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The Ultimate Guide to Planning a Home Birth

Why I chose a Homebirth

Homebirth was not something that I thought I would ever consider for myself or my family. If I am being honest, it sounded like some real deep-woods-hippy-shit. Perhaps all a bit too ‘crunchy’ for my taste. At that point, I had not known anyone personally who had ever given birth at home, except for my Nan and that seemed more like a necessity of having kids in England in the early sixties, more than anything. I was misguided about all of these notions of course, and perhaps you have some misconceptions as well, so stick with me a little longer!

Before having children of my own, I was incredibly ill-informed about the role and competencies of midwives. I also had a ton of misguided ideas about home-birthing. Was it safe? Was it sanitary? What about pain medication? I surely need the drugs!

When I became pregnant with my first daughter everything was so brand new to me. I was just looking for a professional to point me in the right direction. My family physician referred me to an obstetrician. I remember sitting in that first prenatal appointment with my OB completely lost. She explained that she would be taking over my care and that she would attend the delivery at the neighbouring hospital. 

Thinking back, it is sort of absurd how many assumptions were made by my doctors. I remember just ‘going with the flow’ and not asking too many questions. In hindsight, I just didn’t know what questions to ask! 

To be fair, I had great care from my doctors throughout my pregnancy and a fine delivery. But what I didn’t have was a clear understanding of my maternity care options

Accidental Home Birth

With my second baby a couple of years later, I opted for midwifery care and planned for another hospital birth. 

At 39 weeks I had a precipitous labour. This is a very quick labour period, defined by giving birth within three hours of starting regular contractions. From my first contraction to having the baby in my arms was only 45 minutes. My son was born unexpectedly on my bathroom floor! Needless to say, my midwives didn’t make it, which is a very rare and unusual occurrence. Even the paramedics were too late to assist in the actual birth. It was a wild experience, to say the least!

Having such an intense, unplanned home-birth experience could have turned me off the idea of a home delivery altogether. But actually, the opposite turned out to be true. Nearly four years after our son was born (during a global pandemic) we found out we were expecting again. Our third baby was due in February 2021.

If you are considering a home birth, it may seem daunting at first. I hope that my experience will help you make an informed decision. Though every pregnancy is different, as are the needs of parents and babies, I encourage expecting parents to keep an open mind.

Midwifery 

As previously mentioned, I opted for midwives for my second pregnancy. Even in 2016, it was interesting to see how people responded to this news. Some even expressed confusion and concern about my decision. This underscores that there is important work to be done in creating more awareness about midwifery care and the incredible work that midwives do. They are experts in perinatal care and the best decision I ever made. 

Why Midwives?

Registered midwives are autonomous health professionals who provide primary care to you and your baby throughout pregnancy, labour, birth, and postpartum. Much like other prenatal care, the Ministry of Health funds midwifery care in Ontario. 

In Canada, midwives are the only healthcare providers trained and licensed to offer the choice of homebirth to their clients.

Benefits of Midwifery Care

In general, midwives tend to simply have more time to answer all your questions and help you learn about the physical and emotional changes you experience throughout pregnancy. A midwife can also help you think about what kind of birth experience you want – and will support you in your decision.

It is important to note that you don’t have to make any definitive decisions about your birth location right away. Even if you had planned for a home birth, you can decide at any time to go to the hospital (provided that it is deemed safe and feasible to do so by your midwives). 

Prenatal Care

As soon as you know that you are pregnant you should contact midwives to get on their client list. Midwives will set up regular visits, usually every 4-6 weeks to start. These appointments typically run 30-45 minutes, which allows for much more in-depth conversation and ample opportunity to ask questions. Midwives will ensure that you have all the necessary diagnostic testing and blood work throughout your pregnancy. 

Care During Birth 

Another factor for choosing midwives for my second and third pregnancies was the continuity of care. Physicians often have other commitments and patients to manage simultaneously. Attending doctors tend to rely more heavily on nurses for the majority of the labour process. Alternatively, midwives are dedicated specifically to you throughout your labour and delivery. 

Postnatal Care

After your baby is born, you are required to participate in several ‘wellness visits’. This is where your care provider assesses your recovery and the baby’s development. My oldest daughter was born at a very large, busy, downtown Toronto hospital. I hated having to lug her across the city every few days for appointments, especially when I was healing. Midwives come right to your home for those first few visits. 

Myths Of Midwifery Care

There is also a lot of misinformation about midwifery. Most people understand what doctors do, but because midwifery was not regulated in Canada until 1994, many people have limited-if any-knowledge about the practice.

