Planning a Home Birth

If you have decided that you want to give birth to your baby at home then there are a number of things you need to organise beforehand.

Are you eligible?

Providing that your pregnancy is progressing without any problems and both you and your baby are healthy then there is no reason why you should not be able to have a successful home birth. If this is your second baby and your first delivery was complicated, you might be advised to give birth in hospital. This is not to say that you cannot have a homebirth as where you choose to give birth to your baby is your decision, however you need to consider carefully the implications of going against the recommendations of your midwife and antenatal Team.

Make arrangements with your midwife

At your next antenatal appointment tell your midwife that you would like to plan for a home birth so that they may make a record of this in your maternity notes. As your pregnancy progresses, your midwife will advise you on what you need to do in preparation for your home birth.

Some women choose to book an independent midwife or doula to assist them with their home birth. You would normally have to pay for these services. The cost varies depending on where you live and the level of care and assistance that you want. You should expect to pay anywhere from £2,000 for an independent midwife to assist you through pregnancy, labour and birth.

For further information contact Independent Midwives Association.

What if I change my mind?

As your due date approaches you might be less inclined to have a home birth and that is fine. Just tell your midwife/doula so that she can inform the hospital.

Antenatal Preparation

Getting baby into position

There are no guarantees that antenatal preparation will lead to an easy labour with no complications but it certainly won't hinder the chances of this. The most important thing is to ensure that your baby is in a good position ready for their birth into the world. Although good posture is always important, it is never more so than in the final months of your pregnancy. Ensure that you always have good posture and that you are mindful of your movements. The best position you could hope for your baby to be in is head down, facing your back. On your maternity notes this might be recorded as LOA (Left Occiput Anterior) or ROA (Right Occiput Anterior). In this position your baby is well placed to pass through your pelvis with ease.

If your baby is head down but facing your tummy, labour is likely to be drawn out and more painful as your baby needs to turn around for delivery. If your baby is in this position you will most likely need to go to hospital for an epidural to help you through labour.

If the baby is in the breech position it will be unlikely that you will be able to give birth at home as a baby in this position can cause complications during labour.

Antenatal yoga classes

During antenatal yoga classes you will learn exercises which not only help you to relax in preparation for birth but which also use gravity and movement to encourage your baby into a good birthing position. Antenatal yoga classes can also teach you good breathing and coping methods to help you through your labour.

Antenatal classes

An antenatal class is designed to prepare your expectations for labour and birth. They will discuss your pain management options with you.

Antenatal exercise

Labour is called labour for a reason; it requires a lot of energy, it can last for very many hours and can be very tiring. If you do no exercise at all during pregnancy, you will find labour very draining and hard work. Try to do some gentle exercise (geared towards pregnant women) during pregnancy and your body will be better equipped to cope with the demands of labour.

Aquanatal yoga

This is a safe and gentle form of exercise which will help you to stay fit during pregnancy and also aid relaxation. Aquanatal classes teach you priceless breathing exercises to help you during labour and birth.

Planning for Labour

Read and write notes

Being prepared for labour can be very empowering for women. Read as much information as possible on home births, find out about what you can do if your labour isn't progressing very quickly. Write them down as you might be too busy to remember them at the time and ensure your birth partner knows exactly where to find your notes.

Birthing ball

Consider a birthing ball and read up on movements to try during labour. Perhaps you can practice some of them before labour and keep a sheet of movements near the birthing ball for easy reference.

Music

Prepare a CD (or maybe a couple, you could be there sometime!) of music that you would like to listen to during labour. It will give you something to focus on. You might like to consider calm, classical music to help you relax or something a bit more upbeat to help you stay active. Consider all possibilities.

Pain relief and alternative therapy

In the early stages of labour paracetamol will help with initial labour pains. You might want to consider a TENS machine (though not in a birthing pool). Your midwife will be able to provide you entonox (gas and air). Alternatively you may have chosen alternative therapy to help you through labour.

