Tuesday, December 13, 2011

Anatomy of a Homebirth - Breaking It Down

For those of you out there who are new to homebirth, I thought I'd provide a few details so that you can get a basic picture of what a homebirth looks like.

Preparing for a homebirth:

There are several sets of supplies that a homebirth family gathers before the birth, or that are provided.

(1) Supply List - Every midwife has her own individual supply list (there are general similarities) that she requests each family to gather and have ready in a centralized location. Linens should be washed and dried in a hot drier (usually with extra time), then bagged in plastic. Is this necessary? No, not really, but it's just a precaution on the side of safety. Here is my midwife's list:

- Set of extra fitted sheets for the bed - While the mother is in early labor, the bed is made with fresh sheets, then covered in plastic, and a new fitted sheet is put over all of that. Thus, if the bed gets messy during the birth, the top sheet and the plastic can be stripped off afterwards and the mama and baby can be tucked into a clean bed.

- Waterproof bed pad - This can be done with plastic sheeting, plastic shower curtains, or a regular waterproof fitted sheet, for the purpose above.

- 5 clean towels and washcloths, double for a waterbirth - Always needed!

- 5-10 clean receiving blankets for baby, diapers and clothes for baby

- Two medium sized plastic bowls - For the placenta and any other waste.

- Cookie sheet, rimmed - To hold supplies.

- Labor food and drinks for mom and birth team - Food and drink during labor are SO important for the mama! Hospital-birthing mamas, don't forget to pack your own food and drinks to take to the hospital, since many hospitals are still under the (highly mistaken) notion that mothers should be NPO (nothing by mouth) during labor. Good drink choices are juice or Gatorade, good snacks are whatever you like - but stock lots of good stuff, both for you and the team!

- 1 roll paper towels - For general mess clean-up!

- Olive Oil - For perineal massage during pushing (not used for waterbirths).

- 2 empty laundry/garbage baskets - For waste.

- Extra large garbage bags - To fit the wastebaskets.

- Ibuprofen - For after the birth, to help with after-pains and swelling

I am adding things like an afterpains tincture, a heating pad, and a rice sock.

(2) Personal Things - Basically, what would fit into a hospital bag! Things like a music playlist, a birth ball, an inflatable birth tub, chapstick, personal items, etc.

(3) Birth Kit - These are the "pseudo-medical" supplies. Each midwife has a different supply list, and they are ordered by the family from a local supplier, who will usually have a list of midwives' names so that each client can select her midwife's particular kit. Though I don't have one in front of me, a birth kit will include things like:

- Chux pads
- Pads for postpartum bleeding
- Suction bulb
- Plastic cord clamps
- Disposable (keepsake) measuring tape
- Instant ice packs

(4) Midwife's Supplies - Each midwife will bring her own kit of supplies to a birth, the "true medical" supplies. This would include things like:

- Pitocin (for postpartum hemorrhage)
- Syringes
- Suturing materials
- Oxygen tanks
- Neonatal resuscitation equipment
- IV materials (depending on the state)
- Stethoscope, Doppler, and fetoscope

During a homebirth:

When a mother goes into labor, a midwife will keep in touch with her via phone and via in-person check-ins. This will vary based on how quickly a labor is progressing, and on whether the mother is in her first or subsequent labor. With my first birth, I labored for about twelve hours before the midwife came over to stay, while with my second she headed over as soon as we called her (smart woman!).

A midwife will arrive to stay whenever the mother feels a need to have her, usually sometime during active labor. She will stay through the birth and usually two or more hours after the birth, until both the baby and mother are fully stabilized and comfortable. During the labor, birth and postpartum, she is constantly on the alert, checking on the health of both mother and baby (fetal heart tones, maternal blood pressure/temperature/pulse) and making sure that everything stays within normal parameters for safety. If, at any time, she feels that any variable has progressed outside of her practice protocols, she will recommend a transport to the hospital and will accompany the family there.

After the birth, the midwife will make several home visits to the family, usually on days 1 and 3 post-birth, followed by several more in-office postpartum visits (usually at weeks 1, 3, and 6 postpartum).

I have had wonderful experiences with my midwives and my births at home. Though childbirth was easily the most physically challenging thing that I have ever done, it has also been the most fulfilling, transformative, and life-changing as well. I have always felt 100% safe and well-cared for, as well as respected and supported. I will never voluntarily choose to birth any other way - once a woman has had a good homebirth with an excellent midwife, there is no going back.

I would love to answer any other questions concerning homebirth - if you have any, please leave a comment!


  1. Don't forget to pick up some arnica, if you're going to try it for afterbirth pains.

  2. Oh, I forgot to list that! I've actually already got it packed. This time I am waging war on afterpains. :)

  3. Our midwives uses the olive oil with for the perineal massage but adds a bit of the arnica oil in it.


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