When a woman chooses to give birth to her baby at home rather than in the hospital, it is referred to as a "home birth". Some women prefer it for a variety of reasons, for example they may have more freedom to move during labor, they can eat and bathe. They also have the comfort and serenity of giving birth in a familiar place, surrounded by the people they love. However, giving birth at home can also come with risks and challenges, so if you are thinking about this solution for your future baby, it is important to understand in advance exactly what it means to give birth at home. Read on to learn more.
Steps
Part 1 of 3: Doing Research
Step 1. Know the pros and cons of a home birth
Until recently this was the most common way to bring children into the world. However, today in Italy only 0.35% of all births occur at home, and the statistics of most other Western countries are just as low. Currently, although in developed countries it is now a rather rare event, some mothers definitely prefer it to hospital birth. The reasons that push them to this choice are numerous; however, it should be noted that some scientific studies have correlated home births with 2-3 times greater risk of complications. Although this problem rate is not yet very high in absolute terms (it only corresponds to several cases in 1000), undecided mothers must still know that home birth can be a little more risky than in hospital. On the other hand, giving birth to children at home offers some advantages that the hospital is unable to guarantee, including:
- Greater freedom for the mother to move, bathe and eat as she sees fit.
- Greater ability to adjust position during labor to specific needs.
- The comfort of an environment and familiar faces.
- The ability to give birth without medical assistance (such as the use of pain relievers), if desired.
- The possibility of satisfying the religious or cultural needs foreseen for the parties.
- A lower overall cost, in some situations.
Step 2. Know when you shouldn't attempt home birth
In some situations there may be greater risks of complications for the baby, for the mother, or for both. In these cases, the health of both mother and baby far outweighs any minor benefits that home birth may offer; therefore it is advisable to go to the hospital, where experienced doctors and life-saving technologies are available. Below are some situations in which a pregnant woman must absolutely plan to go to the hospital:
- When the mother has some chronic pathology (diabetes, epilepsy, etc.).
- When the mother underwent a cesarean delivery in a previous pregnancy.
- Whether prenatal screening has revealed any health problems of the unborn child.
- If the mother has developed a health problem associated with pregnancy.
- If the mother smokes or uses alcohol or illicit drugs.
- If two, three or more babies are expected to be born or if the baby is not in the head position before the expected date of birth.
- Whether it is a premature or late birth. In other words, you shouldn't have a home birth before the 37th week of pregnancy or after the 41st week.
Step 3. Learn about the legality of home birth
It is generally not prohibited in most governments. In the UK, Australia, Canada and Europe it is legal and, depending on the circumstances, the government may also provide funding. However, there may be legal situations that sometimes make the circumstances a little more complex in some countries.
In Italy it is absolutely legal to have your children born at home. The important thing is to be healthy. You can find a midwife who will come to assist you at the time of birth, by informing you at the hospital or your gynecologist. By doing an online search you will find several centers where you can contact a midwife who comes to your home. On the internet you can also find several sites that detail the rights of home birth and the possible possibility of obtaining contributions (not all regions provide for them)
Part 2 of 3: Planning the Birth
Step 1. Make arrangements with a doctor or midwife
It is absolutely recommended to appoint a qualified and authorized midwife or a doctor who can assist you during the event. Plan well in advance so that you can be sure they will come to your home at the right time; Make appointments and talk to them before the baby is born, and be sure to keep the phone number handy so you can contact them if labor starts unexpectedly.
- You should also make sure that your doctor or midwife can easily refer to other doctors in a nearby hospital if possible.
- You can also consider the idea of hiring a doula, a care figure who can provide you with continuous physical and emotional support throughout the perinatal process.
Step 2. Set up a birthing schedule
Childbirth is an emotionally and physically demanding experience, to put it mildly. The last thing you want during labor, when you are already in a situation of extreme distress, is to have to quickly make important decisions about how the birth will proceed. It is much wiser to create and plan an indicative birth plan well before the crucial phase begins. Try to take into account all stages of birth, from start to finish. Even if you will not be able to follow your plan to the letter, knowing that you have one can cheer you up a bit. To help you set up the schedule, answer the following questions:
- Besides the doctor / midwife, what other people, if any, would you like to be present at the time of birth?
