How did you prepare?

[JanetF]

For your home birth? :)

I found a MW, booked a birth pool, educated myself a LOT from books, journals, the net, independent childbirth classes, watched HEAPS of birth videos, borrowed my MW's HUGE book/journal/video collection, and read every birth story I could find. I had monthly hourly appts too which helped a lot :)

I had a list of stuff my MW recommended we have available - towels, bendy straws, food for me and the support team, pads, some other stuff too.

What about you? Did you nest lots to make your birth space really special?

[poshBecks]

Hi Janet. I never had a home birth, but I just wanted to say you are amazing!! Have fun!! :yelclap:

[shed]

Where do you get a birth pool from?

[JanetF]

Not amazing, Becca-Rae, just informed ;)

You can hire birth pools from local independent MWs, community childbirth groups and some businesses which do nothing else. :)

[shed]

How much do they cost to hire?

I might get one to labour in. Depending on how much they cost.

I would love a home birth but just too chicken so I am labouring at home with my doula and then going to hospital.

[JanetF]

It really depends on the person, group or place you hire from. And in terms of safety, you're actually safer at home with MWs than in the hospital with surgeons and that's true all over the world ;) You might like to look into it more! The country nearest to us in birth climate and outcomes is the US and their studies are done on MUCH larger populations. Read this:

Myth #1 — Hospital births are statistically safer than homebirths.
Safety in childbirth is measured by how many mothers and babies die and how many survive childbirth in less than perfect health.
Studies done comparing hospital and out-of-hospital births indicate fewer deaths, injuries and infections for homebirths supervised by a trained attendant than for hospital births. No such studies indicate that hospitals have better outcomes than homebirths.


Respiratory distress among newborns was 17 times higher in the hospital than in the home.
The U.S. has the highest obstetrical intervention rates as well as a serious problem with malpractice suits.




While maternal death rates have vastly improved since the turn of the century, factors like proper nutrition and cleanliness have played a big part in the change.
Overall neonatal death rates have also improved since the 30s, but homebirths appeared to be safer even then. In 1939, Baylor Hospital Charity Service in Dallas, Texas, published a study that revealed a perinatal mortality rate of 26.6 per 1,000 live births in homes compared to a hospital birth mortality rate of 50.4 per 1,000.[1]
Since the 1970s, research done in northern California, Arizona, England and Tennessee all point to the relative safety of homebirth.[2] The only matched population study, comparing 1,046 homebirths with 1,046 hospital births, was published in 1977 by Dr. Lewis Mehl, a family physician and medical statistician.[3]
While neonatal and perinatal death rates were statistically the same in Mehl's report, morbidity was higher in the hospital group: 3.7 times as many babies born in the hospital required resuscitation. Infection rates of newborns were four times higher in the hospital, and the incidence of respiratory distress among newborns was 17 times higher in the hospital than in the home.
A six-year study done by the Texas Department of Health for the years 1983-1989 revealed that the infant mortality rate for non-nurse midwives attending homebirths was 1.9 per 1,000 compared with the doctors' rate of 5.7 per 1,000.[4] Certified nurse midwives' mortality rate was 1 per 1,000 and "other" attendants accounted for 10.2 deaths per 1,000 live births.[5]
A study of 3,257 out-of-hospital births attended by Arizona licensed midwives between 1978-85 shows a perinatal mortality rate of 2.2 per 1,000 and a neonatal mortality rate of 1.1 per 1,000 live births.
In testimony before the U.S. Commission to Prevent Infant Mortality, Marsden Wagner MD, European Director of the World Health Organization, suggested the need in the U.S. for a "strong independent midwifery profession as a counterbalance to the obstetrical profession in preventing excessive interventions in the normal birth process."[6]
Wagner states that in Europe midwives far outnumber physicians: "In no European country do obstetricians provide the primary health care for most women with normal pregnancy and birth." He states that the U.S. has the highest obstetrical intervention rates as well as a serious problem with malpractice suits and concludes that a strong, independent midwifery service in the U.S. would be a most important counterbalance to the present situation.

