Why do women choose Home Birth?
There are many reasons why women choose to birth at home, the most common being:
• a belief that childbirth is a normal function of her body and not a medical event
• a belief that birth is safer at home
• a desire to stay with the family before, during and after the birth to prevent disruption to family life
• a feeling of having more control resulting from being in a nonthreatening environment
• the increased comfort of being in your own home
• a fear of hospitals, often resulting from a previous traumatic birth experience
• concern about the discomforts and dangers associated with travel while in labour
• for religious reasons
Is Home Birth safe?
Home Birth statistics, both nationally and internationally, reflect that giving birth at home is the safest option in the majority of cases. Home birth midwives carry with them, and are trained to use, equipment for resuscitation
of the baby and equipment and drugs for the treatment of unexpected haemorrhage of the woman after the birth. Because a women at home does
not use drugs during labour and because labour is allowed to follow its normal course without intervention, some of the common but unnecessary procedures used in childbirth are eliminated. Transfer to hospital is readily available if circumstances make this option necessary.
What is the cost?
There is no charge to women and their families. In
New Zealand the LMC (Lead Maternity Carer)
claims the Maternity Services Benefit from the
government on the woman's behalf.
What are the advantages of a homebirth?
Some of the advantages are:
Familiar Environment: During particularly vulnerable times we are all more
secure in an environment which is familiar and non-threatening. It is important
for a normal, natural labour to proceed without interruption. A woman feels much more in control in her own home. Research shows that there are less likely to be complications during labour if she delivers at home.
Midwife: By the onset of labour, following regular visits during your pregnancy, your midwife is a known and trusted friend. She will attend as soon as she is asked and she will observe and support the normal birth process.
She will remain for as long as she is needed throughout established labour and birth. She is skilled in recognising signs that something is not normal. She will continue to visit after the birth for up to six weeks. Less Susceptible to Infection: Both you and your baby are less susceptible to infection from the bacteria you are likely to encounter in your own home than those which exist in hospital or other less familiar environments.
Less Intervention: The labouring woman is encouraged to believe in the natural birthing process, to listen to and work with her body and natural instincts thereby avoiding unnecessary intervention. Experience shows that well informed and supported women birth naturally, and that one intervention measure however small, usually leads to more.
No Medication: A variety of strategies are used at home to ensure the comfort of the birthing woman. These may include the use of: acupressure, massage positioning, water, heat, emotional support, homeopathy / herbs. Epidurals, pethidine and gas should not be available at home due to the associated risks to mother and baby.
Privacy: A woman at home can move about as she feels free to. There are no protocols, routines or strangers to inhibit her. This freedom is essential to ensuring her comfort. The privacy of your own home or garden can be a wonderful way to spend your labour.
Bonding: No separation of the family need occur during or after a home birth, allowing greater opportunity for bonding to occur.
A Family Experience: Family, children, chosen relations and friends who may attend the birth experience a deeper bonding to the newborn baby. Children will not experience the stress of separation from their mother that they may feel if she were in the hospital. It is also easier for the children's needs to be met at home. For fathers the uninterrupted sharing of the birth and the time immediately after the baby is born establishes a solid basis for sharing of the parenting partnership.
Breastfeeding: Research indicates breastfeeding is easily established by home birth mothers. Mothers and babies who have had a relaxed and stress free birthing experience without the effects of drugs are less likely to encounter some of the common post-natal breastfeeding difficulties.
Emotional Well Being: Because the home birth mother has fully participated in her birth and has worked with her body without intervention or the use of drugs, she is much more likely to feel satisfied and elated. This experience along with continued established support from midwife, friends and family means the likelihood of post-natal depression is dramatically decreased.
No Travel: Travel during labour is painful and stressful and may result in inhibiting labour. By staying at home no decision has to be made on when to leave for the hospital or worrying about whether you have remembered to pack all you need and organise everything for the time you are away.