Myth: Midwives aren’t specifically educated or regulated 

Reality: Midwifery has been a regulated health profession for 27 years. It is now publicly funded in most provinces and territories in Canada. The Canadian standard for midwifery education is a baccalaureate degree in midwifery.

Myth: Midwives are only for people interested in having a home birth.

Reality:  In Ontario, between April 2018 and March 2019, 84 percent of births attended by midwives were in the hospital. 12 percent took place at home. 3 percent were at birthing centres.

Myth: If you want pain management drugs or an epidural, you can’t have a midwife.

Reality: Midwives are all about offering informed choice and will provide information on all aspects of care, including epidurals. Your midwives will explain what pain management options are available to you and work with you to develop a birth plan, prioritizing you in the decision-making process.

Myth: Midwives and Birth Doulas are the same.

Reality: Registered midwives are medical professionals trained to provide prenatal care and deliver babies. Whereas, Doulas are nonmedical professionals who provide physical and emotional support during pregnancy, labour, and postpartum. However, they do not provide medical care. Many doulas have great working relationships with midwives, and many people opt to have both attend their birth. 

Initial Questions To Ask Your Midwives 

  • What is the midwife team’s scope of practice?

    Midwives will screen during your intake to establish if you are a good candidate for their care. If you are deemed ‘high-risk’ or if complications arise during your pregnancy, your midwife may refer you to an obstetrician.

  • Who will be attending the birth?

    Midwives typically work in teams, so the birth is very likely to be attended by someone you are familiar with. Depending on the practice, an additional backup midwife may come as well. Ask about how many support people you are permitted to have in the room during labour and delivery. It is important to set boundaries with friends and family so that you can focus on your delivery. Your midwives may also have specific COVID-19 related protocols.

  • What are my birthplace options?

    Midwives usually have privileges to deliver babies at local hospitals, birth centres, and are trained to deliver babies at home. You may also want to learn more about water births. Some hospitals will only allow patients to labour in the water, but not birth in the tub. If you would like to deliver your baby into the water, you may only be able to deliver at home. 

There are many other questions that you are likely to have throughout your pregnancy. There will be a lot of information to digest! Don’t feel like you have to ask a million questions in your first appointment. 

During your first visit, it is recommended that you simply get a sense of your midwife’s general philosophy on pregnancy and birth. A good midwife is expected to prioritize informed care. They will share information and make recommendations about your care but will respect you as the main decision-maker.  

Choosing Home-Birth 

Due to significant advances in modern medicine, hospital births have become widely thought of as the safest option. However, there has recently been a slight shift. More people seem to be wondering if home-birth is a better option for individuals with low-risk pregnancies. 

Since the COVID-19 pandemic hit, midwives from across Canada have been reporting a large increase in home birth interest. Unsurprisingly, it appears that parents are feeling more reluctant to venture out to hospitals and doctors’ offices to access care.

While the pandemic was not a huge deciding factor in our situation, avoiding hospitals in the current climate was somewhere in the mix. Perhaps this is a small turning point for societal norms, with more people considering their birth options outside of the mainstream. 

Why Are People Choosing To Birth At Home?

People who choose to have a home birth will often say it’s because they are attracted to the idea of giving birth in a comfortable environment that they have more control over. Research shows there are equal positive neonatal outcomes for both women and babies, regardless of whether the birth occurs in a hospital or at home with midwives.

Additionally, there is evidence to support that planned home births have lower rates of medical interventions, increased sense of satisfaction with the birth experience, and increased success with breastfeeding spanning over a longer duration. 

Some common reasons parents may choose an at-home birth include: 

  • More autonomy and control over the birthing experience
  • Avoid invasive interventions, such as induction, episiotomy, cesarean birth, or instrumental assisted birth
  • More comfortable in the home environment
  • Avoid having epidural or other medications during labour 
  • Previous baby came very quickly 
  • Interest in a water birth

Mental & Emotional Preparation

If this is your first birthing experience, you may be feeling like there are an exponential amount of unknowns. It’s important to understand that things of this nature will never go exactly according to plan. Best-laid plans can become your ultimate undoing when there is no flexibility.  

The benefit of subsequent pregnancies is that you now at least have a frame of reference, which can be beneficial in the decision-making process. Whether it is your first or your fifth baby, it’s never too late to cultivate a birth experience that is most ideal for you. 

Include Your Partner 

Pregnancy often attracts a lot of care and attention for the person with a growing baby bump! People will ask a lot of questions about how far along you are, how you are feeling, and if you know ‘what’ you are having. The other parent might be left wondering what their role is during the pregnancy. If you want your partner to feel more involved in your pregnancy, including them in learning and planning can be a great bonding experience.