1. The Five Standards of Safe Childbearing, 1981, Stewart, p. 241.
2. Ibid, p. 115-116, 127, 243-246.
3. Ibid, p. 247-253.
4. Texas Lay Midwifery Program, Six Year Report, 1983-1989, Bernstein & Bryant, Appendix VIIIf, Texas Department of Health, 1100 West 49th St., Austin, TX 78756-3199.
5. Labor Pains: Modern Midwives and Homebirth, Sullivan & Weitz, 1988.
6. Mothering, Jan/Feb, 1990.

And this for the most recent BMJ study:
Home superior to hospital birth
Source: British Medical Journal 2005; 330: 1416-22

The largest prospective study of planned home births to date evaluates the
safety of such births supported by direct entry midwives.


Among low-risk women, home births assisted by certified midwives achieve
similar rates of intrapartum and neonatal mortality as hospital births, with
lower rates of medical intervention, reveal Canadian researchers.

"Despite a wealth of evidence supporting planned home birth as a safe option
for women with low risk pregnancies, the setting remains controversial in
most high resource settings," note Kenneth Johnson (Public Health Agency of
Canada) and Betty-Anne Daviss (International Federation of Gynecology and
Obstetrics, Ottawa).

To examine its safety further, the team compared perinatal outcomes for all
planned home births (n = 5418) supported by the North American Registry of
Midwives in 2000, with those previously reported for low-risk hospital
births in the USA.

Overall, 12.1 percent of women were transferred to hospital for delivery.
The incidence of neonatal mortality among those who remained at home was
similar to that documented for low-risk hospital births, with no maternal
deaths. Medical intervention, however, was substantially less common among
home, versus hospital, births, with epidural, episiotomy, forceps, vacuum
extraction, and cesarean section rates of 4.7 percent, 2.1 percent, 1.9
percent, 0.6 percent, and 3.7 percent, respectively.

"Our study of certified professional midwives suggests that they achieve
good outcomes among low-risk women without routine use of expensive hospital
interventions," conclude Johnson and Daviss.

The Midwifery Model of Care.

According to WHO, midwives are appropriate carers for the majority of pregnant women. To learn more about the safety and experience of midwifery, go to the following links:

WHO – “Care in Normal Birth; a practical guide”
http://www.who.int/reproductive-health/publications/MSM_96_24/care_in_normal_birth_practical_guide.pdf

http://www.gentlebirth.org/archives/homsafty.html

http://www.collegeofmidwives.org/safety_issues01/safetyIndex01.htm

http://www.aboundingjoy.com/insstats.htm

Planned home births in Australia 2003 http://www.maternitycoalition.org.au/journal/Birth%20Matters%20Vol%208.4.pdf

“Fish can’t see water: the need to humanise birth in Australia” Marsden Wagner
http://www.acegraphics.com.au/articles/wagner03.html

[tickle]

Hi Janet, so lovely to see you.:thumbsup:
Just a bit of a question. Excuse my ignorance, I have no idea about home births.
Who cleans up after a home birth? I can't imagine that's something that I'd want to do when I have a brand new baby.
Just curious.

[jarrahsmumma]

The midwife would more than likely help, but what sort of mess are you looking at making? :laughing: You will empty the pool yourself, likely the next day. (Great for the garden!) Homw births are soooo diferent to hospital births. You would more than likely not feel like a hospital patient, so you may surprise yourself in the amount of energy you have and how normal you will feel.:smiliedance:

[shed]

I'm convinced but DP is not and I don't have the conviction to keep on at him about it.

Maybe next time. Very likely.

I already transferred from a hospital with a birth centre to one that is closer but has no birth centre. I figured the closer it is the longer I can stay home and I won't really need the birth centre anyway because I will be at home for most of it.

I think a hospital is a very odd place to have a baby!

