One year ago today my son, Samuel, was born at home in our little city home in Hagerstown, Maryland. He was 7 pounds and 6 ounces, measuring 19 inches long. He came out without a drop of blood on him. He started breathing on his own right away. The midwives went ahead and gave him a little oxygen, just to clear his lungs up. My wife and I just laid in bed looking at this little man that fell into our lives. To this day I am thankful that the experience went as well as it did.
I think it's important to mention that not all home births, birth-center births, or hospital births end with happy endings. There are all kinds of studies that show different outcomes based on where you choose to birth you child. Home birth carries some risks that need to be taken seriously.
When my wife and I decided to have a home birth we signed up for a Bradley Class right away. Dr. Bradley is a big advocate for Natural Birth and his class is designed to teach both the woman and man what happens in birth and how to work together as a team to achieve a successful birthing experience. As a man, the class was exactly what I needed. They walked me through all the stages of labor and showed me how to assist my wife during each one. It also taught us what hospital interventions were and how they affect the process of birth. That knowledge is very important when you are in labor and the doctor or nurse is pushing you to get an epidural or induction. Either have their place, and the class lets you know when and how to use them if needed. It should be mentioned that Dr. Bradley was not an advocate for home birth. It's interesting that his class is one of the most popular for those planning to birth at home.
Picking a midwife is probably the most important decision you'll make when planning a home birth. There are lots of different midwives.
CNM's or Certified Nurse Midwives are nurses who go through midwifery school as a Masters Degree Program. Their midwifery training is not any more difficult than non-nurse midwives, however they did complete nursing school. In about every state you can find nurse midwives, however the laws that they operate under vary greatly. Nursing boards vary in their acceptance of home birth and OB's in many situations have to approve a home birth depending on the state. In Maryland we have nurse midwives who can attend a home birth without OB permission, however they are in very limited numbers and have to tip-toe around OB's for fear of being reported to the nursing board. Many nurse midwives work in Hospitals and Birthing Centers, and women across the country have had great births in their care.
Non-nurse midwives include Certified Professional Midwives (CPMs), Certified Midwives (CMs) and Licensed Midwives (LMs). The important thing to remember about these midwives is that all of them go through training to provide prenatal, delivery and post-birth care. The training is a little different depending on the certification. The CPM is the only training that requires attendance at home births or birth-center births in order to certify. The others must attend births but attendance in a hospital setting is allowed.
When choosing a midwife it is important to find out a few things:
- What is her training?
- Who trained her?
- How many births has she attended as the lead midwife?
- How many complications or difficult births has she dealt with?
- What is her plan for transfer if one is needed? What are reasons for transfers?
- Where would she transfer to? Which hospital?
- Does she have a OB who she can call if needed who is friendly to home birth?
- Has she ever lost a baby or mother at a birth?
- What are her emergency certifications? CPR, infant CPR, EMT-B, etc ...
- Will she have a student with her?
- If she is at another birth what is the back up plan?
These questions are just a start. I asked questions for a solid 30 minutes when we interviewed our midwife. Another important part is asking for references. Call some other home-birth families and ask them how things went. Get advice from those with experience and dont be ashamed to ask difficult questions. As a paramedic I get asked by other firefighters all the time all the "what if" questions. I answer them to the best of my abilities.
Hopefully this will get you started. Simple searches online will help you find midwives in your area. I suggest getting into a Bradley birth class and talking to others there. Many times you'll find home-birth families there who are willing to share information and help you along the way.
Thanks for reading and Happy New Year!
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