International perspective

The Netherlands is the odd one out when it comes to childbirth. It’s the only Western country where more than 30 percent of births take place at home. A system of highly trained, independent midwives and maternity aid nurses makes it all possible. But some people wonder whether home birth will survive.

Read the story, Home sweet home birth and listen to the documentary online.

August 31, 2006 | Filed Under Home Birth, Midwives/Midwifery, Politics | Leave a Comment 

Q: Who cleans up the mess from a home birth?

A general rule seems to be your midwife and her assistant(s) will leave your house as tidy as they find it, if not a tad better.

I recommend each family planning a home birth give the home a thorough cleaning by week 37 and do easy maintenance after that until birth day. This should include the bathroom most likely to be used by the mother in the event she gives birth there– make sure toilet, floor, and shower/tub combo are clean; the kitchen where food preparation will take place along with tasks such as medication, herbal, or homeopathic preparation if necessary, and a place to inspect the placenta following birth. If you have pets who shed, vacuuming frequently will cut down on the fluff that may accumulate onto your supplies during labor (or even into the birth tub water).

If space permits, it is nice to have a corner for the midwife apart from you. Women often do better (my opinion) in labor when they are not feeling as if they are being watched or hovered over. The midwife can still be in your home available for your every need, to sneak in for quiet assessments, yet not in your immediate space where she can knit, read, or catch up on her paperwork. If labor is steady and occurs over night, she can use this space to nap. I’ve known many a midwife who can power-nap under the kitchen table!

Your midwife and her team will clean as they go. I ask my clients to have on hand at least two extra large trash bags. One will be used for laundry, the contents of which will then be tossed into the washer before we leave if it is empty and ready for a load and the other for trash (your midwife will carry a sharps container for the proper disposal of needles used for injections, intravenous catheters, and/or suturing).

Most of the time the family makes arrangements for the disposal of the placenta. Many toss it out with the household garbage. One city told us the placenta was equivalent to the menstrual waste of one woman per household and any more at one location required medical waste disposal; check with your city for proper disposal instructions. Other families save it to plant a commemorative tree, bush, or flowering plant. Some midwives’ tales speak of greener grass having been watered with the discarded water from the birth tub or roses the size of cabbages from being planted atop a placenta. I have had families donate their placentas to student groups for study. Still others will ingest the placenta or have it dried into a Chinese medicine preparation.

We work really hard to make sure wherever mom lands there is an absorbent pad underneath her to soak up blood, amniotic fluid, or mucus. Birth, in my experience, tends to be more wet than messy. So we make sure to have an ample supply of towels to dry mom off between trips into the shower or tub. We do our best to make sure there isn’t any blood on the carpets but in case we’re unsuccessful hydrogen peroxide is very effective for soaking up fresh drops without leaving a stain behind. There are no guarantees however so many families will buy painter’s drop cloths to fashion runways out of in areas where mom is most likely to wander in labor. One family who worked in real estate went so far as to use the adhesive plastic floor runners throughout the house. It was perfect and clean up was a breeze!

Bed preparation and protection is pretty easy and for many this is an early labor task. Take a drop cloth or shower curtain liner and put it over a clean, yet okay to get messy sheet. On top of the drop cloth or shower curtain put another clean, yet okay to get messy sheet. Cover your pillows with plastic covers if you like and be sure to use blankets you don’t mind getting messy. And that’s it. Following the birth if the top sheet has been used, we’ll peel that off and reveal the bottom clean sheet and tuck you in.

If you rented, borrowed, or purchased a tub or pool for use in labor and/or birth you will need a hose for getting water into it and that same house can be used to remove the water. Some families do the old siphon trick but a sump pump will do the work quickly without the aftertaste! The water can be drained out a window, through a sliding door, or down the bathroom tub drain. In my practice I provide the tub and the pump, the family is to make sure they have the hose, faucet adapters, and any other supplies needed to complete the set up.

