Midwives offer "choice of birth place" to their clients and are equally comfortable attending births at home or in a hospital setting. Research about home birth is evolving and suggests for healthy, low-risk women home birth is equally safe as hospital birth. Home birth may even offer certain advantages, like lower rates of infection and less use of interventions such as forceps or c-sections. Your midwife will help to determine if you are a suitable candidate for home birth. We encourage you to explore your options and develop a plan with your midwife that best meets your needs.
- All About Home Birth
- Who Can Have a Home Birth?
- What Are The Advantages of Home Birth?
- What Are The Advantages of Hospital Birth?
- What If a Complication Arises?
- What Pain Relief is Available at Home?
- What Happens After The Birth?
- Additional Resources
All About Home Birth
Home birth is a safe option for women with healthy, low-risk pregnancies. Midwives are trained to respond to medical emergencies and carry equipment and medications to treat common complications of childbirth. This includes oxygen tanks for mother and baby, resuscitation equipment for newborns, intravenous supplies, tools for suturing tears and medications to treat heavy bleeding. Usually there are two midwives at every birth. In certain situations we use a trained birth attendant in place of one midwife. The second midwife or second birth attendant will assist your primary midwife near the end of the labour.
Who Can Have a Home Birth?
Home birth is best suited for women with healthy, normal pregnancies that are free of complications. Most women fall into this category. The pregnancy should be at term (greater than 37 weeks gestation) and there should be a single baby in the head-down position. Your midwife can discuss your particular situation in detail to determine if home birth is right for you.
What Are The Advantages of Home Birth?
Current research demonstrates that there is NO increase in stillbirth, neonatal death or maternal death for women who choose a home birth. Studies also show the following advantages for women who birth at home:
- Less likely to have a c-section
- Less likely to have a forceps or vacuum delivery
- Less likely to have an epidural
- Less likely to use medication to start or increase labour contractions
- Less likely to have an episiotomy
- Less likely to have an infection after the birth
- Less likely for their baby to have an infection after the birth
Women chose home birth for a variety of other reasons:
- They view birth as a natural process with no need to be in a hospital environment
- They want to avoid an overnight stay without their partner or other children
- They wish to have a water birth (not available in hospital)
- They feel safer and more in control at home
- They would like the increased privacy of a home setting
- They want to avoid the cost of hospital birth if they do not have OHIP
- They have had a previous positive birth experience in hospital and now feel confident to have a home birth
- They are worried about the effect a hospital environment might have on the progress of labour
- They would like to avoid certain hospital protocols and procedures
- They wish to include a large number of family and friends or other children in the birth experience
- They feel more comfortable in their own environment with own foods, clothing, bedding, shower etc.
- They are concerned about delivering en route to the hospital if there is a history of fast labours
What Are The Advantages of Hospital Birth?
Even though current research does not show increased risks to mother or baby when women chose home birth, there are some advantages to a hospital birth including:
- Quicker access to blood products for transfusion in emergencies
- Potentially quicker access to on-call specialists (obstetrician, paediatrician)
- Additional equipment, medications and staff to assist in emergencies
- Possible delay in ambulance transport if other emergencies are occurring in the community or if poor weather conditions are present
- Access to a physician who could intubate a baby who is not breathing when meconium is present in the amniotic fluid
- Availability of continuous nursing support for mothers who would like a longer hospital stay and feel they would rest better in a hospital setting after the birth
What If a Complication Arises?
If there are problems with your labour, such as slow progress or concerns about the condition of the mother or baby, your midwife will advise you about transferring to the hospital. Depending on the nature of the concern and the stage of labour you would travel either by car or ambulance. During a home birth, we aim to detect abnormalities at an early stage and transfer to hospital before they become emergencies. It is extremely rare for an intervention such as a c-section to suddenly become necessary with no earlier warning sign. However, it is always possible that you may need emergency treatment and it may take longer to access this treatment when transferring from home to hospital. Midwives work together and in partnership with their local hospitals to communicate effectively and transport patients from home to hospital as quickly and smoothly as possible. The midwife will call ahead to the hospital to notify them of the situation and organize a team to be prepared for your arrival. We encourage all clients to attend a pre-admission clinic at the hospital to fill out necessary paperwork to speed a hospital admission. We also notify the local ambulance service of any clients planning a home birth and include important directions and details about the planned location of the birth.
What Pain Relief is Available at Home?
Labours tend to progress well at home, where the mother is relaxed and free to move as she wishes. Women seem to cope best with the discomforts of labour when they feel comfortable, supported and in control. There are several self-help techniques to help women cope with labour at home. These include:
- Breathing and relaxation techniques
- Warm showers or baths
- Different positions
- Movement such as walking, swaying, rocking
- Massage, aromatherapy, homeopathics and other complimentary therapies
- TENS (transcutaneous electrical nerve stimulation)
- Sterile water injections (for back labour)
- Over the counter pain relievers like Tylenol
If a woman feels she has exhausted all options at home and requests further pain medication, care can be transferred to the hospital for additional pain relieving medications.
What Happens After The Birth?
After delivery your midwife will make sure you and your baby are making the normal transition and recovering normally from the birth. We will ensure the baby is breathing well and will help you to breastfeed. We will do a complete newborn exam and clean and dress the baby. We will carefully monitor the mother's bleeding and make sure you have something to eat and help you to shower and dress. We will make sure you are able to pass urine and are comfortable in a clean bed and resting well. We complete our paperwork and give you instructions about warning signs to watch for in the first day. Your midwife usually leaves your house about 3 hours after the birth and will return to your home again within 24 hours. We recommend that you not be left alone for the first day. Someone should be inside the house to help you. Your midwife can be reached 24 hours a day on the pager if any concerns develop.