her. Most GPs are happy to do this medical examination either at home or in the surgery; in the cases where this is not possible an appointment will be made to see a paediatrician at the hospital 24-48 hours after the birth.

Great Books on Home Birth

(Click on the pictures to buy any of these books from amazon.co.uk)

This is a wonderful book that details all the benefits of home birth, complete with supporting research.

It is easy to read and split into relevant and manageable chapters, so that you can scan the sections that you are

interested in or read it from cover to cover. Highly recommended ****