If you are considering a home birth, then read on for all you need to know. From the pros and cons to the practical logistics, LUCY TAYLOR has all your home birth queries covered.
Giving birth is an intensely personal experience and women have different ideas about how they would like their baby to come into the world. There are both pros and cons to having your baby at home with the assistance of a qualified midwife. Women who have laboured and had their baby at home say the calm atmosphere and familiar setting are comforting at what can be a difficult time. Being at home allows you to labour at your own pace, as your labour will not be ‘actively managed’ or moved along with drugs or interventions. You decide whether to have your baby in your own bed or in a birthing pool, cut the cord straightaway or wait until it stops pulsating. There is no need to worry about hospital superbugs or whether your local maternity unit will be overstretched on the night you go into labour. For many women who’ve had a traumatic previous birth experience, or live a long distance from a hospital maternity unit, home birth can be the ideal choice. The cons of home birth include less choice in the pain relief available to you, a severe shortage of midwives working in Ireland, and concerns about the safety of having your baby at home. There are two options for women considering a home birth, depending on where you live.
Community Midwives Home Birth Scheme
This scheme means that you will see a team of midwives for your antenatal care and give birth at home. The service is free of charge. Only women categorised as having a low-risk pregnancy may avail of this service. According to the World Health Organisation (WHO), 80 per cent of all pregnant women have a low-risk pregnancy, but you can discuss this with your midwife. Women availing of this scheme do not have to have their booking appointment at the hospital, although they may wish to – it can be in a local health clinic with a community midwife. Women who are being cared for on a Community Midwives Home Birth Scheme will be offered a scan at 18 to 22 weeks to confirm the pregnancy is low-risk. If any problems develop they are immediately transferred back to full hospital obstetric care. Also, if a mum-to-be feels the scheme is not for her, she can ask to transfer to hospital care. Antenatal appointments take place in a midwives clinic or local health centre. After the birth, mum and baby will be visited at home by a member of the midwife team until the baby is seven-days-old (on some schemes this can be up to ten-days-old)when the care of mum and baby is transferred to the public health nurse. Women who take up this scheme can choose combined care with their GP , who will give their baby a six-week check-up. You will need to contact your hospital to find out whether they run a Community Midwives Home Birth Scheme and, if so, whether you are in the catchment area.
Home birth with a Self – Employed Community Midwife
Home birth is available to all women experiencing a low-risk pregnancy although,in reality, there are very few self-employed Community Midwives (SECMs) in Ireland. Home births are not considered safe if you are carrying twins, a baby in breech or transverse presentation, or have a serious medical condition such as placenta praevia or high blood pressure (pre-eclampsia). Women are carefully screened to ensure they are low-risk before being accepted for a home birth and, if their midwife is concerned, they are transferred back to the care of an obstetric team. SECMs are registered with the HSE but practise independently. They can provide full antenatal care by visiting you at home; during labour and delivery where they stay with you throughout, in your home; and postnatal care in your home up to and including a six-week check-up. Your midwife may also conduct the regular paediatric newborn checks and the PKU (heelprick test) on your baby. She will provide breastfeeding encouragement and support.
Booking a midwife
As soon as you know you are pregnant contact the Home Birth Association (www.homebirth.ie) for information on how to arrange a home birth and the names of midwives working in your area. Once your midwife accepts you, she will need to fill out a Form of Application for birthing pool if your midwife is trained in water birth, or labour in your own bath if they are not – discuss this with your midwife. many women giving birth at home choose to hire a Transcutaneous electrical nerve Stimulation (TenS) machine from a pharmacy.
Transfer to hospital
Even though most home births go to plan, your midwife may decide that you and your baby need extra care and will transfer you to hospital care. Be prepared for the possibility that this may happen while you are pregnant, during labour or after your baby is born. Discuss this possibility with your midwife during one of your antenatal visits.
Costs
If your midwife has made a minimum of 11 visits in total (both antenatal and postnatal) and attended the birth at home, then she is paid €2,400 directly from the hSe. however, the cost of hiring a midwife for a home birth can be between €2,500 and €5,000. If you have private health insurance you may receive a grant from your insurer towards the cost of a home birth. employees and spouses of certain companies with group health insurance, such as An garda Síochána, ESB, prison officers etc., may also be eligible to claim for midwifery service fees. The hospital Saturday Fund makes a payment; while Aviva will pay a doula to attend a home birth.
Maternity Care
This will entitle your midwife to be paid directly for your care by the hSe. The hSe will also provide you with a ‘maternity pack’(containing waterproof sheets, scissors to cut the cord, cord clamps, sterile pads etc.). Blood tests and scans your midwife will require you to have blood tests taken at 12 to 18 weeks and may suggest that you open a file with your local maternity hospital and go through the standard public booking route, in case you need to be transferred to hospital care at a later stage. The number of appointments you will attend varies, but will usually involve a booking visit in hospital, a scan if you want it, and one or two visits in the late antenatal period.
Pain relief
Midwives carry gas and air (the entonox mask) and pethidine. you can hire a birthing pool if your midwife is trained in water birth, or labour in your own bath if they are not – discuss this with your midwife. many women giving birth at home choose to hire a Transcutaneous electrical nerve Stimulation (TenS) machine from a pharmacy.
