“Research over the last couple of decades suggests that home birth is at least as safe as hospital-based birth for healthy women with normal pregnancies”.
This quote is from a circular issued by our governing body the Nursing and Midwifery Council (NMC) as guidance for mothers and midwives attending home births.
Emergencies are rare in normal childbirth. If a transfer to hospital is needed it is most likely because the labour has slowed down. All transfers will ultimately be your decision after my recommendation. There is usually time to discuss the reasons for possible transfer. I will of course accompany you to hospital if a transfer is necessary.
I carry emergency drugs, and resuscitation equipment to all the births I attend.
How can I afford it?
Previous clients comment on what value for money they’ve received! (See birth stories). Of course the cost of doula-type birth support costs much less than Midwifery Care due to the level of responsibility involved. Please discuss the type of care you need with me. Payment by interest free instalments helps spread the cost.
Alternative payment arrangements can be arranged in special circumstances. It is worth a phone call to discuss the options.
No one is turned away solely on the inability to pay!
Why can’t we get this type of care on the NHS?
I hope this will be possible one day because of the one mother one midwife campaign. We are campaigning for a restructuring of maternity services to better cater for women’s individual needs. You will be able to choose hospital midwifery care or Independent midwifery care provided by the NHS. Women in New Zealand demanded better care and got it! This is your chance to make a difference. (see Independent Midwives website for more information)
What if something goes wrong?
It is unlikely that things suddenly go wrong in a normal labour, following a straight forward pregnancy. If a problem is detected there is usually time to discuss what is happening and arrange transfer to hospital. The most common reason for transfer to hospital during labour is that labour is progressing very slowly.
The National Birthday Trust report confidential enquiry into home birth 1994 showed “16% of women booked for a home birth transferred to hospital. Dividing women into primigravidae (having first baby) and multigravidae (having second or subsequent babies), 60% of first-time mothers who had planned to deliver at home, did so, and 40% transferred. 90% of multigravidae who had planned to deliver at home did so, and 10% transferred.”
Some of these transfers occurred before labour actually started, whilst others occurred in labour. The single largest reason for transfer was slow or no progress, accounting for 37.2% of transfers. Premature rupture of membranes accounted for 24.8% of transfers, and most of these occurred before labour started. Foetal distress accounted for 14.8% of transfers.” See more of the report at www.homebirth.org.uk
I carry the same drugs that midwives administer in hospital to treat haemorrhage.If baby needs help breathing (which is rare after a normal labour and birth). I carry resuscitation equipment and am trained, and experienced in using it.
If you have known risk factors I will always call a second midwife to attend the birth, and may recommend that you give birth in hospital.
What Pain relief can I use at home?
Everything but epidural!
Water pool, TENS, Entonox, Pethidine (rarely used), as well as any complementary therapies or techniques you currently use.
Support from a known and trusted midwife throughout and comfort measures such as hot and cold packs, a warm bath or shower, enough to eat and drink, and the freedom to move around your own environment reduce the need for pain killing medication.
An updated systematic review of the effects of continuous labour support was published in The Cochrane Library in 2011, issue 2. This review summarizes results of 21 randomized controlled trials that involved 15,061 women and showed:
Overall, women who received continuous support were less likely than women who did not to:
- have regional analgesia
- have any analgesia/anaesthesia
- give birth with vacuum extraction or forceps
- give birth by caesarean
- have a baby with a low 5-minute Apgar score
- report dissatisfaction or a negative rating of their experience.
Women receiving continuous support were more likely than those who did not to:
- give birth spontaneously (that is, with neither caesarean nor vacuum extraction nor forceps)
- have a shorter labour.
You might like to use aromatherapy, acupuncture, shiatsu, reflexology, homoeopathy, hypnotherapy etc. which are not always welcomed in a hospital environment.