What are some advantages of homebirth?
There are many advantages to homebirth including: safety and avoidance of unnecessary interventions, privacy, comfort of your own personal space, decreased risk of infection, exposure to only a familiar environment, the laboring woman is in control and in the place of central focus rather than staff or protocols, one-on-one care and support, being surrounded by familiar faces, avoidance of stress related to knowing when to leave and travelling to an unfamiliar environment, bonding is enhanced as mother and child remain together as one unit, and pregnancy and birth are viewed as normal, healthy events.
Is homebirth safe?
Numerous studies have shown the safety of homebirth. Additionally studies have also highlighted the improved outcomes when excessive interventions are avoided.
Are homebirths and midwives legal?
Yes. In Iowa and South Dakota, Certified Nurse Midwives practice independently (without a required physician collaborative agreement) and home births are not regulated. Therefore, I am legally able to attend home births in both Iowa and South Dakota. The state will send out a birth certificate packet and you can file for your birth certificate and Social Security Number with one form. Current laws in Nebraska do not allow a Certified Nurse Midwife to attend a home birth.
Can anyone have a homebirth?
Homebirth is a wonderful option for low risk women. It is not suggested for all women and families but many women can give birth safely and comfortably in their own home.
How often will I have prenatal visits and where do they occur?
I offer prenatal care on a typical schedule. This includes visits monthly until 28 weeks, biweekly until 36 weeks, and then weekly until birth. I am available for questions at any time and your prenatal care can be customized to fit your needs whether that involves extra visits or a longer space between visits. The visits occur in your home or at my office depending on the time and availability.
Who can I have at my birth?
It is your birth and it is your choice. You may have as many or as few people as you would like to invite to your birth. It is important to discuss flexibility with all friends/family you plan to include because labor may or may not go as you envisioned and you may desire more support or more privacy than initially expected.
Can I eat and drink during labor?
You are encouraged to follow the cues of your body and eat and drink as desired. You are doing a strong physical work and your body requires nourishment. Having basic snacks and beverages available at home gives you the opportunity to have what sounds good when you need it. The Cochrane Review found no benefit and therefore no justification in the restriction of eating or drinking throughout labor
Do I have to be in a specific position to give birth?
No. There are many advantages to having an unmedicated labor, one being the ability to move freely and change positions as necessary. Labor often progresses better with movement and pain is often better tolerated with movement. What movement you choose is up to you. When it comes time for pushing, these facts remain the same and alternative positions are often preferred; in the end, your baby is born in whatever position you happen to be in at the time. In fact lying flat on your back during birth creates the smallest pelvic opening, works against gravity, and provides the most tension on sensitive tissue.
But doesn’t it hurt?
Our culture surrounds us with horror stories of pregnancy and birth. Random strangers will not hesitate to tell you the worst story they know from their best friend’s cousin. We are all too often told how bad birth hurts and how quickly you should be asking for an epidural. But that doesn’t have to be your reality. Birth is a different type of pain. It is not a pain of injury but rather a pain of work (and some will say it is not even pain at all). But, it is there for a purpose. It draws you inward, it brings you to a safe place, it engages support, and it signals a cascading hormonal reaction that helps you cope, as well as creating an ideal environment with which to begin your mothering journey. It is not something to escape or remove, but simply something to work with and through much like any other great adventure in life. You are strong and you are capable.
What do you bring to a birth?
I feel it is important to be prepared for many circumstances. In normal natural birth very little is needed and my bags barely get unpacked. I have a Doppler and fetoscope for listening to baby’s heart rate during labor, thermometer, stethoscopes, and a blood pressure cuff to evaluate mom during labor and both mother and baby after birth. In the rare case that they are necessary, I also bring IV supplies, antibiotics, oxygen, suction equipment, medications to manage bleeding, suture, and numbing medication.
What happens after birth?
When your baby is born, he or she is placed on your chest. Many studies have shown mothers to be the best source of temperature regulation and have recognized the benefits of early breastfeeding. Your baby is yours and has no better place than to be than with you. Your baby will not be taken from you for any procedures or exams. Early nursing provides benefits to both mother and baby and support is provided as needed. After baby has nursed well and you have had time to bond, a thorough newborn exam is done at your side with education provided about baby’s unique abilities and general newborn care. You will be encouraged to eat and will be assisted to the bathroom and to a shower or bath if desired. We will get the birth area cleaned up and laundry started. Once both you and baby are doing well and feeling settled, we will leave you to rest and bond. I will remain in contact with you through phone and home visits and I am available at any time.
What if things don’t go as planned?
Nothing in life is guaranteed. Many plans are made regarding the birth of your child and I will do what I can to assist you in having the birth you desire. I will always be in close communication with you if I have concerns or if there are decisions to be made. Ultimately, it is your body, your baby, and your birth, therefore all decisions are ultimately yours. The majority of the time, birth is not a medical event and does not require a hospital setting, however in the event that complications arise, I will accompany you to the hospital and will remain with you as needed.
Will insurance pay for a home birth?
Some will and some won’t. I accept clients with and without insurance. There is a flat fee that covers prenatal care, labor support, birth attendance, and postpartum care. This fee is due by 36 weeks and a discount is offered if paid early. Insurance cannot be billed for care until after your birth has occurred. If home birth is a covered service, I will work with you to bill your insurance which will be paid as a reimbursement to you.
- Janssen PA, Lee SK, Ryan EM, Etches DJ, Farquharson DF, Peacock D, et al. (2002). Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia. Canadian Journal of Midwifery,166(3), 315-23.
- Johnson, KC, Daviss, B. (2005). Outcomes of planned home births with certified professional midwives: large prospective study in North America. British Medical Journal. 330, 1416.
- Olsen, O. (1997), Meta-analysis of the Safety of Home Birth. Birth, 24: 4-13.Fullerton, J.T., Navarro, A.M., Young, S.M. (2007). Outcomes of Planned Home Birth: An Integrative Review. Journal of Midwifery and Women’s Health, 52(4), 323-3.
- Singata M, Tranmer J, Gyte GML. Restricting oral fluid and food intake during labour. Cochrane Database of Systematic Reviews 2010, Issue 1.
- Stotland, N. & Declercq, E. (2002). Safety of out of hospital birth in industrialized nations: A review. Current Problems in Obstetrics, Gynecology and Fertility, 25, 134-44.