How do you Arrange a Home Birth?
Contact your local homebirth association or a homebirth midwife for more information.
What is a Home Birth Midwife?
She is a Registered Midwife who provides a home birth service for women and should be affiliated to the Home Birth Association. She can provide:
• information prior to pregnancy
• pregnancy testing
• all ante-natal care
• referral to any other health practitioner or specialist group if needed.
• care during labour and birth at home (and where applicable transfer to hospital is indicated)
• post natal care at home for up to 6 weeks
• six week post natal check of mother and baby
• Her practice is reviewed annually through the New Zealand College of Midwives (NZCOM) by her colleagues and consumers.
The Role of the Midwife
We view the role of the midwife as the guardian of natural birth. The midwife brings her skills and knowledge to the birthing situation and by respecting the autonomy of the woman and supporting the woman's natural physiological process she assists the woman to birth her own baby. It is from this framework that the home birth midwives who are affiliated with the Association work. The WHBA supports these midwives personally and politically and through this we support the women and their families that midwives offer their services to. Ultimately this special link between home birth midwives and the WHBA leads to an improved service and access to that service for all women. We are pleased to say that the quality of this service is reflected in our statistics.
What Responsibilities does the Midwife have?
The midwife acts at all times in partnership with the woman for whose care she is professionally accountable. Her actions promote and safe guard the well being and interests of the woman. She ensures that no action or omission on her part places the woman's well being or safety at risk. She is responsible for
providing information about her service, her experience, her interventions and her beliefs about birth. During her antenatal visits at home the midwife checks on the mother's health and the unborn baby's progress, discusses preparations for birth and breastfeeding and the mother's feelings and desires about the
birth experience. The midwife should be easy to contact at all times and she should provide a backup service that the woman is familiar with.
Choosing a Homebirth Midwife / Back up Midwife
Choosing a midwife to suit your individual needs is important so you need to ask around friends and the community and the local branch of the New Zealand College Of Midwives for suggestions. You have the right to meet with more than one midwife on a no obligation basis before making a choice.
Some of the things you may like to consider are:
• how long has she been a midwife
• why did she become a midwife
• does she provide a statement of the way sheviews birth and therefore the
• basis for her practice
• how many births the midwife does per month (her caseload)
• her age and whether she has children
• the convenience of where she will provide pregnancy care
• how many home births has she attended
• her transfer rates and under what circumstances she transfers
• what are her arrangements should she not be available at the time of your birth.
• is she a member of her professional body (New Zealand College of Midwives) and does she have her practice reviewed annually. For a more detailed list of considerations see "Home Birth and Other
Alternatives to Hospital" By Sheila Kitzinger published by Double Day 1991 pages 80-81 and/or the New Zealand College of Midwives Handbook of Standards)
Transfer to Hospital
If a woman should change her mind during labour or should some complication arise before or after birth, she will be transferred to hospital. During her pregnancy she and the midwife will have discussed the care the midwife provides in hospital. Some home birth midwives provide full care for women who plan to labour and birth in hospital.
