What are the benefits and risks associated with home birth?
The benefits of midwifery care go above and beyond the setting of birth. In an ideal world, mothers would be informed and empowered throughout the pregnancy, birth, and postpartum regardless of their birth setting. I love homebirth because mothers and babies are subjected to fewer unnecessary interventions with comparable outcomes to hospital deliveries. For more information about the safety of homebirth, check out this recent study of 16,000 planned homebirths http://mana.org/blog/home-birth-safety-outcomes At home, mothers have more control over their experience. They are free to get into whatever position is comfortable, eat and drink throughout labor, and include their partner in the experience. Homebirth is wonderful for babies because they are not routinely taken from their mother, which allows for an undisturbed initiation of breastfeeding and bonding.
Some disadvantages of any out-of-hospital setting, including home and birth center, is delayed access to emergency surgery and blood products. Midwives mitigate the need for these resources by carefully screening clients to ensure they are low-risk and therefore good candidates for out-of-hospital birth. Midwives also carry anti-hemorrhagic drugs, antibiotics, oxygen, supplies for IV therapy, and newborn resuscitation equipment for mothers and babies who require assistance.
What considerations should you make before deciding to have a home birth?
The most important question for low-risk mothers to consider is – where will I feel safe having my baby? If the answer is ‘in a hospital,’ then she will probably have the best outcome in a hospital. If the answer is ‘at home,’ then she will likely have a more fulfilling experience at home. In the same way that a mama cat will find a dark, quiet place to have her kittens, birthing women need to have a quiet, comfortable place where they feel safe in order to fully let go and birth their babies.
What is a home birth like? (Various options, types, etc.) Who should be in the room to help?
Birth is raw, and beautiful, and intense, and pushes women past what they ever thought was possible. This is true regardless of birth setting or the mode by which the baby leaves her mother’s body. Homebirth simply highlights these qualities because, for the most part, midwives don’t interfere with the mother, the baby, or the process.
The question of who should be at the birth comes up a lot in consultations. It is absolutely necessary to have at least two, experienced care providers who are certified in neonatal resuscitation present for the delivery. Once the baby is born, there are two ‘patients,’ so it is important to have a caregiver for each of them. Most partners are present and supportive in one capacity or another. Some partners even catch their babies! Additionally, many women will choose to hire a doula, someone trained to provide physical and emotional support for women in labor.
What is the most common misconception you'd like to see overcome during your time as a midwife?
One belief I would like to help foster in the general public during my career is that midwives are highly trained medical providers. My road to becoming a licensed midwife included two bachelors degrees from the University of Southern California, three years of didactic education at the Nizhoni Institute of Midwifery, thousands of clinical hours as an apprentice in both home birth and birth center practices, and a rigorous licensing examination from the Medical Board of California. We are experts in normal, physiologic birth, which means we are acutely aware when a pregnancy or labor starts to veer outside of normal. I believe that as women start to demand alternative options for maternity care, the type of exceptional, individualized care midwives provide will become more mainstream.
What motivated you to become a midwife?
When I was an undergraduate at the University of Southern California I lived in Mombasa, Kenya for a semester while I was conducting research for an honors thesis in political science. My research was on maternal and infant healthcare on the Swahili coast, specifically programs (or lack thereof) working towards UN Millennium Development Goal V (reducing maternal morality). I was fortunate enough to interview and eventually work with a Swahili midwife who let me catch a few babies while I was there. It was like a light went off in my head and I knew without a doubt that this is how I wanted to spend my life; kneeling on floors, sometimes covered in amniotic fluid, placing wet, squishy babies into mama’s waiting arms.