Here in Kitsap County we enjoy many options for low-risk, healthy clients who are looking into venues where they might like to give birth. One of these options is homebirth. Kitsap County is home to several of our own licensed, professional midwives, and we are serviced by midwives who live outside our community but attend homebirths here.
Homebirth with a licensed provider who has experience in this environment is very safe, and is on the rise in our community. While the margin of families choosing homebirth is relatively small in comparison to those choosing to birth at the hospital, the number is slowly growing over time as families discover this viable option.
Clients who are electing to have their babies at home will work with one of the midwifery practices that service Kitsap County. Some of those practices will include BirthDay Midwifery, West Sound Midwifery, Off the Grid Midwifery, Gig Harbor Midwifery, and the Gumnut Blossom Midwifery. You can find more links to local midwives on Peninsula Birth Network.
Healthy, low risk clients who desire an unmedicated birth are strongly encouraged to meet with midwives and find out more about the out-of-hospital option. Very often we hear, after the birth, “If we had known homebirth was like that, we would have chosen it,” and by then it’s too late to go back. Get your questions answered about midwifery care and make an informed decision together about what that might look like, before deciding on your venue for your unmedicated birth.
General Birth Experience
Clients will see their midwives throughout their entire prenatal, birth and postpartum period, up to six weeks. Licensed midwives can make referrals to other specialties if your care requires this, can order tests and labs and ultrasounds that are needed or that you desire, and will oversee your health and the health of your baby during your duration of care.
Midwives generally enjoy working with professional doulas who can provide more hands-on support for the clients and help keep them more comfortable at home. This allows labor to progress more comfortably and with support at home, and the midwives can arrive at an active point of labor.
When you go into labor, you will call your midwife and let them know what is happening. They will counsel you on what to do next. Most often, rest, hydration, snuggle time, and distraction are recommended so that your labor can progress before your team assembles.
Midwives will often have a student midwife, and a birth assistant in attendance with them. This might seem like many hands, but all of these people are trained and skilled in assisting the midwife if there is an emergency requiring all of those hands. The team is skilled at staying out of your space as much as you desire, and checking on your progress and welfare all along the way without being intrusive to your flow of labor. Your doula will remain with you and provide the hands-on support you need, help you develop questions you might have if a decision has to be made, and help your partner and family understand what is happening so that they can participate in the way that works for you.
When the midwives arrive, they will set up their gear, which includes medication for hemorrhage, resuscitation gear for both mother and newborn, herbs or other medications to help with the discomforts of labor, birth kit for the delivery, tools for repairing your perineum should there be a tear, and more. They are fully equipped to keep a mother and baby stable if there is an emergency, until EMS arrives and can transport you to the hospital for more advanced care.
After the birth is complete, the team will empty the birth tub and pack it away, put a load or two of laundry in, and clean up the mess left from the birth process so that you can rest comfortably. While they monitor your adjustment, they will be encouraging you to rest, eat, celebrate, and snuggle your baby, right in your bed. After a few hours of monitoring, they will provide you postpartum instructions and will let you know the next time they will come to visit and check on you, usually, about 24 hours after the birth.
The routine procedures involved with homebirth are minimal:
- Check of vitals upon arrival (heart rate, blood pressure, temperature, fetal heart tones), and periodically after this
- About every 30 minutes, using a hand-held doppler, listening to the baby’s heart tones
- If you are GBS positive, you are likely to receive antibiotics administered via IV in labor, every four hours. You can strategize this and explore other options with your midwives in advance of your birth.
Most midwives encourage clients to listen to their bodies, push in the position that feels best, avoid cervical exams unless a decision needs to be made with the information, encourage partner to catch baby if they desire to, encourage breastfeeding, and do not “rush” the progress of labor with medical means. Sometimes, a little rushing is necessary, or a client changes her mind and desires pain medication, at which time, the midwife can facilitate transfer to one of the local hospitals where she will relinquish care to the provider on site.
Choosing a provider for your homebirth
When interviewing midwives, we encourage you to think about what it is that you most want to know to feel safe and comfortable in their care, just like you would with an obstetrician.
Some questions might include:
- How many births have you attended, and what kind of emergencies have you dealt with?
- What happens if you are at another birth when I go into labor?
- How often do you transfer clients out of care, and what are the most common reasons for that?
- What happens if there is an emergency at home, like a hemorrhage?
- What is your philosophy about (allopathic medicine, natural medicine, homeopathy, herbs, etc.)?
- What will the birth team be when I go into labor?
- What are the expenses involved with a homebirth and how does insurance help with that?
Think about the unknowns, or concerns, you have about having your baby outside of the hospital, and bring those questions to your consultation. Knowing the answers will allow you to make an informed decision about where you would feel most safe giving birth, and what venue will bring you closest to the vision you have for the birth of your baby.