• Julie Smeaton

What About Birth at Home?

In light of the most recent government guidelines during the Coronavirus Pandemic, I think the best thing you can do if your pregnant is to prepare for all eventualities.  This is always important in any birth plan but even more so now. I’m aware that people who wouldn’t have considered homebirth before may start to see it as a safe option for them and their families and I want to share some reassuring information.  As someone who has done it and wants to support anyone who is considering it, I’m here to talk in the coming months. *Safety* 🧠 The most recent research reported in the Lancet medical journal in 2019 has shown that planning a homebirth is as safe for low risk women as planning a hospital birth. In addition, you have a much lower likelihood of being recommended forceps, ventouse or a c-section if you plan to birth at home. The research assumes that you do not have Covid-19 at the time of birth and if that were the case clearly different advice would apply. Please see below the link to the Lancet research and also really helpful NHS handouts on homebirth. *Physiological Pain Relief* 🙏🏻 Homebirth is in and of itself a form of pain relief. Being comfortable and safe in your home environment and not under any threat or time pressure means that you perceive pain differently. Oxytocin and beta-endorphins rise naturally as you labour with no intervention, meaning you can feel love and euphoria which helps with pain. Conversely, in an environment where you feel stressed or unsupported your adrenaline rises which increases your perception of pain and can lead to a fight or flight response- not helpful at all and can result in labour slowing down or stalling. *Gas & Air* Entonox can be provided in a portable can (like a scuba diving tank) that works in the same way as a hospital one and can be invaluable during the hardest parts of labour. Some NHS trusts also offer pethidine or diamorphine, a pain relief injection which can be given at home.

*Two Midwifes with medical equipment*👩‍⚕️👨‍⚕️ Usually at a homebirth you will have two midwifes attend you that stay until your baby is born and afterwards to check you are ok. This is considerably better than hospital when you will have one midwife, who may change shift. Over a 16 hour period in hospital you could have 4 different midwives, including a change of midwife just as you are about to deliver your baby. This does nothing for continuity of care and can be very unsettling. It might be worth noting here that in busy times in hospital, it’s possible that you wouldn’t be assigned your own midwife until you are in established labour. It’s also worth knowing that your midwifes will carry extensive medical kit should you or your baby need it. This includes a doppler to monitor your baby’s heartbeat in labour and the same resuscitation equipment used in a hospital should your baby need help taking its first breaths. They obviously carry sterile equipment to cut the cord, synthetic oxytocin should you show any signs of haemorrhage and vitamin k should you want to give that to your baby after birth. Essentially everything that is available to you at a birth centre, is available to you in the comfort of your own home. *You can birth where you want*🛁 One of the main reason’s women choose to birth at home is the ability to use any props they want in the comfort and safety of their own home. Nobody is going to tell you there are no pools available or you must stay on your bed. A birth pool can be hired locally or bought, and these are much more comfortable than a bath or hospital birth pool as they are inflatable and therefore padded. They also are taller, ensuring the pain-relieving warm water reaches up and around your lower back and bump. They are easy to fill with a hose connected to your tap and result in zero mess. There is a disposable liner that can be disposed of once the pool is drained and that is all there is to it. *Mess isn’t an issue* People often think of homebirth being messy. In reality, people prepare of course. You can lay plastic sheets followed by comfy old sheets/towels on your bed, couch or floor depending on where you feel most comfortable. A lot of women find birth happens in the safe space of the bathroom which is easy to clean. Mess just isn’t an issue and it’s a lot more sanitary to have your own shower after than sharing a dirty shower room with 3 other postpartum women on the same ward… *Transfer to hospital can still mean a great birth* 🏨 Sometimes mothers make the choice to transfer to hospital during their homebirth. This does not necessarily mean anything has gone wrong and is most often for things like a long labour and the mother would like an epidural or meconium in the waters meaning you might decide to have further monitoring. The great thing about a planned homebirth is that so much of the work of labour is done in the comfort of your own home that the rest of labour is more likely to continue in a physiological way. It also means less time spent in a hospital where your movements are restricted. 🌟In these uncertain times, staying at home for as much of your labour as you can is more important than ever. If you plan a homebirth you can stay at home for longer, knowing if your baby wants to arrive at home you are prepared.🌟

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