Preparing for a home birth
If you're planning to have a home birth, your midwife will tell you all about what preparations you need to make. Do as much as you can about four weeks before your due date so that you don't have to rush around getting everything organized at the last minute, and you are at least partly prepared if your baby comes early.
Decide which room you're going to use for the birth and arrange everything so that it's convenient and comfortable for you and your midwife. Put the bed at right angles to the wall, with plenty of space on each side so your midwife can reach you easily. A week or two before your due date, she'll bring round a home birth pack of medical equipment. The contents will be sterile, so don't open the pack.
Whether you want to deliver your baby on to the floor or your bed, the bed itself and the floor area below and immediately around you will need to be protected during the birth. Make sure you have some old clean sheets, big towels, and a large piece of plastic sheeting to hand so that it can be put down quickly when the time comes.
What your midwife will need for a home birth
It's useful to put a small side table or a tea trolley next to the bed so your midwife has somewhere to put her instruments and other equipment, although a couple of tea trays will do. She'll also need a bright, adjustable reading lamp so she can direct light on to your perineum. Have a torch (with spare batteries and bulb) ready too, just in case there's a power cut.
Stock up on food, drink, and other essentials in the few days before your baby's due. When shopping, remember that you'll need food for your midwife and for any visitors you may have as well as for yourself, your partner, and your other children (if you have any).
When labour starts
When your contractions are coming every 15 minutes, are about one minute long, and don't die away when you move around, telephone your midwife according to your arrangements. First labours often take a while to get going so, although your midwife will want to know that things have started happening, she's likely to suggest that you try to relax and get some rest until you're in full labour - it's important to conserve your energy. All independent midwives can be contacted by mobile phone, so it's easy to keep in touch.
Final preparations for a home birth
Make sure everything else that you and the midwife will need, for the birth and immediately afterwards, is ready - including your comfort aids, bowls for washing, a bedpan (or a clean bucket), clean towels, and large plastic bags for the soiled sheets, sanitary pads, and used dressings. Then put out a clean nightdress or large nightshirt for yourself, make sure you have clothes and nappies ready for your baby, and prepare her cot.
Her equipment will include a sphygmomanometer to take blood pressure; Pinnard stethoscope or sonicaid; Entonox (gas and air) cylinder; urine-testing sticks; local anaesthetic and syringes; scissors; suture material; mucus extractor; resuscitation equipment; intravenous equipment, in case of bleeding; syntometrine. If you want to make sure there are pain-relieving drugs available, she'll give you a prescription in advance.
Going to hospital unexpectedly
With the help of a skilled midwife or doctor, a home birth is completely safe for both you and your baby. But, as is also the case with hospital births, there can be complications, and if there's a serious problem you might have to go into hospital instead of having your baby at home. If that should happen, your midwife or doctor will go with you.
It can be bitterly disappointing if you can't give birth at home after all your plans, but if you and your partner accept that this might happen and talk about it in advance, it'll be easier to cope with it if you do have to transfer to hospital. It's better to tell yourself that you're going to start your labour at home and see how it goes before deciding where your baby will actually be born.
Your home birth checklist
Most preparations can be made well in advance, but you'll still have a few things that you need to take care of at the last minute.
When you go into labour, you should:
- call your midwife
- make contact with your partner or birth coach
- get in touch with whoever's going to care for your other children, if it's not your partner
- check that the room is ready
- check that your labour aids are conveniently to hand
- make yourself a hot, sweet drink.
Factors against a home birth
Normally, it's as safe to give birth at home as it is in a hospital, but there are circumstances when a hospital birth is your only option.
Factors that will rule out a home birth include:
- if you have a condition such as diabetes before your pregnancy, or you develop it during pregnancy
- when you've had complications in previous pregnancies
- when your pelvis is too small for your baby's head to pass through
- when your baby is in the breech position
- when you develop a medical problem that puts you, your baby, or both of you at risk, such as: high blood pressure; anaemia; excess amniotic fluid; active herpes; placenta praevia; abruptio placentae; pre-eclampsia; or eclampsia
- when you have a multiple pregnancy
- when your baby is premature
- when your pregnancy goes well beyond your EDD (see Are you Overdue?).
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