Preparing For Homebirth

LAST TWO MONTHS OF PREGNANCY:

  1. Drink one cup of raspberry leaf tea and/or pregnancy tea each day
  2. Have one serving a day of vitamin K rich foods or supplement with oral vitamin K
  3. Practice relaxation techniques including perineal massage each day
  4. Prepare for breastfeeding
  5. Take a probiotic every day such as Florajen3
ORDER YOUR BIRTH KIT: Birth kits are available to order from a couple sources.  www.1cascade.com or www.birthwithlove.com, or call 800-434-4915. Under the quick links, clink on order a birth kit.It’s listed under Hatcher, Leah or Morning Glory Midwifery.
  1. IN ADDITION to your birth kit, the following things should be in one place, ready for the midwife to check at the 34-36 week home visit. Have your emergency numbers posted by the phone.
Get these items and keep them with your birth kit in an empty laundry basket.
  • 1 roll of unopened paper towels
  • Oral digital thermometer
  • Watch or device for timing contractions
  • Two large plastic trash bags
  • Flashlight with fresh batteries
  • Medium size hand mirror that can get wet
  • Bottle of Hydrogen Peroxide for stains
  • Bottle of rubbing alcohol
  • Q-tips for cord care
  • A small bottle of olive oil
  • Plastic covering for mattress
  • Extra maxi-pads
  • 8-9 inch bowl for the placenta
  • Large pot with a lid that fits
  • Flannel backed vinyl tablecloth to protect the floor
Optional: Rice sock, heating pad, crock pot for hot compresses, goldenseal powder for umbilical cord care. For Water Labors/Births: A food grade hose of proper length, an adapter to connect the hose to the faucet and a fishnet. Optional: A flotation “noodle”
  1. MORE SUPPLIES NEEDING PREPARATION
  • 5 of each: large towels, hand towels, washcloths & receiving blankets.
  • Baby’s clothes including hat and booties.
  • Two sets of sheets for your bed.
A month before your due date, wash & dry these items and store in pillow cases near your other birth supplies. After the birth, you will need a clean nursing nightgown, a nursing bra or supportive undershirts for mom, a breastfeeding book at hand, and plenty of diapers, wipes, etc. for the baby. CLEANLINESS: Exposure to your body’s natural bacteria is what your baby needs to kick start it’s immune system. You will not infect yourself or your baby if an average level of hygiene is maintained in your day-to-day living. Plan to do lots of skin to skin time with babe. BEDMAKING:First put a clean fitted sheet and a flat sheet on your bed. Then put on the plastic mattress cover or plastic (this is probably something you will throw away, don’t get one that covers top & bottom of the mattress, just one like a fitted sheet - some people use a shower curtain). On top of the plastic put another clean fitted sheet. If your waters are leaking or you have bloody show, you should use one of your blue underpads to protect your bed or furniture. MISCELLANEOUS:If you have light colored carpeting, consider what you could use to protect it. Flannel backed vinyl tablecloths work well, flannel side up. You will need a path from the bed to the bathroom, and it is a good idea to protect the floor at the side of the bed since so many women decide to birth on the floor. PLANNING:Please feel free to discuss your wishes for the birth in depth, from dad’s involvement, to special music, candles and whatever birth position sounds appealing to you. Some parents want to have photos or a video of the birth. It’s a good idea to have the camera-person be a friend of yours, rather than one of the birth team, as our responsibility is to keep watch over all the vital signs. It is also helpful if the photographer has seen a birth before. Think about your birth positively and plan for the best possible experience for your family. Then let go emotionally and be willing to accept the experience you are given as it unfolds. PEOPLE AT THE BIRTH:Remember that this is your home and your birth experience. You do not need the midwife’s permission to ask people to attend your birth. Ideally, people who attend your birth should be supportive of the idea of homebirth. You should be comfortable and at-ease with these people. Don’t allow yourself to feel you “should” invite someone because they want very much to be there. Many people feel the act of birth is as private as the act that created the baby. It is a great privilege to attend a birth and that privilege should not be dispensed lightly.  The mother must not act as “hostess” to a party. If she feels the need to take care of others during her labor it can interfere with the birth. It is good for people at the birth to know that if their presence is making labor difficult for the mother, they may need to leave. Helpers at the birth should be prepared to HELP. They can prepare food for the family and birth team, take care of your other children, and help with laundry and clean-up after the birth. CHILDREN AT BIRTH:Children generally do very well at a birth. They need to be prepared for the fact that mom will be working hard, and mom may make some noise as the baby comes down. They need to know that there will be some blood, and that baby may have blood on it at birth. It may be helpful to role play, show them a birth video and/or show them pictures of a birth. It is essential to have someone at the birth whose job is to care for the children. This person should not be the father, but someone else with whom they feel close. The children need to be able to leave the room if they are uncomfortable, and the helper taking care of the children needs to be willing to miss seeing the birth if he or she is needed by the child/children. BABY DOCTOR:Before the baby is born, you should find a physician to see the baby. I do a thorough exam of the baby at birth and will refer to a physician if anything is in question. Please plan to see a doctor within a few weeks of the birth; this visit is a good opportunity for you to make a connection with a physician in case you need one as your child gets older. If you’re considering a circumcision, arrangements should be made before the birth. CARSEAT:Be sure to obtain a car seat before the baby is born. Make sure it fits in your car and works with your seatbelts. PREPARING FOR THE POSSIBILITY OF TRANSPORT: The transport rate for homebirths is low, but the possibility must be considered in your preparations. It is very important to have emergency phone numbers