Planning for a home birth is a safe and positive option for healthy women who are experiencing a straightforward pregnancy. Many women choose this path because they understand that having a baby is a normal part of a woman's life that works best without interference.
Other reasons women plan a home birth are the desire to experience the continuous one-on-one care midwives provide, to labor and birth in the comfort and safety of their own home, to have privacy, to be surrounded by people they love and trust, to have the freedom to eat, drink and move as they need to and to be able to bond with their babies without interference. In a home birth, the infection rate for both mother and baby is less than half that of hospital births and unnecessary medical interventions are avoided.
Here are some ideas to consider if you're interested in taking this route:
1. Know your WHY.
Your WHY is the sum of your emotions and thoughts about birth and birthing. Emotions are the compass of our decision making. As you consider your birthing options, are you running away from something or are you moving toward something that will enrich your life and your birthing experience? Strong negative emotions interfere with a clear decision making process.
Explore your WHY with curiosity and non-judgment. Your understanding of why you want to have a home birth will guide your decision-making and color your birth preparation.
2. Do some ghost busting!
"Ghost busting" refers to finding and clearing any negative emotions and thoughts that could have an undesirable effect on your birthing experience. It applies to all pregnant mothers and their birth partner regardless of birthing location. Think back to a memory related to birth that made an impression on you when you were a child. Maybe you witnessed the birth of a sibling or a pet, or watched a birth on television or a movie, or you overheard a conversation about birth. Remember what was said and how you felt. As a child, what did you tell yourself about what you heard or saw? What conclusions about birthing did your young self reach?
Your childhood impressions are like the monsters under the bed: once you shed some light on them, they go away. Unexamined, these seeds will grow roots and they'll populate your birth experience. How are your child-made rules influencing your birth preparation?
Other ghosts to clear are the ghosts of sexual abuse or sexual violence. Abuse issues are sometimes triggered during pregnancy, labor, birth or breastfeeding in the form of body sensations such as nausea or tension, memories or flashbacks. Common triggers can be vaginal exams, overpowering health care providers, the intensity of labor and feelings of lack of control.
Sometimes what might look like a very long labor or "failure to progress" is really a woman working through these issues during labor to the best of her ability. Clearing these ghosts now will free your mind and body to gestate, birth and mother in peace and with joy.
3. Create your Birth Vision.
More organic and more flexible than a traditional birth plan, your Birth Vision is how you would like to experience the birth of your baby. It focuses on what you want rather than emphasizing what you don't want. Your Birth Vision will expand and evolve as you learn more about yourself and the options available to you. If you have a birth partner, creating a Birth Vision together is a wonderful way to begin your co-parenting journey.
The purpose of writing your birth vision is twofold. First, this is a valuable part of your childbirth education process. This is your opportunity to research and familiarize yourself with procedures and interventions often used in labor and birth. For easy reading, it's best to write your distilled Birth Vision on one side of an 8.5 x 11" piece of paper. I recommend that parents also focus on newborn care (when to cut the cord, which procedures are acceptable to you, who will remain with baby at all times if mom is indisposed). Your newborn care preferences become extremely important in case a transfer becomes necessary.
Second, your written Birth Vision serves as a communication tool and map to help your birth team navigate birth with you and honor your wishes. It will remind your birth partner of what to advocate for when you are busy in labor-land and you might not be able to speak for yourself. It is a valuable tool to clearly communicate with your care provider. Discussing your Birth Vision with your care provider will help you determine if you are on the same page. (Pun intended!)
4. Hire the best birth practitioner.
Interview as many midwives as you can! Listen to your gut and if you hear any red flags, pause and trust yourself. You know when something is non-negotiable for you. If something does not work for you now, it sure won't work when you are in labor! The interview process can last as long as the pregnancy. You can fire your practitioner at any time. The sooner you make the decision, the more options will be available to you.
Some important issues to find out about are: transfer rate, circumstances for transfer, if transfer happens during labor would she transfer with you, training/certification/experience, is she certified in Neonatal Resuscitation, what emergency supplies she brings to a birth and what is her back-up plan. There is a comprehensive list of questions to ask your midwife on growingslower.com and in many other websites.
The website Citizens for Midwifery has a state-by-state guide to midwifery in the United States. If home birth with the support of a midwife is not an option in your area, other options might be a birth center, naturopathic physician, a family doctor, traveling midwives, birthing in a different state or birthing unassisted. To find a midwife in your area, try: Midwives Alliance of North America, Mothers Naturally, American College of Nurse-Midwives and Midwifery Today. Other sources are word of mouth and your local birth network.
5. Gather your supporting cast.
Birth is a process that is easily disturbed by unnecessary interventions and distractions. A woman’s dilated cervix can close in the presence of disruptive people or actions (this is known as cervical reversal). Since you are the one using your body to give birth, you get to decide who will be there in a supportive role. Remember, a woman in labor is not a hostess and birth is not a spectator sport!
If someone in your life is unsupportive, irritating, impatient or has negative feelings about normal birth, they do not belong in your sacred birthing space. Even if this person is your mother or mother-in-law! For your peace of mind, each person must have a clear, specific role. If you have other children, who will be taking care of them other than your birth partner? Consider hiring a birth doula. A doula is a professional labor support person. Research shows that the support of a doula improves birth outcomes and increases birth satisfaction. Some people can have dual roles to limit the size of the crowd.
6. Prepare for postpartum now!
Pregnancy is such an exciting and busy time that pregnant parents often forget that they will come out of it with a baby! Sounds funny, yet it is true. There is no way to really understand the impact a new baby will have in your life until the baby comes Earth side.
Pregnancy is the time to gather your postpartum support. Identify your community resources: breastfeeding support, pediatric chiropractor, baby wearing, mothers' groups, gentle parenting resources, etc. After the birth, give yourself a few days without visitors to rest and bond as a new family. Food is a major issue for a new mom. Have a friend organize a meal train or cook and freeze before the birth. Post a list of jobs on your refrigerator door to let visitors know what you need. People want to help; they need to know what you need. Arrange for extra help, and consider hiring a postpartum doula. (You will be happy you did!)
7. Remember: self-care is a daily practice.
We birth the way we live. The childbearing years are a time for you take exquisite care of yourself. The best time to start? Before conception. This information will be beneficial to you even if you're at the end of your pregnancy.