Most recently, the regulations related to COVID prevented my husband from attending our prenatal appointments. With this being our third pregnancy, I didn’t consider the impact that this would have on him. I realized how important it was for us to have check-ins throughout the pregnancy about our thoughts and feelings. Establishing strong communication with your partner will allow for a smoother experience.

Who Should Attend?

Who you choose to be present during the birth can have a huge impact on the outcome of your labour and delivery. You want to make sure that your primary support person is someone who you trust, and who makes you feel safe and calm.

This may or may not be your partner/the other parent of your baby, a friend, or a relative. The most important thing is that this person understands their role and respects your choices. 

Birth Doula

If you don’t have someone in your life who would be a good support person, you may consider hiring a birth doula. Doulas are specifically responsible for attending to your physical and emotional needs. They offer non-judgmental support, guidance, evidence-based education and practical hands-on support, including comfort measures like massage, breathing, and positioning techniques. 

Set Boundaries

Choose a support team equipped to advocate on your behalf, freeing up your emotional and mental energy to be solely focused upon yourself and your baby.

Don’t feel pressured to have people at the birth that you don’t actually want to be there. Your comfort should come before everyone else’s. Read that line again! You may have several people in your life who express interest in being present for the birth of your baby, but it is so important that you prioritize your own needs.

Speaking from personal experience, the fewer people you have present the better. 

Attend Prenatal Education 

There are a variety of education classes, workshops, and other resources available to prepare expecting parents for the arrival of their baby. If you are a first-time parent I would recommend a prenatal education program that provides information about a variety of topics related to pregnancy, birth, and infant care.

Independent birth education classes are usually much better than hospital classes because they tend to go much more in-depth, though private offerings may have a cost associated. 

The content of the classes will vary, but should include some of the following:

  • Labour and childbirth process
  • Medical procedures and interventions
  • Birthing positions 
  • Relaxation and pain management (massage, breathing, water)
  • Healthy pregnancy
  • Mental health during and after pregnancy
  • Supplies needed if preparing for a homebirth
  • How to prepare a birth plan
  • Breastfeeding
  • Postpartum care
  • Caring for a newborn
  • Opportunity to ask questions

Take A Babymoon

The babymoon trend is a celebratory vacation that allows parents-to-be to spend quality time together before the baby arrives. Honestly, though, you don’t need to plan an expensive or elaborate trip to experience the benefits of pre-baby rest. 

Whether it’s an exciting getaway or a simple staycation, it’s most important that you can take some time to focus on self-care. 

This may include: 

  • Much needed physical rest for your growing body
  • Recharge your mental energy 
  • Take inventory of your emotional readiness for the birth
  • Intimacy and connection with your significant other 
  • Have a little fun that is just about you
  • Communicate with your partner about your hopes for the birth and new baby 

Consider A Birth Plan 

Many people have mixed feelings about the value of writing a birth plan, which might have more to do with the term itself than with the concept. The issue with the term birth plan is that it can be somewhat misleading. In reality, it should be less of an exact plan and more of a list of preferences, or birth wishes. 

Birth Plan Checklist

It is impossible to predict what will happen during labour with so many variables in the mix. It’s still worth considering what the ideal experience would look like for you – and what you hope to avoid.

Before The Birth: 
  • Determine who will be attending the birth
  • Birth location  
  • Labouring in water and/or water birth
  • Personalize the atmosphere 
  • Food and drinks  
  • Prenatal education – birthing techniques 
Labour And Delivery: 
  • Birthing positions and equipment
    • I would like to push in the water, on the bed, in a squat, etc. 
  • Pain management techniques and comfort measures
  • Interventions
    • Artificial rupture of the membranes or leaving membranes intact
    • I would like to avoid cervical exams
  • Mirror to see the baby crown
    • Touch the baby’s head as it crowns
  • Role of the support person
    • Catch/let my partner catch the baby
    • Cord-cutting 
  • I would like to have photography/video
  • Please remind me to drink and eat
Postpartum And Newborn Care: 
  • I would like my baby placed immediately on my chest
  • Leave the umbilical cord attached until its completely white and no longer pulsing
  • I would like to encapsulate my placenta
  • Leave any vernix kept on my baby  
  • I plan to breastfeed and would like assistance with this

Create An Alternate Birth Plan

Remember, preparedness is important but having too rigid a birth plan may be more harmful than helpful. The key is to expect the unexpected and try to integrate some flexibility into your plans. A backup hospital plan is a good idea in case you change your mind at the last minute or medical challenges arise. 

