The Mysteries of Midwifery and Home Birth-The Questions I Had
/The Mysteries of Midwifery and Home Birth
Having a home birth with a midwife can be very scary, and most people are scared because they haven't looked into it much. When I would tell people I was having a home birth I would get a lot of worried looks and a billion questions. Below I have provided those questions as well as some of my own that I had asked in my decision of having a home birth.
What does the midwife’s care provide you with?
The midwife cares for you from the moment you find out your pregnant until a few weeks after birth, as well as will provide you with resources and support after birth including emotional support. This includes all monitoring, preparation, ultrasounds (done at a proper facility), and testing needed/required (such as, Glucose test, ect.) The midwife will also be there to help birth your child making sure you and your bundle are safe.
What can you expect during a midwife appointment?
The midwife will have you take any necessary tests (usually a pee test), listen to your baby’s heartbeat, measure your belly, take your blood pressure, and go over any questions you have. The midwife will also go over any material you should be aware of at that time, or educate you on certain parts of pregnancy. What’s awesome is she will stay with you until she has answered all your questions. Usually appointments go from 30 minutes to 1 hour.
Do midwifes work with high risk mothers?
This is determined by the scope of the midwifes comfort and abilities/certifications, as well as what risk category you are in. The first appointment with a midwife, she determines how many risk factors you have, and if a home birth is the right option for you and the safety of the baby. If you are of high risk, the midwife may decline care and recommend you to a hospital. Every birth is different and a home birth might not be the safest option for you.
Does a midwife have alternatives worked out with a hospital?
The percentage of home births that end up having to go to a hospital for a serious risk is 7%. Whilst home births bring up the worry of if something goes wrong that a hospital could easily manage. Home births with the ability to move around and have a more active labor reduced the risks of problems occurring during labor. To answer this question, you could set up an appointment to meet with a doctor at the closest hospital you choose, the likelihood of you actually going is slim. That doctor you would meet probably wouldn't be the doctor you deliver with in a case of an emergency transfer. Therefor would be a waste of your time, as well as that doctors time. In the case of an emergency transfer, the midwife would call the hospital of your choosing (usually the closest) or if you had time a doctor of her choice that she has worked with before. The midwife would then have all of your medical records and would update the doctor on duty of the situation at hand. This gives the doctors confidence and understanding of the situation to perform what is necessary for the safety of the mother and baby. These doctors for emergency pregnancies in the ER are certified OBGYN’s, their job is strictly delivering babies whose mothers are brought into the ER.
What complications can the midwife not handle?
C-Sections, and epidural are the main ones.
Does the midwife have fetal monitoring available?
YES! Her monitoring is a little different, it is the same technology used in hospitals, but its not the kind that straps to you making it hard to move around. The fetal monitoring she uses is handheld making it easier to use when the mother is in other positions or moving around to ease pain and discomfort. This is great because when in labor, if you're in a position that the babies heart rate isn’t responding properly to contractions or the stress is too much, it gives the mother the ability to change positions comfortably to ease the stress of the baby. With the handheld monitoring system, it makes it easier to adjust instead of being held in one position or area.
Can the midwife perform an episiotomy?
Yes! The advantage of home birth gives more movement so the pelvis can actually fully expand, therefor reduces the chance of tearing. But in the case of the situation if an episiotomy is necessary the midwife can perform one. With that being said, there are ways to help prevent tearing, most minor tears don't need to be sutured and heal better naturally. But in the case of a major tear, the midwife does have the medicine and tools needed to suture.
Post birth medication and testing?
Post birth there are 3 main medications given to newborns.
-Antibiotics given in the eyes.
-Vitamin K injection
-Hepatitis B Shot
Antibiotics in eyes are given to newborns in the case that the mother may have chlamydia or Gonorrhea. These aren’t necessary if the mother has been tested negative for these. In the case the mother wasn't tested or is unsure these antibiotics are highly recommended and the Midwife does carry this medication with her.
Vitamin K injection, after a baby is born every baby has a vitamin K deficiency this is 100% normal. Within 7-8 days after birth this deficiency levels out to the normal amount. Vitamin K is given and is especially important if the baby has any bruising, a traumatic birth, a C-section was performed, or if the baby is male and will be having a circumcision done. The vitamin K helps the blood to clot and can prevent a rare bleeding disorder and/or hemorrhaging. The midwife is also equipped with this injection.
The Hepatitis B shot, however, in not carried by the midwife. This shot is most crucial in a hospital setting. Being born in a hospital babies can be exposed to many different things. When a newborn is taken to have all testing done, is cleaned, and all medications given that are necessary they can be exposed to Hepatitis B. Therefor is crucial to be given to your newborn.
If you are having a home birth this isn’t a risk and the shot is not provided by the midwife. If you still would like this shot, a good time to get it is at your 8 week pediatric appointment.
There are 3 State required tests that must be given/offered by the midwife:
1. Congenital Heart Defect Test- the baby is hooked up with a monitor in their finger and toe to measure blood flow and test for heart defects, this is very non-invasive.
2. Blood Metabolic Screening- This is the most invasive test (done within 48 hours), blood is drawn and tested. This tests for rare but potentially serious disorders.
3. Hearing screening- this test can be done up to 6 weeks old, and is done to make sure your baby is hearing.
After birth midwife care?
After birth, the midwife will make sure the baby and mom are healthy and doing good, as well as clean up the pool and anything else that needs cleaning. The midwife will also not leave until the baby has latched and has gotten a good first meal, as well as if you are formula feeding. The midwife will then come back 12 hours later to check on mom and baby, and make sure the baby is getting enough food. The midwife will then plan additional appointments as needed to make sure mother is doing good, baby is getting enough food, and to provide support when needed. Midwife also wants to make sure mother isn’t affected by postpartum depression. In my case where I was transported for C-section, the midwife continued to check on me every day for 3 days after birth, and then we planned additional appointments to make sure baby was doing well with nursing, and I was happy and my scar was healing.
What was different about my glucose test?
Instead of drinking that nasty drink they usually have you drink. I was told to eat 2 eggs, 2 pieces of toast, and a large glass of juice 1 hour before my appointment. When the midwife arrived, I had my blood drawn, and that was it!
Can midwife check for elevated bilirubin levels?
Yes, she uses a trans-cutaneous method (meaning she doesn't draw a bunch of blood from the baby) I’m sure you wonder if this method is accurate? Well because I was transported to the hospital for an emergency C-section they did have to check bilirubin levels by drawing blood. We compared the lab results with the trans-cutaneous method, and they were accurate!
