Behind the Scenes of Home Birth
If you have stumbled across home birth or Midwifery care, you have probably seen the videos. You know...the beautiful magic of birth. The ones that make you whisper "yaaaassss girl" through your own tears of joy. The ones...all the ones...that make you like an addict glued to your screen and longing for more. (or is that just me?!) So what is a home birth actually like? What's happening behind the screen and all the edits, when the music isn't playing and birth is raw and real? Ever wonder what prep went into that or what happens after the video is cut off?
It starts with reaching out to a local Midwife - email, call, text. Then we have a consultation and answer any questions. Most commonly we are asked safety questions and billing questions.
We start care at 10-12 weeks, although sometimes it starts even before conception with nutrition and fertility advice and support. After months of visits, consisting of hours and hours of standard prenatal care as well as holistic care, we have bonded as a team, and all the prep work has been done. Kids and family are encouraged to attend! (and often help) Supplies are gathered from a list, a medical birth kit has been customized specific to each family and arrives at the home about 3-4 weeks in advance. Plans are made for siblings during the birth and can range from removing them from the home to including them in the birthing process, it really depends on what the mother to be is most comfortable with.
Typically labor starts with some sort of contraction activity. Maybe it's a few days of off and on "prodromal labor" or it may start with discharge, water breaking etc. Usually we are back and forth in communication with the mother (at all hours of the day and night) until we think she is in active labor and ready for some extra support. On average we arrive when a mom is about 5-6cm dilated. Sometimes we get "false alarms" and a mom is 1-2cm dilated and we work to "labor down" encouraging her to rest and not engage during early labor activity. Once we arrive we do an assessment which includes taking a mother's vital signs, and many times, but not always, a vaginal exam. We decide if we will be staying or laboring the mother down for rest.
If we stay, we then bring in all of our gear and set to work: Oxygen tank and tubing as well as resuscitation equipment for baby is all checked and rechecked for functionality. Warm blankets are piled on top of a portable resuscitation cradle, in case it's needed baby will have extra warmth while being worked on. We prepare and lay out pharmaceutical medications for bleeding emergencies (pitocin, cytotec and methergine) as well as herbal tinctures and homeopathics to support various complications from a mother experiencing anxiety to labor pauses or stalls that do not require pharmaceutical treatment.
Then comes the fun stuff: inflating and lining the birth tub, setting up trash and laundry bags within easy reach, making postpartum tea so it's ready when the time comes, making sure the bed is protected with plastic lining and a fresh soft sheet put on top, we open and lay out "chux" bed pads to keep things clean as we go, baby blankets are bundled in a heating pad to stay warm while mama labors.
In our bags ready for use if needed we also carry things like catheter kits and suturing instruments as well as numbing medications-just in case mama has some collateral damage.
Our laptop and phones settle on a nearby dresser so we can update the chart for just about everything. We listen to babies heart beat through a contraction from a full 3-5 minutes frequently and chart the results. We monitor mamas vital signs and pretty much every move she makes is charted: position changes, frequency and intensity of contractions, if she moves into the water, rolls on a ball, starts moaning, uses the restroom, vomits, etc... it's all charted!
We are ready to be support: hands on massage, whispers to remind her shes strong and encourage her birthing process, refilling drinks or filling in so her partner can take a much needed break.
If she's handling things well, we leave her alone! Why try to fix what's not broken? Many times we find ourselves alone in another room nearby, listening to her vocalizations (oh we can tell alot by observation alone), and whispering quiet conversations. We Facebook. We Instagram. We text. We sip coffee. We crochet baby hats and giggle quietly with anticipation of the precious new life making its way earthside. It's often dark or dimly lit and these are the sacred spaces where magic enters the room. and trust me when I say it shows up every time. There is almost a palpable door that opens at birth. It truly is a spiritual event. Maybe that's because it's a calling for me, but that's my perspective. This is our "church."
This is typically the point where you see the video's on youtube. A mother working hard, labor sounds, and seemingly easy a baby enters the world, safely at home.
Oh...that's not all...what you don't see after is the delivery of the placenta, a flurry of activity from reassessing mothers vitals/stability to make sure she's doing okay after all that, baby is assessed on mamas chest and nursing begins-typically within 20-30 minutes. Mother and baby are moved to a clean bed if this all happened in the water and we begin clean up activities as we continue to assess mother and baby for safety. If mom needs any stitches, now is the time this is done, numbed up and taken care of right in her own bed holding her precious baby.
The tub (full of blood, stool and clots as well as other birth related fluids) is drained with a sump pump - the water goes down the "u bend" of the toilet (so basically it auto flushes and doesn't overflow) the liner is removed and the whole tub is wiped down with disinfectant and deflated. The plastic on the floor is lifted and removed so the area is open and clean again.