- Where are you going to give birth? Keep in mind that, most of the time, you will be able to move around to find the best comfort.
- What tools or accessories will you need to have on hand? Talk to your doctor if you want, but you'll generally need plenty of towels, sheets, pillows, and blankets, as well as waterproof bed and floor covers.
- How do you plan to manage the pain? Will you take pain medication, follow the Lamaze method, or find another idea to overcome the pain?
Step 3. Plan to travel to the hospital
The vast majority of home births take place successfully and without complications. However, as with any birth, there is always a small chance that things could turn out differently, with risks for the baby or mother. For this reason, it is important to be prepared to go to the hospital right away in an emergency. Fill up the car with petrol and keep all the cleaning products, blankets and towels in the vehicle that could be useful in case you need to go to hospital urgently. Study the fastest route to the nearest emergency room - you can even get some practice on those roads.
Step 4. Choose the place where you want to give birth to the baby
While you will be able to decide where and move during most of your labor, it is a good idea to have a place in the house in mind as the final place of delivery. Choose a safe and comfortable spot; your own bed is often preferred, but you can also give birth on the sofa or on a soft part of the floor. Regardless of the place you choose, make sure it is thoroughly cleaned and provided with all the essential accessories, such as towels, blankets and pillows, before the event. It's a good idea to put on a waterproof plastic tarp or cover to avoid blood stains.
- If the need arises, the clean and dry shower curtain also works as a waterproof barrier to prevent stains.
- Although they will most likely already be provided by your doctor or midwife, you should also be safe to get sterile gauze and ties to keep on hand to cut the umbilical cord.
Step 5. Wait for signs of labor
Once you have all the necessary preparations in place, you just have to wait for the early stages of childbirth to begin. The average pregnancy lasts about 38 weeks, although healthy labor can begin within a week or two of the expected date. If you notice the signs before the 37th or after the 41st week, you must go to the hospital immediately. If not, be prepared for any of the following symptoms that indicate impending birth:
- The waters break.
- The cervix dilates.
- Blood appears (a spill of pink or brown blood-tinged mucus).
- The contractions last from 30 to 90 seconds.
Part 3 of 3: Giving birth
Traditional childbirth
Step 1. Follow the directions of your doctor or midwife
The healthcare professional you have chosen for home birth has been properly trained to deliver babies safely and is licensed to do so. Always listen to his advice and do your best to follow them. Some of its indications may temporarily cause you to increase in pain; however, be aware that her purpose is to help you get through childbirth as quickly and safely as possible, so try to follow her instructions as best you can.
The other recommendations in this section are intended only as a rough guide; you must always stick to what your doctor or midwife tells you
Step 2. Keep calm and focus
Childbirth could be a prolonged, painful ordeal, and some degree of nervousness is almost inevitable. However, it's never a good idea to get caught up in thoughts of despair and despair. Do your best to remain as relaxed and lucid as possible: it will allow you to follow the directions of the doctor or midwife to the best of your ability, with the aim of making childbirth quick and safe. It is easier to stay relaxed if you are in a comfortable position and breathe deeply.
Step 3. Look for signs of complications
As mentioned above, almost all parties in the house go smoothly; however, there can always be a small chance of problems. If you notice any of the following symptoms, go to the hospital immediately, as they may indicate serious complications that require technical support and skills you may not have at home.
- Traces of stool appear in the amniotic fluid when the waters break.
- The umbilical cord exits the vagina before the baby is born.
- You have vaginal bleeding other than normal bloody discharge or your normal discharge contains an exaggerated amount of blood (the normal discharge of fluid is pink, brown or at most a little tinged with blood).
- The placenta does not come out after the baby is born or is not intact.
