The majority of births at home are in the water. Consequently ‘mess’ is contained in the pool. As part of your homebirth equipment list you would have also gathered painters drop sheets from your local hardware. These are placed over your lounge or bed or mattress and then covered with an old bed sheet. This creates a comfortable birth space while protecting the area where you or your partner are choosing to birth. In the hours after birth your midwife remains present in your home. After you are showered and tucked up in bed breastfeeding and getting to know your little one we often tidy up and return your home to a relative state of normal.

This can involve putting on a load of washing, starting the draining process for the pool, tidying up your kitchen. I won’t promise that this always happens as sometimes we too are tired and need to sit quietly but it is always my intention.

Siblings are often joyously present at the birth of their newest family member when the birth is at home.  They have usually developed a relationship with the midwife as they are present at most antenatal visits and have had the experience of finding and listening to their own heart beat with the Doppler and having their midwife show them how baby is lying in the womb. 

They have also usually well acquainted themselves with the insides of the antenatal bag of their midwife and feel completely comfortable with her in their home.

They tend to associate the midwife with the impending arrival of their new sibling. Birth is created as a normal life event.  

What we need when we are in labour cannot always be known until we are actually in labour.  It is not uncommon for a woman to not be able to labour actively until her other children are either asleep or settled with another person either at home or away from home.

It is also not uncommon for a woman to go into labour in the evening once their other children have gone to bed, or in the wee hours of the morning when the household is in deep sleep. 

Children will often wake just as baby is being born and come and share in the miracle. 

It is wise to have a support person available just in case you may need them for your older children. 

It is not unusual that women booked to birth with the same midwife in any given month will birth within a few days of each other even if they do not know each other. It is incredibly unusual for your midwife to be at another birth at the same time that you need her. But should your primary midwife be unavailable your back up midwife will step in as your primary midwife.

The short answer is no. This is why so many women birth in the pool at home. It provides a place to rest and escape gravity which takes weight off tired joints. It also provides relief to some of the intensity of the contractions. I say to women that if they are thinking of using the pool, it is best to save it until wild horses couldn’t keep them out. This way the pool provides maximum benefit when you absolutely need it.

Basic equipment required for a normal birth – scissors (to cut the cord), a cord clamp and blueys, scales, tape measure, stethoscope, blood pressure cuff, thermometer

Oxygen

Equipment required to manage obstetric emergencies (just like they have use the hospital)

Suturing materials

It is all contained in a bag or two and your midwife will set up her equipment when she arrives to you in labour. Usually we keep it out of sight so you are not alarmed by the sight medical equipment in your own home. Altho some women have said to me they feel reassured by the presence of the equipment.

The most common reason for transfer to hospital is because labour is not progressing. When this happens it is not considered an emergency and the decision to transfer is made in a timely fashion.

True obstetric emergencies are rare in low risk women who have had no obstetric interventions to begin labour or during labour. These obstetric interventions are not available in the home environment.

In the instance of an emergency:

- All Registered Midwives are trained and practiced in responding to and managing obstetric emergencies.

-If you are birthing at home your midwife carries all necessary equipment and medications in the instance an obstetric emergency occurs.

- Midwives who work with women planning to homebirth are educated and experienced in assessing the wellness of mum and baby throughout labour and birth; and responding according to the National Midwifery Guidelines for Consultation and Referral.

- Your back up hospital has all the required information pertaining to your obstetric history. This prevents delay in communication should urgent transfer be required.

It is interesting to note that if you were birthing in a peripheral maternity hospital it will take a minimum of 30 minutes, and at times hours, to respond to an emergency with appropriate personnel and an available operating theatre.

Thirty minutes is the commonly the amount of time taken to transfer into hospital from home in an emergency.

At the time of decision to transfer the hospital is notified of the imminent arrival and emergency. This enables the hospital to have all required personnel on site and a theatre set to go if required at the time of arrival.

As a midwife providing homebirth we are governed by the Australian Health Practitioner’s Regulation Agency (AHPRA).

To maintain our registration we are required to:

- Have had at least 3 years experience as a Midwife

- Attend to at least 20 hours of professional development every year

- Annually maintain our clinical competency skills in the management of obstetric emergencies, cannulation and perineal suturing

- Consult and refer appropriately according to the Australian College of Midwives National Midwifery Guidelines for Consultation and Referral

- Have Professional Indemnity Insurance that covers antenatal and postnatal care. Currently there is no insurance available for labour and birth and a legislative exemption has been made for this.

- Notify the Health Department within 24 hours of any planned homebirth attended