A: Yes! As long as you are healthy and wish to take an active role in your maternity care, you are a great candidate for a home birth.
A: The main risk of VBAC is uterine rupture at the incision scar. Uterine scar tissue is weaker than surrounding tissue, so women who have had cesareans are at SLIGHTLY higher risk of having the uterine tissue tear during birth (uterine rupture), compared to women who have not had cesareans. This risk is lowest if you have only had one previous uterine surgery, had a low transverse incision, eat a healthy diet, do not smoke, allow at least a year after surgery before becoming pregnant, and labor is not induced.
If the reason for surgery does not necessitate another surgery (for example, you had a cesarean for breech position or for failure to progress), you may consider having a home birth after cesarean (HBAC). We can discuss this further during a free consultation. (In Idaho, licensed midwives are not allowed to care for women who have had 2 or more previous cesarean births. This stipulation is specific to Idaho and there are more options available in WA state.)
A: Childbirth is beautiful but it can be messy sometimes. However, we midwives are very good at containing the messes and cleaning up when necessary. Most of your birth supplies are actually to keep your birth environment clean. We do not leave until your birth space is tidy and comfortable. You can expect to have a garbage bag full of trash and one full load of laundry after the birth.
A: Anyone! You can have a doula, your mother, your best friend, anyone who can provide good support for you during labor and is supportive of your decision to have a homebirth. However, please remember that birth is not a spectator sport. If you feel like you don’t have privacy and are being watched, this may interfere with the hormones of labor. And if you have other children, they are welcome too although we do suggest having a designated support person for young children.
A: As long as you feel safe, comfortable, and the place is reasonably clean and warm, your home is the best place to give birth. Some people who live in apartment buildings let their neighbors know before hand of their plan to give birth at home but others don’t, figuring that homebirth is usually not any louder than everyday activity in the home. Some people who house-share with others offer to buy a hotel room for them to stay at for a few days surrounding the birth.
A: Licensed midwives can not carry pain medications. We do however offer something that helps most moms not even think about pain medications – loving support and the freedom to labor at your own pace in a comfortable environment, surrounded by people you trust.
Since research shows that stress hormones and tension increase pain and slow labor, we work to keep your environment as low-stress and relaxing as possible for you. We encourage you to move freely during labor, which helps you to cope with the contractions and helps the labor progress. You’ll be free to eat and drink as you wish, which increases your pain threshold and gives you energy.
Many women choose to spend at least part of their labor in water, either the shower, tub or one of our inflatable birth pools. We like to call this hydrotherapy “the midwife’s epidural”, as it is the best tool for pain relief that we carry. Being in water is soothing, facilitates rhythmic movements and buoyancy, and can work to take the edge off of even the most intense contractions of labor. Also, having fewer interventions and interruptions during labor allows your body to naturally release hormones and endorphins that assist with pain management. This is a tremendous help to you and an important part of facilitating undisturbed physiological birth, as we strive very hard to provide as out-of-hospital midwives.
A: Although homebirth is statistically safe, it does not guarantee a problem-free pregnancy or birth. If complications do arise during pregnancy, you may need to consult with and possibly transfer care to an obstetrician.
Both midwives who attend your birth are trained to provide immediate care for emergencies, including postpartum hemorrhage (too much bleeding after the birth) and neonatal resuscitation (CPR for newborns). We bring all the necessary equipment and drugs, as well as herbs, to manage any special challenges. Since we only provide care for healthy women, and intervention during labor is limited, the chance of a true emergency is very low.
In fact, most transports (to the hospital) are for non-emergency situations, such as a long labor without progression, maternal exhaustion/dehydration, or the laboring woman’s desire for pain medications. If complications develop during labor or birth that are beyond our scope of care, you will be transferred to the nearest hospital.
We would prefer transport via your personal car and a midwife would ride with you, continuing to monitor you and baby, alerting the hospital staff that we’re on our way and also, give all the important details of the situation. This is usually the most efficient and satisfying way to transport to the hospital. A midwife will continue, depending on the situation, to offer support at the hospital but your care will be officially transferred to a physician.
We provide information on your current health conditions and offer copies of your records for a smooth transfer of care. We’re usually able to continue on with home postpartum care for you and baby after you are discharged from the doctor’s care.
A: Ultrasound can be a useful tool but is not routinely necessary in a healthy pregnancy. Some reasons an ultrasound may be recommended include uncertain dates, abnormal vaginal bleeding, possibility of twins, abdominal pain, decreased fetal movement, or if you have previously had a cesarean.
Many clients planning a homebirth do decide to have a 20-week fetal anatomy scan done for personal reassurance. We offer ultrasound orders and prefer to work with the independent Inland Imaging offices throughout Spokane, as opposed to hospital imaging offices.
A: We have a very minimal birth supply list that we give our clients. Most of the supplies you will already have around your house such as extra sheets, towels, and receiving blankets. Other important items you will need to purchase are things we use to keep your home clean such as under pads, plastic sheets, and hydrogen peroxide. A few extra items are needed if you desire to borrow one our inflatable birth pools. You can expect to budget $30-$60 for your personal homebirth supplies. We will bring all the medical equipment and other supplies needed for the birth.
A: Yes. We love having doulas at homebirths, especially for first-time mommas. A doula offers different services than midwives; having a doula with you ensures continual emotional and physical support throughout your entire labor. Midwives do some of this too, though their main function is to monitor the progress and safety of labor and birth for you AND your baby.
A: Midwives are qualified to provide all the care for postpartum moms and their newborns, given everything is normal. We perform a complete newborn exam within a few hours after birth. If your situation presents the need for your baby to see a physician, we will let you know and will discuss your options with you.
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