- The child is not cephalic.
- The child appears in distress.
- Labor does not reach the stage of delivery.
Step 4. Make sure your assistant is monitoring the dilation of the cervix
During the first stage of labor, the cervix dilates and widens to allow the baby to pass. At the beginning, the discomfort may be minimal but, as time passes, the contractions gradually become more frequent and intense. At this point you may begin to feel pain or pressure in the lower back or abdomen, which increases as the cervix dilates. During this phase, the assistant must perform frequent pelvic exams to monitor progress. When the cervix is fully dilated and reaches a width of about 10 cm, you are ready to enter the second stage of labor.
- You probably feel the need to push, but the assistant will tell you not to do it until the cervix has reached a dilation of 10 cm.
- At this time, it is usually not too late to take pain medication. If you've made this choice beforehand and have pain relievers on hand, talk to your doctor or midwife to see if they're appropriate.
Step 5. Follow the assistant's instructions to push
In the second stage of labor, the contractions become more frequent and more intense. You may feel a strong urge to push, and if the cervix is fully dilated, your doctor will tell you that you can. Talk to him or the midwife to report any changes in your condition. The assistant will guide you to tell you when it's time to push, how to breathe and when to stop; follow his instructions as much as you can. This stage can last up to 2 hours if it's your first birth, while if you've had other babies before, it could be much shorter (sometimes even less than 15 minutes).
- Don't be afraid to try different postures, such as standing on all fours, kneeling, or squatting. Your doctor or midwife usually wants you to put yourself in the position that you find most comfortable and that allows you to push more effectively.
- As you press and push, don't worry if you accidentally come out of stool or urine, it is absolutely common and your assistant is prepared for this. Focus solely on the thrusts to get the baby out.
Step 6. Push until the unborn child goes through the birth canal
The force of the thrusts, in combination with the contractions, causes the baby to move from the uterus towards the vagina; at this point, the assistant may be able to see the child's head; this is called "crowning" and, if you wish, you can take a mirror and see for yourself. Don't get frustrated though if the baby's head disappears after the crowning, as this is normal, as the baby's position moves along the birth canal during labor. You will need to push hard to get the baby's head out. As soon as this happens, the birth attendant should free the amniotic fluid from his nose and mouth and help push the rest of the body to fully extract the unborn child.
If the birth is breech (i.e. the feet come out before the head) this is a problem that carries additional risks for the baby, and most likely it will be necessary to go to the hospital. Most babies who assume the breech position must be born through a caesarean section
Step 7. Take care of the baby after birth
Congratulations! You have just successfully delivered your baby at home. At this point the doctor or midwife pinches and cuts the baby's umbilical cord with a pair of sterile scissors. The unborn child should be cleaned by wiping it with clean towels and then wrapped in a warm blanket.
- After giving birth, the midwife will advise you to start breastfeeding him.
- Don't give him a bath right away. When it is born, you will notice that it is coated with a whitish layer: this is a completely normal situation and the covering is called vernix. It is thought to have the purpose of protecting the unborn child from bacterial infections and moisturizing the skin.
Step 8. Get rid of the placenta
Once the baby is born, even if the worst is over, you have not yet finished the birth. In the third and final stage you have to expel the placenta, which is the organ that nourished the fetus when it was in the uterus. Light contractions (so mild, in fact, that some mothers do not perceive them) separate the placenta from the uterine wall and after a while the placenta passes through the birth canal. This process generally takes about 5 to 20 minutes and, compared to the actual time of birth, it is a relatively painless phase.
If the placenta does not come out or does not come out intact, you must go to the hospital; in this case, in fact, it means that there is a medical problem which, if neglected, can have potentially serious consequences
Step 9. Take the baby to a pediatrician
If she appears in perfect health after birth, she probably is. However, it is important to take him to a doctor for a thorough examination within a few days, to make sure he is not suffering from some condition that cannot be easily identified. Plan to see your doctor within a day or two after giving birth. The pediatrician will examine the baby and give you all the necessary information.