[the_queen]

Shed, I'm like you. I'm very enthusiastic about home birthing, but DH is not convinced. It's about the nicest thing he's said to me for ages, "I'm worried something will go wrong". I try to explain that there's more chance of everything going right - but he still isn't convinced. That I will feel more relaxed and calm at home, which will facilitate a quicker labour and easier birth. But still, he's not convinced. What I need is a MALE home-birthing advocate who can explain everything to him :rolleyes:

Janet, I'm thinking of hiring a birthing pool (I'm labouring at home for as long as possible too) but someone said to me I should just buy an inflatable swimming pool, one of the big ones. I'm not so sure. I'm thinking I will probably need some very stable sides to grip onto, and lean on. So an inflatable one wouldn't really do the trick. But at the Babies Expo, the home-birthing stand had an inflatable pool there as an example of what you can hire? So I'm confused :confused: What is your opinion on this? :D

[Tam-I-Am]

Hi Janet. Just a question for future reference (I have an 8 month old, but am planning more in the future)

I always wanted a home/water birth, but I guess I didn't really know where/how to look into it with DD. Just wondering -

1 How much does it cost to hire a private midwife - do you need pvt health insurance, and how much is covered?

2 Although I'm very convinced by the research you presented - what happens in the unlikely event that something does go wrong - is there a contingency plan?

3 What if you were, for example, to need stiches afterwards - are midwives qualified to do this?

4 how would I go about finding a private midwife where I live?

I think you're awesome - Good luck so much with your home birth. I hope it's a fantastic experience!!:)

[mummyof5]

Hi Tami and Claire,
Well, obviously it's not Janet, but I'm sure she won't mind me throwing in my 2 bobs worth.
If you take a gander at some of the other homebirth threads there is a wealth of info about cost and insurance....personally my first 2 hb's cost $1500 and $1700 respectively, but that was some years ago in Sydney and paid upfront (by the 37 week home visit). On the Mornington Peninsula where my last 3 were born, it cost in the vacinity of $1300 for each birth. This was an out of pocket expense for us as we don't have Private HI. Alot of midwives these days will allow the birth part of the costs to be covered afterwards when you get your maternity allowance, so frankly if you discuss money with them, alot are very adaptable re costs.
With all homebirths, you should book into the local public (or private if you want.) hospital, usually you have to do a booking in appointment, sometimes they create a bit of a fuss, but on a whole I haven't had much problem, that way if you do decide a hospital transfer is needed, as with my 2nd child, they already have your details and history....
In the vast majority of homebirths, stitches aren't actually needed, as episiotomies (sp???) are not done, and tears, if any, are usually small...however, having said that, yes, midwives are trained to do all that, they do carry oxygen and drugs to stem blood flow etc.:thumbsup:
For my first birth I literally looked through the yellow pages and talked to midwives until I found one I was comfortable with. It was a bit harder in Vic (and I didn't know BubHub existed), but after contacting the local council in desperation, they put me onto a midwife who wouldn't take me on for a HBAC, but she referred me on to my beautiful midwife who did, and delivered my subsequent children...:yelclap:
Luckily for you, this site has lots of numbers you can call in each state to get the names of private midwives.
Good luck, hope you found this helpfull....
Kylie.:ecomcity:

[JanetF]

Yep what Kylie said :)

1 How much does it cost to hire a private midwife - do you need pvt health insurance, and how much is covered?
Many health insurance companies are providing for all or some of hbs nowadays because they realise that it's cheaper than paying for surgeons who aren't really needed anyway. No one pays for you to take your kid to an ENT for a head cold and seeing a surgeon for care for normal birth is just as ludicrous. MWs have better outcomes so it's cheaper in the long run as well as the short term for health funds to pay up. You need to really persist with some though as it's being planned and implemented and the desk staff don't often know about it. Without health cover (I don't have any!) you can also claim back on the medical expenses part of your taxes once it's over the medicare limit. There's also the baby bonus and what better way to spend it???