posted by your phone. I supply you with this form. You should have an idea who can care for the children if we need to transport. Some mothers pack a small bag with a change of clothes and clothes for the baby just in case a transport is necessary. You should be sure to have a car available with a full gas tank. Make sure you know what your insurance requires you to do to authorize an ambulance. Generally transport is via private car. PREPARING FOR LABOR: As you get close to your due date, you’ll start to want to “nest”. You can use that time to prepare for your labor. Don’t use up all your energy, but do make sure you have some meals in the freezer for the post-partum period. You will want a well stocked refrigerator. You need nourishing food on hand for you during the labor and after the birth, and for your friends and attendants. Fruit, veggies, bread and soups work well. So does a casserole that can be popped in the oven after the birth. Have those ice cubes made up! During labor it’s nice to drink clear fruit juices or coconut water. Miso is very good for labor and post-partum. Please get several bottles of your favorite natural energy drinks. These drinks restore your electrolyte balance, and provide your body with readily available glucose. V8 or tomato juice is also good. The house should be clean with a clean sink and tub in the bathroom and plenty of fresh towels there. EARLY LABOR: Labor usually starts with mild contractions. Try to go on with your normal life for as long as possible. All early labor signs (contractions, bloody mucus) can go on for days. If it is night time, please go back to sleep. It is very important to rest while you can since labor may well start in earnest the following night, and you don’t want to start out tired. If this is your first baby you may be up for several nights. It is not uncommon to have a long latent phase where it takes several days to dilate to 4 cm; which is where active labor really starts. Assume this is the case and pay as little attention as possible to early labor. The contractions will generally get stronger and closer together. If you are not sure this is “real” labor, try changing your activity. Rest if you have been busy. Get busy if you have been resting. Try taking a warm bath “Real” labor will not go away or change with these activities. “Real” labor will get stronger.
  • Keep nourished with easily digestible food as your body tells you. Even if you don’t feel hungry or thirsty, have a glass of clear juice (apple cranberry or grape) or raspberry leaf tea with honey or sugar every hour or so, don’t forget.
  • Keep your bladder empty. At least every 2 hours go to the bathroom. It may sound silly, but it’s important.
  • Get the birth room ready; make the bed and get out your supplies.
WHEN TO CALL:     DO NOT TEXT that you are in labor. Please let me know as soon as you think you might be in labor, if you have bloody show, if you have contractions, or if your bag of water releases. Leah’s cell: 808-855-0207                          (my husband Keith’s number is 808-855-0208) Leave a message if I don’t answer. Call again if it’s urgent. I’ll call back soon. I will come to be with you when you start active labor or when you want me to come; this is usually when contractions are lasting 60 seconds. I can always come and check on you and retire to another room, or even go home for awhile if things are not changing. IF YOUR WATERS BREAK:Call me as soon as your water breaks! Be prepared to tell me the color and odor of the fluid, and if the baby is moving normally. Should your water breaks with a big gush, unless you know the baby is engaged, lie down at once and have someone listen to the baby’s heartbeat, or call me to do so. Usually the heartbeat can be heard with an ear pressed to the mom’s belly over the baby’s shoulder. Try this prenatally. We need to be sure the cord didn’t slip down with the rush of fluid and get pressed by the baby’s head. If the heartbeat is normal (120 - 160) then go ahead and move around as you wish. Labor starts with a gush of fluid that continues to leak in about 10% of all births. It also means that the protective membranes around the baby are now gone and the baby is open to outside bacteria. Should you even suspect that your water has broken, do not take a tub bath or have intercourse until it has been determined otherwise. Infection is a real possibility. Change your underwear and pad frequently or wear none at all. Wipe from front to back when using the toilet. If labor does not start in a few hours, start taking your temperature and 500 mg. of Vitamin C every four hours. Drink lots of fluids to replace what is being lost and stay at home so you are not exposed to other people’s bacteria. If you’re GBS positive: do a rinse with chlorhexadine (Hibiclens) solution and repeat every six hours (as directed). THE BIRTH: Once I know you are in active labor, I will call my assistant. We will carefully monitor labor to be sure all is proceeding as smoothly as possible, making suggestions when needed. During labor, I check mom’s condition - vital signs, and fluids in and out, and cervical dilation if needed. The baby’s heart-rate and position are monitored regularly as well. I carry emergency equipment and am experienced at handling the more common complications and emergencies. Most births proceed with only minor variations from the norm, but I will not hesitate to suggest transfer to the hospital if that seems to be the safest course. A healthy mother and baby are the primary goal. We do all we can to see that your baby’s birth is gentle and joyful. We will do our best to facilitate your birth plan. We want the baby to breastfeed soon after the birth. Once baby has fed well, we will do the newborn exam, which includes weight and measurements. Save your phone calls until you have all of the vital statistics! POST-PARTUM CARE: After the birth, I will give you written and verbal post-partum care instructions. I will come back to see you between 24-48 hours and as needed the first week. I can do the Newborn Metabolic screen if arrangements are made ahead of time. I will use pulse oximetry screening to rule out any congenital heart problems. If there is any problem with you or the baby, I will see you as often as necessary. I like to re-check baby’s weight at 1 and 2 weeks of age. Plan to come and see me for a final check-up at 4 to 6 weeks post-partum.