Qualities we expect in a Midwife
A midwife should believe that birth is a normal physiological process rather than an illness, an instinctive process which for well women should not normally need medical or technological intervention. A midwife has an ethical responsibility not to intervene in the normal process of labour and birth. Her practice should reflect a wholehearted dedication to this philosophy. A midwife should see her role as a facilitator who can help a woman explore and research options for her birthing experience and help her express her own needs in the birthing situation. The midwife can do this by including the woman in her own healthcare, building her knowledge of, and confidence in, her own body. The midwife must at all times respect a woman’s right to make informed choices over her birth. It is the woman who is in charge of her birth (or her advocate who she has asked to act on her behalf) and it is the woman who delivers her own baby. From this philosophy we see it is important that a written birth plan be viewed as a document of informed consent, a respected contract of care between a woman and her midwife. A midwife needs to be informed and up to date, technically proficient, capable of recognising abnormality and knowing when referral is appropriate. She needs to be able to provide information fully and impartially for a woman to be able to make informed choices. A midwife needs to be able to work well under pressure and be able to respond in an emergency. A midwife needs to be knowledgeable and comfortable with a broad range of natural aids to women's wellness. A midwife should be prepared to be accountable to her consumers and the midwife profession for the way she practices.In terms of professional qualities a midwife needs to show through her life experience an affinity with women, and that her desire to support and empower women be the main focus of her practice. She needs to be culturally and socially aware, respecting all the definitions of family and capable of attending a woman she is caring for without prejudice towards her personal circumstances. A midwife needs at all times to maintain a professional attitude, respecting the privacy of the woman she is caring for. She needs to be aware of the issues that are affecting women in today's society and to care for a woman sensitively, woman to woman, in the environment the woman chooses and in a way that will lead to greater feelings of self esteem and confidence for the woman. A midwife should belong to her professional body i.e. The New Zealand College of Midwives (Inc) and adhere to the standards of practice of such a body. Midwifery is a Women Centered profession.
The Pregnant Woman's Bill of Responsibilities
The pregnant woman is responsible for:
• learning about the physical and emotional process of labour, birth andpostpartum recovery
• learning about good pregnancy and birth care so that she may choosethe best possible arrangements to meet her personal needs
• learning about the way in which her midwife practices
• caring for herself both physically and emotionally during pregnancy
• attending her antenatal appointments and informing her midwife if she is unable to attend
• her own preparation for home birth in a society which may be unsupportive
• meeting agreed upon requirements for preparation for birth at home
• informing her midwife of any relevant physical or emotional information which may affect the outcome of her birth and parenting
• choosing a suitable support person (persons) for her birth and for ensuring they are prepared for their role at her birth
• ensuring her support people carry out her preferences if she is unable to express them during labour
• the preparation of children for the birth and for the choosing and preparation of support people for children
• acquiring information about breastfeeding and the care of the newborn and registering the baby's birth
• arranging home support for herself and her family for after the birth
• evaluating the quality of care she has received and making any dissatisfactions she may feel, known to her midwife or to the Coordinator, Midwifery Standards Review , in her area.
The Pregnant Woman's Bill of Rights
The pregnant woman has the right:
• to choose her place for giving birth, how she gives birth and to be treated with dignity and respect
• to choose her midwife and be fully informed of her midwife's qualifications and experience
• to choose who will be present at her birth and the right to refuse entry or ask anyone to leave her place of birth
• of access to information about birth and particularly home birth
• to know about the way her midwife practices and what care she provides including antenatal, labour and birth and postnatal care
• to expect any information she gives her midwife to remain confidential
• to comprehensive and individualised antenatal care
• prior to the administration of any drug, medication, procedure or test to be informed of any direct or indirect effects or risks to herself or her unborn or newborn baby
• to determine herself whether she will accept the effects or risks of the above and give or withhold consent according to that decision
• to extra medical support when needed
• if transferred to hospital, to be treated with respect and courtesy and to be accompanied by her midwife and support person of her choice
• not to be separated from her baby except for valid medical reasons
• to comprehensive postnatal care including support for the establishment of breastfeeding, assessment and care of her newborn, and information about relevant screening tests and notification and registration of birth
• to be informed if there is any known aspect of her or her baby's care or condition which may cause her or her baby problems later
• of access to her and her baby's records and a copy of her noteswhen desired.
• in the event of an unexpected outcome to her pregnancy or birth to receive all the additional support and services that she needs
• to express any concerns about the care of herself and her baby to her midwife and receive satisfactory resolution of those concerns. She may also use the Coordinator, Midwifery Standards Review , NZCOM,in her area to express any concerns. This article is used with permission of the Waikato Home Birth Association Inc. It forms part of their brochure “Have you Considered a Home Birth?”, the full version of which can be found at
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