You May Have To Go To The Hospital If:
  • The labour is not progressing 
  • The baby is showing signs of distress
  • Your waters have meconium staining 
  • Baby is breech 
  • You need pain relief beyond what your midwives can provide
  • You decide that you would be more comfortable at the hospital
    (and your midwife deems it safe for you to change locations)  
Back-Up Hospital Plan Checklist:
  • Bring along your health card and credit card for parking expenses 
  • Have a hospital bag packed and ready to go 
  • Include baby essentials, personal care items, and clothing for yourself
  • Make sure your infant car seat is properly installed in advance 
  • Ensure your vehicle is accessible and has gas for transportation 
  • Store extra towels, a shower curtain, or a waterproof pad in your vehicle to sit on 
  • Keep your cell phone charged and bring a power cord 

Preparing Your Environment   

At some point, typically during the third trimester, your midwives will conduct a home visit. Generally, they will want to ensure that you have a clean and comfortable space to safely deliver your baby. Your midwife may provide you with some specific recommendations for preparing your home for the birth. 

Tips For Preparing Your Birth Space  

Choose a space in your house that you will feel most comfortable in during your labour and birth. Your midwives will need easy access to running water, electricity, and a small table to set up their supplies. A well-heated room with access to a bathroom with a tub would be ideal. The bed should be accessible from both sides. 

The best part of labouring in your own home is that you have complete control over your space. Consider what would be your ideal birth environment that would foster calm and relaxation throughout the labour. 

Lighting – You may want to have the lights dimmed down (smart light bulbs are great for customizing your lighting) or a small lamp – both be a nice alternative to harsh overhead lights. 

If you are labouring during the day, you might want to have window coverings available to block out the sun. A Himalayan salt lamp is also great for the bedside table, as the soft glow is just enough for attending to your baby and nursing throughout the night. 

Music And Sound – Many people like to curate a calming music playlist for some background noise. Be sure to have your device set and ready to go. Some sound apps can be great. White noise, rain sounds, or waves can be very soothing and something to focus your attention on to relax. 

Visuals – Positive birthing affirmations posted up around the room can be comforting, and a source of strength and motivation during labour. Creating beautiful affirmation art pieces can be a nice activity to have at a baby shower or a ‘mother blessing’. Any pictures or photographs that fill you with happiness will also be a great addition to your space. 

Smell – Aromatherapy is a traditional practice of using essential oils from plants to enhance well-being. These can have some positive impacts during labour.

Lavender, Bergamot, and Clary Sage are all oils that are calming and grounding, great for reducing anxiety. Peppermint oil has cooling properties and also helps to reduce nausea that can occur during labour. Citrus oils are great for supporting energy levels. Be sure to use high-quality oils and do your homework to ensure that they are pregnancy safe. You may opt to diffuse the oils, use a roll-on, or incorporate them into a massage oil or spray. 

Temperature – You may get chills during labour and babies can lose heat quite rapidly. It’s recommended that you have a well-heated room for the birth, especially in the winter months (if you live in an area with a colder climate). You might want to have a small fan nearby that you can point directly on yourself, as needed during labour. 

Prepare Your Bed For The Birth

In the weeks leading up to your estimated date of delivery, you will want to have these items on hand to prepare your bed and birthing area:

  • fitted sheets – I was told these are easy to launder, but take my advice- just toss the sheet away. It’s not worth keeping it. 

  • A waterproof layer – A plastic drop cloth or shower curtain would work great 

  • Absorbent underpads – Your midwives may supply these, or ‘puppy pads’ will also do the trick

You may also want an extra waterproof current or pads available to cover your floor or yoga mat if you decide to labour on a firmer surface than your bed.

How To Make The Bed:

  1. Place a clean fitted sheet on the bed
  2. Cover the fitted sheet with the waterproof plastic layer 
  3. Cover with the next fitted sheet
  4. Place an underpad overtop the sheet so it doesn’t get soiled 
  5. After the baby is born dispose of the underpad/fitted sheet in the wash
  6. Remove the plastic layer and discard 
  7. Climb in and enjoy the fresh, clean sheet underneath 

Home Birth Supplies Checklist 

When it comes to collecting all the items you will want and need for the birth, it’s best to start early so that you have plenty of time to have everything ready before the baby arrives. 

Of course, not everything on the lists below is an absolute necessity, but they are a great place to start when considering what is going to make you most comfortable. 

Nourishment 

Many practitioners have a policy that you may not eat or drink once your contractions have begun. This was one of the most frustrating aspects of my experience with a hospital birth. After hours of labouring, I was hot and so thirsty but was only permitted to have ice chips. As a result, I was left feeling stressed and exhausted, which can prolong the labour process. 