2 Although I'm very convinced by the research you presented - what happens in the unlikely event that something does go wrong - is there a contingency plan?
You have a hospital booking and you go there if you need. In birth it's very very rare for anything to go wrong quickly in a normal, phsyiological birth. Interventions are what cause most problems so avoiding them makes us safer in the first place!

3 What if you were, for example, to need stiches afterwards - are midwives qualified to do this?
As Kylie said, tearing is REALLY rare in hbs and most MWs never see the need for an episiotomy in many thousands of happy births. Small tears don't really need stitching and individual MWs have different policies on this. Just ask the ones you interview.


4 how would I go about finding a private midwife where I live?
Ask me in a PM when you tell me where you live :) I run the Australian home birth network so I don't lack those resources ;)

[mummyof5]

Hello again all,
Just to answer the birth pool questions, I forgot about in the last ramble. I used an inflatable pool every time to labour in, though never did deliver in it, as I need to feel grounded when I birth...
You can buy them at Kmart, believe it or not. They have three rings of air up the side, so are quite a comfy height, and an INFLATABLE bottom - most important part of all!!! It's the same as some midwives hire out! I got my last one at the end of summer clearance for like $40, so not sure what they cost full price, but shouldn't be too much. I donated my pool to the midwife when I was finished with it. You clean it out with some bleach when finished using it. Easiest way to empty it is with a hose same as you do with a water bed and things.
If you are worried about stability, remember they are pretty stable when full of water, but if still anxious, place one part of it up against a buffet or lounge arm or something more solid, I found that quite helpfull.
For the ladies who are interested in hearing from the male perspective, my hubby has offered to start a thread for the homebirthing dads to contribute to, if that would be any help??
By the way, my midwives, along with hubby and or mum have always cleaned up any mess there might be. They will bring or ask you to get either bluey's or some other sort of protective covering for your bed or floor etc. Painting drop sheets ($1.50 at bunnings) or tarps from the el cheapie shops are great under a sheet on the floor, and if the sheets are old ones, you can toss the lot at the end...easy!!
Sorry to ramble on again!!!
Kylie.:ecomcity:

[skandranon_uk]

Hi there, i have only just joined so im not sure how long this thread has been running, but i had a beautiful home birth last 4th july..

It was planned from being 3 months pregnant, and it was what i wanted for the birth of my last child, as i knw the snipety snip was inevitable i wanted it to be just perfect ( not usual for a home birth)

I delivered my twins nvd at 25 weeks and my huge baby boy at 42 weeks at 10lbs 8 oz so the docs knew i was capable of doing it...

There were a few worries at one stage as they thought baby was too big but after another scan they revieled baby was good weight but not in any way too big for a single mw to handle.

So as time went on i had a few extra appointments with my mw and she talked me through the various bits of equipment that would be delivered to my home in due course....And as planned a huge bag was delivered along with 4 canisters of Entinox and Oxygen (just in case)....a machine was also brought along just in case baby needed a little more help at first off.

It was stored in my bedroom ( the planned room for delivery) and at first was a little scarey i laid there and looked at it many a time and wondered if i was doing the right thing ----------. Then as i got to near my dates the mw rechecked the equipment and we just waited, then early morning on 4th july he he, it all started, very very quickly too, went down to have drinks and bath (blooming downstairs bathroom :( ) and such like and never actually made it back up the stairs, by the time the 1st midwife arrived i was ready for pushing so she didnt even ring for the secondry midwife on call to come, i just pushed away, and delivered my beautiful baby girl at 4:04 on the 4th how cool was that..

It was the most relaxing and un fussy labour ive had and i woulds recommend it to anyone having second or after baby.............id imagine it would be a ittle scarey if its your first, as you don tknow what to expect.

As for who cleans up well we had been told to gather old towels to use that could be thrown away they colecxted most of the remaining waters and the yucky mess, and the mw had lots of disposavble like blue covers that she took with her..it wasnt really messay at all and i was on t squidgy couch
id imagine it would be even less messy on a flat bed

right id better sign off getting carried away here

love to all.xxx

skan