What Does Homebirth with a Midwife Look Like?
Clients often ask me what homebirth with a midwife looks like? Protocols differ from practice to practice but there are a few things you can expect from most qualified and experienced midwives. Here is a quick overview of your midwife-attended out-of-hospital birth looks like with a Midwife’s Kaleidoscope.
Before your homebirth,your midwife will help you make your birth plan, decide who to invite to your home birth, answer your questions about what to expect, provide childbirth education or refer you to classes, and help your support people plan on how to best support you. She has ensured that birthing at home is the best option for you and has a full view of your health care and your life from which to be confident in supporting you at home.
Your midwife answers your phone calls 24/7, listens to your voice through contractions, asks you how your baby is moving, whether you believe your waters have opened, what other changes you see in your body, who is supporting you, and with your help determines whether this is labor and if you are ready for your midwife.
Your midwife heads to your home when you are ready. For some, that is early in labor offering support and encouragement, reminding you to eat, drink, rest. For others, you may want to wait until labor is active and established. She will come to you without fail no matter day or night, weekend or during the workweek. She will probably bring an assistant, who will also come when it’s your time, no matter when your time is.
Upon arrival, your midwife enters your labor space quietly and with great respect. She greets your family and friends, your children, your animals and comes to find you in your birth cave. She silently observes where you are at in your birth process just by watching, listening, feeling. She waits until your contraction is finished and you open your eyes. Then she greets you and asks your permission to provide you care.
She brings clinical skills with her. She takes your vitals, listens to your baby’s heart rate, ensures you pee and eat and drink and rest. She may feel your belly to see where baby is. She may check your cervix, and she may not because she can see and feel when your baby is coming by many other ways.
She brings her hands. Hands that have touched your belly and your baby for months, hands that know how to gently guide a baby into the world, hands that know how to act quickly when needed and how to remain folded on her lap when not.
The midwife will likely bring a bag she rarely opens. A bag full of medications and herbs and equipment to deal with any emergencies that may arise outside of the hospital. She is prepared to start an IV, administer medications for bleeding or baby’s health, help baby breathe, suture, give oxygen. She is unlikely to need this bag but she knows how to use what is in it.
Midwives know that there is a dynamic and intricate dance of labor that cannot be expected to follow a timeline. Your labor is your labor, not an average or a plot on a scale. As long as you and baby are doing well, midwives watch and wait.
When it comes time for your baby to come, you decide where that happens. You decide which room, which position. You decide how fast or slowly you bring your baby into the world. You decide whether you push your baby out on land or in the water, whether you push or breath. The midwife’s job is to guard safe passage for you and baby, to listen and look and support and offer suggestion.
There may come a point where your midwife’s tone or words change. Where she begins to communicate in a way that indicates that more action is needed from you and her, when it no longer feels like a suggestion. If you hear this, you will know and you will act because you have spent months building trust with this midwife. You trust her hands and her heart and her head. If these times enter your birth space, you and our midwife will work as a team to usher baby safely earthside.
When your baby comes, your midwife will place or baby in your arms, or wait for you to pick her up, or not touch her at all if you have been the one to “catch.” She will ensure your baby is breathing well and you are not bleeding and then she will again watch and wait, so as not to interfere with these first precious moments. She will not cut baby’s cord, or remove baby from your arms.
Your midwife will help you find your feet, remind you that you still have some work to do, and then you will birth your placenta. You will push your placenta into this world, just as you pushed your baby out. Your midwife will not pull your cord or try to force your timeline. She will watch and wait, help you and baby to latch if needed, and encourage you to finish up this last little bit of work.
Your midwife will remain after your home birth for as long as it takes to make sure you and baby are stable and healthy. She will observe, take vitals, cook you some food, do your laundry, clean up any birth ‘mess,’ help you and baby nurse. She will help you to the bathroom, suture if needed, and do a full newborn exam before leaving.
After your home birth, your midwife will answer the phone 24/7. She will return in the days to come to ensure that you and baby are safe and well and supported, that breastfeeding is going well, that baby is having plenty of diapers and little jaundice, that your bleeding is normal, that your breasts aren’t sore or damaged, that any tears are healing. She will check to make sure you have food in the house, and people supporting you. She will file for your baby’s birth certificate and social security number. Your midwife will remain in your life as your healthcare provider in the weeks following birth.
Hope this helps give you a general sense of what a home birth with a midwife might look like. If you are interested in scheduling a free initial consultation, email us at firstname.lastname@example.org or call 623-206-8531.