You should also undergo a medical examination; childbirth is an intense and demanding process and, if you have the feeling of feeling somehow uncomfortable, a doctor should be able to evaluate if there is any problem
Childbirth in the water
Step 1. Evaluate the advantages and disadvantages of water birth
This is exactly what the term implies: giving birth in a pool full of water. This is a method that has become very popular in recent years, and even some hospitals currently offer swimming pools for giving birth to babies. However, some doctors do not believe it is as safe as conventional childbirth. Although some mothers advocate this technique, stating that it is more relaxing, comfortable, pain-free and "natural" than traditional methods, be aware that it carries some risks, including:
- Infection caused by contaminated water.
- Complications due to the swallowing of water by the unborn child.
- Although very rare, there is sometimes a risk of brain damage or death from lack of oxygen when the baby is underwater.
Step 2. Know when it is not appropriate to give birth in water
As with any home birth, water birth should not be attempted if the baby or mother is at risk for certain medical conditions. If you fall into one of the situations listed in the first section, you do not have to opt for this type of birth, but you must go to the hospital. Also, it's largely not recommended if you have herpes or another genital infection, as you could pass them on to your baby through water.
Step 3. Prepare the tub for the birth
Within the first 15 minutes of labor, the doctor, the midwife or a friend fill a small pool with about 30 cm of water. You can find on the market special pools specifically designed for water birth that you can rent or buy. Take off all garments from the waist down (or you can decide to stay completely naked if you prefer) and enter the pool.
Make sure the water is clean and that the temperature does not exceed 37 ° C
Step 4. If you wish, you can ask your partner or birth attendant to go into the pool with you
Some mothers prefer to have their partner in the pool with them as they give birth, for emotional support and intimacy. Others prefer the doctor or midwife instead. If you want to have your partner in the pool with you, you should first do some tests and lean back on his body when you push.
Step 5. Go through the stages of labor
Your doctor or midwife will help you throughout the process, showing you how to breathe, push and rest when appropriate. When you feel the baby is about to be born, ask your doctor, midwife, or partner to come over to grab the baby as soon as it comes out. You should have your hands free to hold on to during the thrusts.
- As with normal birth, also in this case you can choose the position that you find most comfortable. For example, try pushing while bent over or kneeling in the water.
- If, at any time, you or the child show signs of complications, get out of the pool.
Step 6. Remove the baby from the water immediately
As soon as it is born you have to hold it over the water so that it can breathe. After a few moments of cradling the baby, carefully step out of the pool so that the umbilical cord can be cut and the baby can be dried, dressed and wrapped in a blanket.
In some cases, it can happen that the baby already starts defecating while you are holding him. In this case, keep their head raised from the water and move them away from the contaminated water immediately, as they could get a serious infection if they inhale or drink their own feces. If you are concerned this may have occurred, take the baby to the hospital immediately
Advice
- Make sure you have competent friends or a qualified nurse nearby.
- Do not give birth alone, without a doctor or nurse to assist. There may be some serious problems that you wouldn't know how to deal with without someone's help.
- If you can, wash the vulva before the baby is born. This way you keep the area as clean as possible to create a hygienically healthy environment for the unborn baby.
Warnings
- The midwife, friends and even the doctor may be a little anxious during a home birth. In today's society, this is not an overly comfortable situation. However, try to figure out if they seem reluctant or distracted. Don't rail against them unnecessarily.
- If you are giving birth to twins and the first is cephalic but the second breech, the situation is quite difficult (keep in mind that usually this means that one leg starts to come out while the other stays inside, therefore surgery is necessary. of a trained and qualified midwife, doctor or nurse to solve this difficulty).
- If the umbilical cord is tangled around the baby's neck or, in the case of twins, their cords are knotted or the babies themselves are joined anywhere on the body (in this case we are talking about Siamese twins), delivery usually requires a caesarean section. So, make sure you always have a qualified helper by your side.