There are many different therapies which can be considered during labour such as aromatherapy, acupressure and massage. You should read up on these well before labour and discuss this with your midwife or doula so they can help you to make an informed decision.

Makes notes and ensure that your birth partner knows what you want to use and when and where any essential oils are stored.

Hospital bag

Yes that's right; prepare a hospital bag for a home birth in case you need to transfer to hospital in an emergency.

Things to pack: T-shirt, nightdress, disposable pants, toothbrush and toothpaste, shower gel and deodorant, clothing for baby, nappies, cotton wool, camera, money for phone, energy food and drink.

Food and Drink

It is important during labour that you keep your energy levels up by drinking little and often as well as having snacks so that you don't get hungry. Have bendy straws on hand so that your birthing partner can assist you with drinks. Try drinks like fruit juices, water or glucose energy drinks.

Don't forget to have enough food in for everyone; birthing partners, children, midwives and doulas get hungry too!

Other children

If you have other children who are likely to be at home when you give birth you might want to consider asking a friend or relative to sit with them so that your birthing partner can concentrate on you.

Birthing Pool

Many women who choose to give birth at home will use a birthing pool to help with labour pains. If you hire a pool make sure you have a practice run at setting it up before labour begins so that you can be sure you have all the right fittings and attachments. If space allows, you could inflate the birthing pool in the weeks leading up to your due date and only fill it when it is required.

It is important that you consider whether or not your floors will be strong enough to hold a birthing pool full of water. Perhaps a downstairs room would be the best choice?

No matter how hard you try, not all water will remain in the pool so make sure that your floors are well protected with a large tarpaulin under and around the pool. Make sure you have further sheets available should you choose to give birth to baby outside of the pool.

When you get out of the pool you will need towels to dry off and warm up and you will also need towels for the baby.

Many mothers spend time on their knees during labour in or out of the pool, so consider some folded sponge, foam or kneeling pad to make yourself more comfortable.

Have a mirror to hand so that you and your midwife can see what is happening during a water birth.

During the first stage of labour the water temperature needs to be on the cooler side or you are likely to feel nauseous. During the second stage of labour you might want to increase the water temperature to around 37C.

Birth plan

Research home birth plans online so that you can be sure you have thought of everything. The purpose of a birth plan is to help you, your birth partner and your midwife/doula to know what you want from your birth experience. If there are certain aspects that you are particularly keen for your midwife to take note of, highlight it with a marker pen.

Once you have prepared your birth plan give it to your midwife/doula prior to your due date so that they may familiarise themselves with it. Also give a copy to your birth partner so they know what you expect from your labour.

Equipment

A couple of weeks before your due date your midwife/doula will bring a birth pack containing everything that she will need throughout your labour and birth.

Write yourself a list of everything you will need for your home birth so that nothing gets missed.

Things to consider:

• Plastic sheets to cover the floor, sofa or bed.
• Old towels or sheets to go over the plastic sheets.
• A couple of 'sick' bowls - just in case!
• Blankets or throws to keep you warm.
• A bright desk light or torch so that the midwife can check your vagina after birth.
• Baby blanket to keep him or her warm after birth.
• Bin bags to put all the dirty laundry in after birth.

Everything else you would need is the same as if you were packing a bag for a hospital birth. Clothes for you and your baby, toiletries, nappies and cotton wool.

What happens after my baby is born?

Once the baby is born, you need to deliver your placenta. The midwife will help you to deliver the placenta and ensure that it is complete. She will then check you for any tears which might need stitching. Providing there are no complications with the placenta and you haven't torn too badly, the midwife will help you into bed and clear up any mess. She will make sure that the baby is well and healthy and will stay with you to help with baby's first feed. Once she is happy that you are comfortable to be left she will leave you alone.

Over the next couple of days you will be visited by the community midwife every day to make sure that you and your baby are well. Within three days you will be visited by a GP or midwife to give your baby a full check-up. During the first two weeks primary care for you and your baby will be through your community midwife. After this time your care will be transferred to a health visitor who will carry out all postnatal checks.