A doula's guide to home birth
Home birth is becoming more and more popular since the coronavirus has entered our hospitals and with home birth teams slowly being reinstated, I thought it would be useful to put together a guide to help you navigate your home birth with ease.
What I personally love about home birth is that you’re keeping all of your options open. I think it is a really misunderstood concept, as an either/or option, when actually home birth gives you a chance to explore how you feel on the day and choose what’s right for you. You can change your mind at any time and with most labours starting at home, you give your body the best chance of following it’s feelings without the pressure of travelling in unless of course you want to.
Having your antenatal appointments in your own home is so much easier too (and safer currently) and if you have other children at home, even more convenient. You also get time with your midwives, real time to ask your questions and talk things through and then when you are in labour, they’ll come out to you when you need them and your body is free to let go, without any pressure to go anywhere else.
Imagine having the reassurance of a midwife coming to see you in early labour, what a difference that would make? And if you do decide you want to go in to hospital, no problem, you’re transferred in with the help of your lovely home birth midwives for a smooth transition.
So what can you do to prepare for your home birth?
There are already some great home birth lists out there and www.homebirth.org.uk is a fantastic site for information, all in one place…but I wanted to share how I prepare with my Mums for their home births.
Firstly, truly understand birth…what does birth need? I often look at birth as it’s own separate force…it has it’s very own wish list and if it’s met, birth can be wonderful and empowering and life lifting. Birth is fuelled by the beautiful hormone of love, oxytocin. The more oxytocin, the stronger the flow of labour, ensuring things keep moving, your surges keep coming and your body’s own pain relief, your endorphins kick in to support you.
What does oxytocin need to thrive? Privacy, darkness, feeling unobserved and feeling safe. Birth is clever, so clever. Your body is going to protect your baby at all costs, so if the environment you’re in doesn’t feel safe, you’re going to ‘hold on’ to your baby. This is one of the reasons inductions can be so challenging, women’s bodies don’t fail, they’re simply super protective and keeping their babies safe.
‘A ‘failed induction’? You could just as well call it a successful defense against premature birth’
The Womanly Art of Breastfeeding.
I think the easiest way to relate to oxytocin is through sex. Oxytocin is released during sex. Think about where you have sex… it’s private, intimate, so your body can let go and orgasm. Imagine if someone walked in, turned on the lights and started lifting the covers up and stared at you…would you get there? I know I wouldn’t. I always think men have sex more physically but women, we have sex more emotionally, to get there we need to switch off…just like in birth.
Birth needs flow, pure and simple, so a home setting can really offer that flow without bringing in a need to watch your labour (no need to count anything) because you don’t need to go anywhere.
‘the first intervention in birth is walking out through the front door’
Home Birth Support Group UK
A majority of your labour can be spent just as you would normally spend your time. There is no need to set the stage and that is another great benefit of being home, you can do as you feel, not as you think.
If you would like a deeper understanding of how birth feels and how to maximise your comfort and coping in labour please do watch the videos myself and Natalie Meddings (author of Why Home Birth Matters and How to Have a Baby) recorded where we have detailed conversations around labour and birth. How to Have a Baby series here.
So what do you need?
In terms of practicalities, firstly who will be with you? Your partner? Will you have anyone else there too? It’s something to really consider…every person in the room is an oxytocin booster or an oxytocin drainer, choosing wisely is so important because it will directly impact your birth. if you’re thinking about a pool birth, if your birth partner is setting up the pool, who is with you? Are you happy to be left to it or would you like someone else there for added support?
Sometimes the support of another person is really needed and sometimes that can be a trusted friend, a loving sister, a nurturing Mum but what matters is ‘can you let go in front of them?’ Some women simply know they want someone who has been through it, they want that female presence but friends and family feel too close. That’s why doulas work.
So you’ve got to grips with the physiology of birth, you’ve thought about your support team, so what else do you need?
Yourself
informed and confident around your birth choice and well supported (home is a great option if it feels safe to you, be where you feel safe)
Your birth comforts
These will be different for every woman but could include -
essential oils - lavender to bring calm, citrus for nausea (digging your nails into a fresh lemon is also great, one of Natalie’s tips), frankincense for intensity, clary sage (to pick up contractions if things have gone quiet and there is a need to get things moving) & peppermint (sniff to release the placenta or a couple of drops in the loo).