We bring the placenta back into the room on a clean pad at the foot of the bed and inspect it with the family. If you can get pass the "ick factor", the placenta actually gives us loads of information and it's fascinating to learn about what life was like for baby on the inside. It's less "icky" when it's your own placenta as well, you'll just have to trust me on that one! Kids attending LOVE this part it's gross and cool and fascinating all in one --science man!
Once mama and baby have had a couple hours to nurse and be undisturbed as much as possible, we add a little extra light to the room (oh yes, we've often been working in the dark this whole time, it's quite cozy), bring a big ol heating pad to the bed right next to mama and do a full pediatric physical on the baby, talking about what we are looking at as we go and stopping to calm baby if fussiness happens. This is the same exam a hospital pediatrician would do to discharge, except by and large we are more gentle and slow for baby (and mamas) sake.
This is usually when daddy (or partner) gets a good snuggle and we can assist mama on her first bathroom trip. She gets lovely concoctions of herbs and medical grade honey, bottom spray and lovely depends (if you haven't heard to use depends postpartum-well now you have, you're welcome). While one of us is assisting mama in putting herself together in the restroom (maybe even sneaking in a quick shower) the other is pulling the chux pads, top sheets and plastic off the bed so that underneath is cozy comfy scrumptious sheets and partner and baby climb in to wait for mama.
She returns to her resting place and we bring her a warm cup of tea and snack. The family babymoon begins-days and hopefully weeks of resting, bonding (it's not just "the golden hour" that's important)...an intricate exchange of hormones guides the whole process that lasts a full 6 weeks...and beyond!
Sitting on the foot of the bed, postpartum instructions are given (and sent via email). A little sign is hung on the door reminding guests to wash their hands when entering, and not stay too long. We make arrangements to return the next day...and about 4 hours after the birth, we load up all our repacked gear and head home to sterilize used instruments, shower, eat our own meal (that's never at meal time) and catch up on sleep.
We also return for several follow up visits to care for both mama and baby: 24 hours out, 3-4 days later, day 7-8, 2 weeks, 4 weeks and graduation from Midwifery care at 6 weeks postpartum. Most families schedule an appointment with pediatrics to establish continued care for baby at about 8 weeks out. Mamas won't even need follow up with an OB/GYN! We got you girl!
And that my friends, is a little sneak peek behind the scenes of home birth!
Did you home birth? What was your behind the scenes like?
Love and Light,
Midwife Randi
It starts with reaching out to a local Midwife - email, call, text. Then we have a consultation and answer any questions. Most commonly we are asked safety questions and billing questions.
We start care at 10-12 weeks, although sometimes it starts even before conception with nutrition and fertility advice and support. After months of visits, consisting of hours and hours of standard prenatal care as well as holistic care, we have bonded as a team, and all the prep work has been done. Kids and family are encouraged to attend! (and often help) Supplies are gathered from a list, a medical birth kit has been customized specific to each family and arrives at the home about 3-4 weeks in advance. Plans are made for siblings during the birth and can range from removing them from the home to including them in the birthing process, it really depends on what the mother to be is most comfortable with.
Typically labor starts with some sort of contraction activity. Maybe it's a few days of off and on "prodromal labor" or it may start with discharge, water breaking etc. Usually we are back and forth in communication with the mother (at all hours of the day and night) until we think she is in active labor and ready for some extra support. On average we arrive when a mom is about 5-6cm dilated. Sometimes we get "false alarms" and a mom is 1-2cm dilated and we work to "labor down" encouraging her to rest and not engage during early labor activity. Once we arrive we do an assessment which includes taking a mother's vital signs, and many times, but not always, a vaginal exam. We decide if we will be staying or laboring the mother down for rest.
If we stay, we then bring in all of our gear and set to work: Oxygen tank and tubing as well as resuscitation equipment for baby is all checked and rechecked for functionality. Warm blankets are piled on top of a portable resuscitation cradle, in case it's needed baby will have extra warmth while being worked on. We prepare and lay out pharmaceutical medications for bleeding emergencies (pitocin, cytotec and methergine) as well as herbal tinctures and homeopathics to support various complications from a mother experiencing anxiety to labor pauses or stalls that do not require pharmaceutical treatment.
Then comes the fun stuff: inflating and lining the birth tub, setting up trash and laundry bags within easy reach, making postpartum tea so it's ready when the time comes, making sure the bed is protected with plastic lining and a fresh soft sheet put on top, we open and lay out "chux" bed pads to keep things clean as we go, baby blankets are bundled in a heating pad to stay warm while mama labors.
