Home birth is something I've grown passionate about in the last few years. I began my medical training in emergency medicine and learned quickly that having a baby at home was "dangerous and irresponsible-everyone dies." I believed what I was taught because, as an ambulance worker, that's all you see-trainwrecks by irresponsible midwives and dire circumstances. It wasn't until I was pregnant with my second child that I really started to look deeply into the idea of homebirth. I started to realize that not all midwives are created equal and they aren't well regulated in the US. Where I live (the state of Utah) anyone can essentially start calling themselves a midwife and delivering babies, so researching who you're hiring is especially important.
Soon after my own second birth I stared working for Cyndi as her Assistant. She is a Certified Nurse Midwife, meaning she's essentially a Nurse-Practitioner that has specialized training in midwifery. She can prescribe medication, place IV's, is certified in Neonatal Resuscitation (both to perform it and teach it) and carries a hospital room with her in a very large Mary Poppins bag. Nurse-Midwives are the happy middle ground or bridge between the homebirth and hospital world. I've also had the privilege of photographing and working with other midwives including CPM's and DM's and have been very impressed or disappointed (so I'm not saying that a CNM is your only option, there are responsible midwives across the board).
A 2012 study found: "Differences in practice between CNMs and MDs seem to be well documented, particularly in the use of technology. Yet, the findings provide evidence that care by CNMs is safe and effective. CNMs should be better utilized..." The review, published in the January 2012 issue of Women's Health Issues, also found reduced incidence of perineal lacerations (tears in your vagina) and a higher likelihood of breast-feeding in births attended by certified nurse midwives. Patients of CNM's tend to also be better educated about their births and better prepared for birth and breast-feeding.
What many people don't realize is that a key part, probably the most important part of a midwives job is risk management. This means that if red flags arise throughout your pregnancy and birth, you may find yourself "risked out" of your midwives practice and escalated into the care of an OB. We're not homebirth or die around here. This is why homebirth can be such a safe and gentle option-by having good prenatal care with a vigilant midwife you can assure that you'll have a safe experience delivering your baby at home.
But what about the part where everybody dies? Well the 2 things you run into with full-term, healthy, low-risk women is the risk of bleeding and the risk of baby not wanting to breathe. Those are quickly remedied. A good midwife should be trained in Neonatal Resuscitation, have an assistant that is trained as well, and carry all of the necessary equipment to perform it. According to American Academy of Pediatrics "Approximately 10% of newborns require some assistance to begin breathing at birth. Less than 1% require extensive resuscitative measures." Those are great odds, and of the few we've needed to resuscitate, every one has perked up almost immediately with very little assistance. In terms of bleeding, CNM's treat it using the same drugs and procedure that they do at the hospital.
Not everyone is a good candidate for a home birth and not everyone wants to have one, and that's fine. My mission is to help women see and understand what their options are, and to also see that home birth can be a safe and wonderful option. Staci was gracious enough to let me capture and post this beautiful and intimate experience of her birth at home with Cyndi, to show off some of the key elements of a home birth.
Staci was GBS positive (the swab test they do towards the end of your pregnancy). This meant she needed antibiotics before delivery to prevent possible infection. She wasn't a fan of the IV so she kept it covered for the 10 minutes it was in.
People often assume that Cyndi and I show up, put a stick in your mouth, corral you into a bathtub and deliver your baby in a huge mess, pack up and leave. It's a little different than that-we're really big on chucks pads (no mess), safety and allowing you to labor how and where you want.
Before the birth Staci ordered her birth kit. It included chucks pads, mesh panties, a peri bottle, cord clamps, straws, measuring tape, baby hats, and several other needed supplies.
Staci had decorated her guest bedroom for the birth with birth affirmations from her blessingway.
You'll notice the huge bag (Mary Poppins bag) next to Cyndi as she sets up oxygen and resuscitation equipment. We set it up before every birth and hope we never have to use it.
Unfortunately Staci had a very small water heater-meaning we had to go old school and boil water to help fill up her birth pool. Laboring and delivering in water is a great form of pain relief and many women choose water at some point during their labor. It makes me laugh every time I have to use the phrase "Go boil some water" during a birth because it feels so Little House on the Prairie.
Staci trying to look like she's in labor.
Staci actually in labor.
It's pool time.
Things were actually getting serious and starting to hurt a bit more.
Staci's husband was incredible and hopped in the tub with her to support her.
We check fetal heart rate using a doppler instead of mother's needing to wear a continual monitor.
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Baby! Sweet relief.
We quickly assess baby on mom's chest to be sure everyone is doing well.
We closely monitor how baby is oxygenating using an sp02 monitor immediately after the birth.
Anatomy lesson! How cool is this placenta?! Staci's amniotic sack (bag of waters) was made of steel and didn't want to break. You can see it here stretched over Cyndi's hand. That is where her baby lived for 9 months!
After the birth we give the parents and new baby a chance to bond and breast-feed. Then we follow up with Postpartum Instructions.
Postpartum Instructions are a list of the do's and don'ts for postpartum-including eating nutrient dense food and resting well.
Cyndi performs a full newborn assessment, checking reflexes, vitals and weighing and measuring.
Daddy gets to diaper and dress baby for the first time.
If you have more questions about homebirth or birth in general, feel free to contact me or comment below. Like I said before, my mission is for women to be informed and make the best decisions for them. Any way I can promote awareness about something I feel could be beneficial to the birth world, I do it! Here are a few more articles about birth found on my blog:
And special thanks to Alecia Dawn Photography for allowing me to use many of her photos. I was attending this birth as Cyndi's Assistant and could only snap a few in the beginning before I had my hands full with other duties. We had quite the fun birth team attending this birth.
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