soft lighting - candles (flame or electric), fairy lights
blankets and cushions to build a nest on the floor so you can spread out if needed
eye mask, ear plugs to shut the world out
soft scarf/sarong (something thin), to throw on and off as your temperature changes, burrow your head into it…
Hot water bottle or two (with covers) - a small one in the front and on the back can feel so good
A good drinking bottle with a straw - to stay hydrated and the straw so someone else can bring it to your mouth if needed (even tipping your head back to take a sip can be distracting)
Snacks - nourishing and packed with goodness, some favourites are nuts, dried fruit, raw bars, bananas, honey toast, porridge (porridge is also great for a stalled labour)
Tens machine - lots of women find them useful, pain relief in your own hands and you can probably borrow one from a friend, just buy new pads off amazon
Water - Shower beating on your back, a soothing bath, a birth pool
hypnobirthing tracks, relaxing instrumental music (music with lyrics can feel overstimulating in established labour) or any sounds/music that lets you lose yourself…
Birth wall/space - wherever you might be labouring, it’s lovely to have a space filled with positive affirmations, fave pics, love notes, children’s pictures, anything that makes you feel relaxed and happy
Homeopathy (highly recommend talking to a homeopath first) - suggestions are pulsatilla (for feeling wobbly, emotional), aconite (for anxiety/fear), secale (for birthing the placenta), arnica (for pain/bruising)
Ask your birth partner to learn a couple of key massage techniques - the hip squeeze and applying sacral pressure, both can feel really good and both easy to learn
Your birth preferences printed out and left out for the midwife
Your breath, always there for you, always grounding, deep breath in and a longer deeper breath out, relax your shoulders, your jaw, anything that you can and breathe…
Land birth supplies
If you’re not having a pool, it keeps things simpler in terms of what you need. As long as you have some clean old sheets and spare towels to birth onto and then lots of cosy blankets, dressing gowns etc to keep you and your baby warm afterwards then you’ll be fine.
Water birth supplies
If you’re having a pool, you may be hiring one with all the kit or you may be buying one and need to think about the accessories separately.
Birth pool (smaller birth pools fill quicker which is good to factor in especially if you’ve had a quick labour before) Some birth pools come with covers - this can be useful if you want to fill the pool ahead of time and keep the heat in, or fill it half way with hot and then top up with cold when it’s closer to you getting in (also worth checking your boiler can cope)
Liner - which you throw away after use and acts as a scoop to gather any remaining debris after you’ve drained it.
Pump - to reverse pump all the water back into the toilet/drain outside/sink.
Hose - a clean piece of hose to fill the pool and then drain the pool.
Tap connectors - to secure the hose to your taps (worth a test run)
A thermometer - to check the water temp stays at 37 degrees celsius.
A sieve - for scooping
Waterproof floor sheets - be mindful that these can be very slippy so placing a few towels on top can help.
Something to support yourself getting in and out of the pool - a small step with a towel on top is great
Milton sterilising fluid to clean the pool afterwards
Other bits
A birth ball to rock on, lean on, rest on.
A bucket is useful for sickness and for filling the pool if the boiler packs in or for emptying if the pump isn’t working.
A small heater can be great post birth to keep the space warm and cosy which also helps with birthing the placenta.
Inco/puppy pads - useful for post birth so wherever you are having skin to skin and birthing your placenta, you can protect the surfaces and change them easily (I also found them very useful for changing my daughter on the bed post birth)
A camera handy - to capture those precious first moments if you want to - easy to forget in the moment so you can always ask the midwife to take some when she can.
A good lamp for your midwife post birth
A mirror if you’d like to look
A soft cord tie - you don’t have to use a plastic clamp which can get in the way of the nappy and a soft cord tie is gentler on the skin
A sterile container if you’re keeping your placenta, more info on what to do with your placenta here
Bin bags for soiled sheets etc (most of it will wash if you want it to, salt and a cold wash will get the blood out, if there’s any blood on the carpet a good scrub with very cold water works)
Post birth box/bag
(good to have handy and even more so if you need to transfer)
Big comfy pants and soft thick maternity pads are essential post birth and comfort is key
Arnica for healing
If you’re climbing back into bed and staying skin to skin that might be all you need…
You may want a soft nightie with buttons down the front for feeding
Water, food! Your post birth food will be remembered forever, what are you going to have?? Whatever you choose it will taste AMAZING.
Muslins are always handy and if you have a giant size one, you can use it as a light blanket for your baby too.
Clothes for you and your baby if you’re not getting tucked up in bed straight away. For you something super soft and baggy for comfort.
Nappies with cotton wool and warm water to clean them with.
Special touches
(a few non essential ideas which you might like)
A snack basket - for whoever is attending your birth, tea and coffee out and ready, some treats and then no worries about hosting anyone because it’s all there for them, easy to find. A note saying please help yourself and you and your partner can switch off that care taking part of yourselves.
Fairy lights around your gate or an electric candle outside on the wall so your midwives can find you easily, it’s helpful and signals to the magic inside.
Something for you and your partner to do…it’s important to your birth that you can relax and switch off from ‘being in labour’ and being watched and waited on…so maybe you and your partner could cook a lovely meal or bake your baby’s first ever Birthday cake - and they can take over when things ramp up…a restless birth space will bring adrenaline so ease that with a mini project.
And don’t forget to enjoy it…with all the planning, the preferences and the worry it can be so easy to forget that this is your baby’s birthday, it’s happening and no matter what, it’s truly incredible and you are bringing your beautiful baby earthside…YOUR BODY IS AMAZING.
Doula love
Jen
x
My new postnatal online course, earthside is out now
a practical and gentle guide to new motherhood
@theminimalistdoula