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Although home birth is not easily accessible in South Africa, some women still go to great lengths to seek out a way to birth their baby in an environment that is comfortable, non-threatening and familiar – their home.
Hospitals as a place to give birth
Hospitals have become the most unquestioned, unchallenged place for the modern woman to give birth. Until the 1940s most births (55%) still occurred in the home. By 1973, in the US 91% of babies were being delivered in hospital.
In the past 30 years or so babies in the Western world have been born in a highly clinical environment, with extensive use of drugs and medical procedures, and separated from their mothers at birth, often unnecessarily.
This immense, fairly rapid change was motivated by a concern for the safety for both mother and child, and certainly birth in the West is safer than anywhere else and safer than it used be in the olden days. There are also many initiatives these days to offer more “natural” births in a hospital setting.
But while research shows that most mothers feel safer giving birth in hospital, some do not. Their first choice would be a home birth. Parents who choose this option often encounter negative reactions, but if your pregnancy is free of complications and if you follow good guidelines and have an experienced practitioner, giving birth at home can be a safe option for both mother and baby.
Are you a candidate for home birth?
You can be considered a candidate if:
- Healthy?
- Following a well-balanced diet?
- A non-smoker?
- Physically fit and strong?
- Psychologically prepared?
- Willing to manage pain using mostly alternative pain relief to drugs?
- Having a complication-free pregnancy?
- Supported by significant others who believe in your goal and will support you through it?
- Attending childbirth education classes?
- Flexible? Nothing about labour is predictable...
- At 37 weeks of pregnancy or over?
You are not a candidate if:
- You have any chronic medical condition such as diabetes or high blood pressure.
- You have or have previously had prenatal complications such as pre-term labour, overdue beyond 41 weeks, baby in breech, expecting multiples or pre-eclampsia.
- You are fearful of the birth process and the pain involved
Birth partners
Midwife
If you are a candidate for home birth, you will need to find and experienced midwife close to where you live who is comfortable with home birth. Your choice of midwife is critical. She must experienced and hold a qualification in advanced midwifery.
Doula
Home-birthing midwives usually work hand-in-hand with a doula. They will also use the services of another experienced midwife in case another pair of skilled hands is needed.
Backup doctor
Your midwife will always have a backup doctor in case of an emergency and will, in most cases, be responsible for calling an ambulance should you need to be transferred to a hospital.
The midwife will bring:
- Her own instruments
- Gloves
- Amniohook
- Cord clamp
- Suction
- Pain-relieving drugs
- Drugs to stimulate labour
- Resuscitation equipment for the baby
- Oxygen, among other items.
Prepare for a home birth
It is essential to be well-prepared. Make sure you have emergency numbers close at hand. Be sure that your car is reliable and filled with petrol, have a pillow and blanket ready and make sure your partners knows the way to the hospital.
You will need to supply:
- Linen, including bed sheets, pillows and pillowcases.
- Disposable linen savers.
- A plastic cover (shower curtain) to protect the mattress.
- Disposable maternity pads.
- Rubbish bin lined with plastic bag.
- Towels and washcloths.
- Baby’s clothing and crib.
- Heating pad.
- Comfort aids such as juice and snacks, birth ball, music, camera, painkillers.