So, why the food restrictions? The main concern seems to be that having food in your stomach can present complications if you need general anesthesia. The anesthetic can cause vomiting, running the risk of breathing issues and infection. 

Despite evidence emerging that there appears to be no clear health risk to eating and drinking during labour, hospitals continue to advise against it. Bring this up with your midwives, as they will be able to discuss the risks and benefits with you.

Snack Ideas 

Labour is hard work that takes an incredible physical toll on your body. Sustenance supports your energy, strength, and stamina throughout the labour, such as:

  • Avocado
  • Hard-boiled egg
  • Grass-fed yogurt and granola
  • Banana or apple with nut butter
  • Whole grain toast with nut butter 
  • Smoothies 
  • Dried fruit and nut mix 
  • Energy balls 
  • Frozen grapes or berries
  • Natural sugars from healthy sources provide quick energy
  • 100% applesauce (pouches are great) 
  • Muffins 
  • Oatmeal 
  • Soups (avoid high sodium) 
  • Grass-fed beef bone broth  
  • Jello 
  • Plain pasta with grass-fed butter

Recipes

You may experience some nausea and stomach upset during labour, so eating easily digestible foods in small portions is key. Avoid heavy, greasy foods that can be hard on your stomach. Sugary foods and drinks are also not great choices, as they can make you feel nauseous and tired. Be sure to stay hydrated, especially early on in your labouring. 

Here are some recipes that are often used, in some variation, during pregnancy, labour, and postpartum. 

What to Expect When the Baby is Born 

Once the baby is safely delivered, the midwives will likely give some time for the family to be together. They will then complete a newborn exam, weigh the baby and help you to breastfeed if you wish. 

Midwives will typically stay at your home at least two hours after your placenta is delivered, and make a plan for follow-up home visits before they leave. Your only job now is to rest and bond with your baby!

Postpartum Recovery  

The birth of your baby can feel like a much-anticipated finish line after a long pregnancy and exhausting birth. However, in many ways, it’s more of a new beginning than an ending.

The weeks following the birth of your baby are crucial for rest and healing. Sometimes this is referred to as a ‘lying-in period‘, and it deserves as much attention to planning as any other stage in your pregnancy. 

Unfortunately, in our more modern times, the idea of an intentional lying-in period is falling by the wayside. Western society and ideals make us believe that our worth is measured by how busy we are.

It has taken me until my third pregnancy to actually consider what I need from the days and weeks following the birth. This is just to say that it has been a long journey to prioritize myself in my maternal experiences. 

Creating a ‘Lying-In’ Plan 

The lying-in period is a window of time after you have given birth when you will heal and bond with your new baby. Your body has been through so much, and intentional self-care and rest are crucial at this time. Expecting parents are encouraged to take time to consider how they can best prepare and create space for a healing and nourishing postpartum experience. 

Set boundaries on visitors

In the early days of postpartum your job is to rest not entertain. Guests should be helpful, not a strain on your energy. Don’t feel obligated to respond. If you are getting a million social media messages, texts, or phone calls, don’t be afraid to put your devices away for a bit. People are usually checking in to be polite, and shouldn’t expect an immediate response. 

Who are your people? Consider who might be available to support you in the home with general household tasks or assist with caring for your other children. At first, you should be doing very little physical activity and even just being on your feet too much can increase bleeding and prolong recovery – avoid stairs altogether

Take care of your needs too

With the whirlwind of welcoming a brand new human into the world and into your life, it can be easy to forget that you need to also take care of yourself. Be sure to:

  • Eat and hydrate. Stock up on easy, nourishing foods and premade meals before the baby arrives.
  • Prepare a self-care kit. Make sure your physical healing and recovery needs are being taken care of. 
  • Rest and recover. After a few days you may feel guilty for not doing ‘enough’,  or you may start to think that you need to ‘bounce back’ right away. Instead, remind yourself that you both need and deserve this time. 

Additional Reading

There is a ton of information and reading material out there, but you may become overwhelmed with the sheer volume of opinions. I suggest doing some general research to get a feel for what kind of pregnancy, labour, and birth practices resonate most with you.

That said, if you are looking for a place to start, here are some of the books that I found useful for one or more of my pregnancies.

Disclaimer 

Please be advised that I am not a  physician or medical professional. The information shared above is based on personal experiences and opinions, strictly for informational purposes. It is in no way meant to act as official medical advice. Always consult with your doctor or licensed medical care provider about matters of your health and well-being. 

Hey! Let’s Chat!

Did you have a homebirth?
-What was one thing you wish you knew before?

Are you currently considering or planning a home birth?
-What would you like to learn more about?

Comment below! I would love to hear from you!

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