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December 5, 2015

Boot story – What Midwives Carry to Homebirths

Alright, you have decided to look into the option of homebirth because you heard that the current national guidelines suggest that as a healthy woman expecting a healthy baby, you are less likely to have medical interventions, for example episiotomies and caesarean sections, but also have far better clinical outcomes for you and your little one (Brocklehurst et. al 2011).

Meanwhile you have probably noticed that the growing homebirth trend is quite controversial, and while your friends may have already told you their horrendous birth stories, they went into even more detail when you told them about your homebirth plans. It slowly sinks in that your friends may have experienced these horrible things not even though they were in hospital but perhaps…because they were in hospital. Did the birth environment really have an impact on your friend’s experience?*

You start to make your research and probably end up with a check list that looks like this:

1) Is there high quality evidence that suggests home is the ideal place of birth for healthy women & babies – tick!

2) Can I get to know my midwives and if so are they comfortable attending and supporting a normal birth at home? Or are they terrified and anxious in the same way like my neighbour’s husband who fainted three times because Lucy said she felt pushy and could sense the baby being really low? – need to find out!

3) What would my midwives bring to my house – surely they are not coming empty handed…

…well, that’s exactly the sort of thing I would like to explain today. The visible – and invisible – things that midwives bring to a homebirth.

 

Visible:

I driving a Ford Fiesta and my equipment fills the boot right to the roof. Let’s start with the my birth bag: I have a lot of disposables in there: gloves, gauze, gels, umbilical cord clamps and scissors (that are of course only used after the cord stopped pulsating- also known as optimal cord clamping. More information on which can be found at blood to baby). The more serious things are catheters, i.v. access and i.v. liquids.

 

I carry Entonox cylinders (aka gas & air), an oxygen cylinder for a ‘mum-is-feeling-dizzy scenario’, and Ambu-bags for mum & baby to help them with their breathing.

Of course we also bring drugs – these are emergency drugs and gladly they often expire before we get to use them because ‘blue light’ emergencies are extremely rare during healthy births. Also as midwives, we pick up suspicious things early to adjust your plan and get you where you need to be.

Also my sonicaid to listen to baby, blood pressure cuff as well as mirror & torch (you water birth ladies you) are always on board.

Many of us bring mats, shawls, homeopathy, aromatherapy, tena lady pants, massage oils, music and other happy hippie stuff that may be complementary.

Midwife Anna Home Birth Equipment 3 new

Invisible:

Training training training…midwives nowadays are trained to support women in a healthy labour, in a tricky labour, to help keep labour remain normal and in times when mum & baby need help. We deal with all kinds of scenarios and regularly attend workshops, conferences & study days to keep our skills up to date.

Philosophy, personality, experience…I also bring my clinical judgement and intuition, which are located halfway between my brain, my heart and my subconscious. I approach birth from the perspective that most women absolutely could give birth naturally if we only would just let them. My role is to give you a safe bubble during your labour to ensure you are undisturbed and protected and therefore make a smooth transition into motherhood. My clinical judgement is constantly assessing the situation: are the surges coming regularly, are they long enough, how frequent, what position is baby in, how is mum moving according to baby’s position, what is babies heartbeat doing, when did she last go to the bathroom, how is her blood pressure, pulse and temperature, blood loss, when did she last drink and eat…and so forth…

The London Birth Practice home birth coffee break edited

So while I actively try not to do anything to you and it looks like I am being extremely bored scrolling through my phone (sorry guys – I never learned knitting) I am doing a lot to enable you to achieve the best possible outcome.

 

I hope you can now tick the third box on your check list knowing which visible and invisible things midwives carry to homebirths and rest assured that they are extremely well equipped and ready to focus on you and only you.

Please let me know what else is on your check list when researching the ideal place of birth!

 

With all my admiration and conviction that you strong and amazing women totally can do it…

Your midwife Anna

 

*We all know women that had a lovely birth in hospital, too!

 

Reference:

Brocklehurst P., Hardy P. & Hollowell J.: Birthplace in England Collaborative Group (2011) Perinatal and maternal outcomes by planned place of birth for healthy women with low-risk pregnancies: the Birthplace in England national prospective cohort study. British Medical Journal 343, d7400.

 

Alright, you have decided to look into the option of homebirth because you heard that the current national guidelines suggest that as a healthy woman expecting a healthy baby, you are less likely to have medical interventions, for example episiotomies and caesarean sections, but also have far better clinical outcomes for you and your little […]

 
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