The best advice I can give you about how to prepare for your home birth is simple: Gather all of the household supplies and customized birth kit your midwife requests unless other arrangements are made. Keep the items in one place, a laundry basket for instance and maybe a new one at that because new babies generate laundry! On birth day your midwife or her assistant(s) will head for that laundry basket and assemble your supplies neatly in one place without going on a household scavenger hunt!

August 28, 2006 | Filed Under Home Birth, Home Birth Preparation | 2 Comments 

VBAC water birth at home

Enjoy this … thanks to Emma’s mom who was kind enough to share it with the world!

August 26, 2006 | Filed Under Home Birth, VBAC | Leave a Comment 

Imagine that: “emergency birth” at home!

If a severe flu outbreak hit Orange County, women in labor could be turned away from quarantined hospitals. Prepas and Lorri Walker want to let people know about alternatives to hospital births: birthing centers and home births. Currently 1 to 2 percent of babies are born at places other than hospitals. In a disaster, midwives and other medical personnel could deliver babies in offices, homes or businesses.

Now there’s a twist! Planning a home birth as a back-up to the hospital! Actually it’s my belief that every family planning a hospital birth should be prepared for a home birth to optimize the safety of it. We read many stories of unplanned home births or births on the way to the hospital and wonder how much better could these good outcomes have been had they been prepared for the what-ifs? I’m not suggesting everyone learn how to be a midwife but having a few of the basics on hand (like cord clamps instead of dirty shoelaces) or learning newborn resuscitation ahead of time could only help a panicked dad help his new baby.

This disaster plan is a great idea! Imagine a civil service corps of licensed midwives experienced in out-of-hospital births equipped with basic birth kits and integrated into the emergency response teams! Even on a daily basis it would be fantastic to enlist midwives onto paramedic teams for those unplanned home births. I’ve heard it many times from paramedics and firefighters the last thing they want to do is attend a birth! The last thing I want to do is go to a fire or car accident call so wouldn’t it be nice to integrate specialties?

Lorri mentions in the article that if you gave her an hour and Winnebago she’s have a birth center on wheels. True! Just with the basics on hand I’d guess that most home birth midwives have enough supply on hand to attend 10 births back-to-back. This is such a fantastic idea it makes my head swim with the possibilities of how I could do my part.

Name-dropping: If the name sounds familiar, Lorri Walker was mentioned in my third Podcast with my husband. She was my own midwife for our three home births. Her friend Robbi Prepas is a dynamo and has the most amazing travel stories from her calls to service around the world. I have attended births with both of them and would happily join any disaster relief team they spearhead. Read the full text of Disaster Plans for Childbirth at RedOrbit.com.

August 26, 2006 | Filed Under Home Birth, In the News, Midwives/Midwifery | 2 Comments 

Cranky Midwife

This description of what I am a part of– and perhaps what you are part of if you’re a regular reader– takes the cake. It’s from a blogdoctor as some sort of compliment to another for his or her part in revealing the dangers of home birth:

home birth activist-jihadist movement

Wow. I can’t think of anything else to say to even write a complete post… except keep fighting the good fight all of you Crusaders for Freedom of Choice in your health care be it with a direct-entry midwife, a certified nurse-midwife, an obstetrician, a family practice doctor, or all by yourself in the hospital, a free-standing birth center, or in your home. I don’t understand resorting to insults and name-calling. It’s not a very productive way to communicate or make progress and perpetuates “sides” to arguments which really are a lot closer to the same (informed choice, informed consent in this instance) than one might be willng to admit.

I am also slightly annoyed at the word movement that seems to suddenly be everywhere, appended to home birth. It is amazing to me how in such a short time home as the norm has turned into a movement without any regard for home birth always being an option. We didn’t invent home birth, we invented hospitals and birth centers for birth.

Please share your thoughts on that inflammatory title given to home birth advocates. Is it just annoying on the level of pizzas are for home delivery, not babies or is it really offensive especially given current world events? Come out of lurkdom and share your thoughts (I know you’re peeking :) )!

August 23, 2006 | Filed Under Politics | 5 Comments 

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