Labor and Birth Care

Labor
When the mother's labor begins, she calls the midwife. The midwife may be intimately involved right from the beginning of labor, or she may be present in more of a peripheral sense. At homebirths, family and friends frequently join together to provide encouragement. Husbands or partners may be the primary source of support for the birthing mom. The midwife can help fill this role if other support is not available.

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 calm those 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.

During labor the partner and family members nurture the mom. The midwife watches for complications or signs of distress in either 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) cause 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 try whatever position she wants: on her side, squatting, sitting or kneeling.

Complications
Occasionally, complications occur during labor. The midwife is trained to recognize the early signs of complications and to take necessary action. Transport to the hospital during the birthing process may be necessary for the health of 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 cesareans is generally very low for midwives attending homebirths, compared with hospital births. Part of the reason for this low rate is the fact that most homebirths are kept low risk by good prenatal care. Furthermore, midwives generally don't hurry the birth, which, ironically, often speeds it up ending in a C-Section. When a midwife and mother build a personal relationship, this trust helps women let go and have their babies more easily. Labor and childbirth are a natural process, and unless distress to the mother or baby is indicated, no one interferes with this process through drugs, medical equipment or cesarean intervention.

Birth
Homebirth allows for full participation of family members. Under the guidance and assistance of the midwife, husbands or partners have an opportunity 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 placed on the mom's stomach or breast immediately, providing security, warmth and bonding between mom and baby. In the rare case in which 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 also 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 many people carrying out procedures on the baby. This can cause a baby to shut down or shy away from people.

At home, on the other hand, there is time to be quiet, calm and peaceful. Those first moments are sacred-baby's special bonding time with parents. A new baby wants only love and nurturing. This early bonding allows the baby 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 common after hospital births than homebirths.

One of the benefits of homebirth is that after the birth and bonding time, mom and baby can be tucked into their own bed to rest and sleep. The husband or partner sometimes joins them for rest and deeper bonding.

After the baby is born, the midwife 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 usually continues to check on the mother, baby and family for six weeks, although some midwives continue to get calls for much longer. Some families and midwives form lasting friendships.

In addition to your partner, you may want to consider having another person available to help at your birth. The roles of labor support and midwife are two different jobs.

If you are in and out of labor over a period of days, or are simply experiencing a very long labor with slow progress, you should expect that we will not be with you the entire time. We may come and go, checking in on you and giving recommendations for support, or I may sleep at your house.

If you have other children who will be present at the birth, you should have someone available, other that your partner, who will see to their needs when you are in labor and afterwards.