In our bags ready for use if needed we also carry things like catheter kits and suturing instruments as well as numbing medications-just in case mama has some collateral damage.
Our laptop and phones settle on a nearby dresser so we can update the chart for just about everything. We listen to babies heart beat through a contraction from a full 3-5 minutes frequently and chart the results. We monitor mamas vital signs and pretty much every move she makes is charted: position changes, frequency and intensity of contractions, if she moves into the water, rolls on a ball, starts moaning, uses the restroom, vomits, etc... it's all charted!
We are ready to be support: hands on massage, whispers to remind her shes strong and encourage her birthing process, refilling drinks or filling in so her partner can take a much needed break.
If she's handling things well, we leave her alone! Why try to fix what's not broken? Many times we find ourselves alone in another room nearby, listening to her vocalizations (oh we can tell alot by observation alone), and whispering quiet conversations. We Facebook. We Instagram. We text. We sip coffee. We crochet baby hats and giggle quietly with anticipation of the precious new life making its way earthside. It's often dark or dimly lit and these are the sacred spaces where magic enters the room. and trust me when I say it shows up every time. There is almost a palpable door that opens at birth. It truly is a spiritual event. Maybe that's because it's a calling for me, but that's my perspective. This is our "church."This is typically the point where you see the video's on youtube. A mother working hard, labor sounds, and seemingly easy a baby enters the world, safely at home.
Oh...that's not all...what you don't see after is the delivery of the placenta, a flurry of activity from reassessing mothers vitals/stability to make sure she's doing okay after all that, baby is assessed on mamas chest and nursing begins-typically within 20-30 minutes. Mother and baby are moved to a clean bed if this all happened in the water and we begin clean up activities as we continue to assess mother and baby for safety. If mom needs any stitches, now is the time this is done, numbed up and taken care of right in her own bed holding her precious baby.
The tub (full of blood, stool and clots as well as other birth related fluids) is drained with a sump pump - the water goes down the "u bend" of the toilet (so basically it auto flushes and doesn't overflow) the liner is removed and the whole tub is wiped down with disinfectant and deflated. The plastic on the floor is lifted and removed so the area is open and clean again.
We bring the placenta back into the room on a clean pad at the foot of the bed and inspect it with the family. If you can get pass the "ick factor", the placenta actually gives us loads of information and it's fascinating to learn about what life was like for baby on the inside. It's less "icky" when it's your own placenta as well, you'll just have to trust me on that one! Kids attending LOVE this part it's gross and cool and fascinating all in one --science man!
Once mama and baby have had a couple hours to nurse and be undisturbed as much as possible, we add a little extra light to the room (oh yes, we've often been working in the dark this whole time, it's quite cozy), bring a big ol heating pad to the bed right next to mama and do a full pediatric physical on the baby, talking about what we are looking at as we go and stopping to calm baby if fussiness happens. This is the same exam a hospital pediatrician would do to discharge, except by and large we are more gentle and slow for baby (and mamas) sake.
This is usually when daddy (or partner) gets a good snuggle and we can assist mama on her first bathroom trip. She gets lovely concoctions of herbs and medical grade honey, bottom spray and lovely depends (if you haven't heard to use depends postpartum-well now you have, you're welcome). While one of us is assisting mama in putting herself together in the restroom (maybe even sneaking in a quick shower) the other is pulling the chux pads, top sheets and plastic off the bed so that underneath is cozy comfy scrumptious sheets and partner and baby climb in to wait for mama.
She returns to her resting place and we bring her a warm cup of tea and snack. The family babymoon begins-days and hopefully weeks of resting, bonding (it's not just "the golden hour" that's important)...an intricate exchange of hormones guides the whole process that lasts a full 6 weeks...and beyond!
Sitting on the foot of the bed, postpartum instructions are given (and sent via email). A little sign is hung on the door reminding guests to wash their hands when entering, and not stay too long. We make arrangements to return the next day...and about 4 hours after the birth, we load up all our repacked gear and head home to sterilize used instruments, shower, eat our own meal (that's never at meal time) and catch up on sleep.
We also return for several follow up visits to care for both mama and baby: 24 hours out, 3-4 days later, day 7-8, 2 weeks, 4 weeks and graduation from Midwifery care at 6 weeks postpartum. Most families schedule an appointment with pediatrics to establish continued care for baby at about 8 weeks out. Mamas won't even need follow up with an OB/GYN! We got you girl!
And that my friends, is a little sneak peek behind the scenes of home birth!
Did you home birth? What was your behind the scenes like?
Love and Light,
Midwife Randi
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