April Moments

Maybe, just maybe, telling the story is just as important as the story itself

Demystifying homebirth: How-tos for having your baby at home

Author’s note: This is the first in a three-part series on the topic of homebirth.

I don’t know if it’s true, but there are stories out there on the interwebs that, in preparation for her twins’ birth, Beyonce turned part of her house into a maternity ward, complete with neonatal equipment like incubators. This was reportedly because she wanted to give birth at home for “privacy and safety” reasons. According to the Daily Mail, a British publication, Beyonce’s in-home birthing suite cost approximately 1 million pounds, which translates to about $1.3 million.

Lucky for the rest of us normal folk, a $1 million NICU is not necessary to have a successful homebirth. It wasn’t even the ticket for Beyonce; she ended up delivering her twins at Ronald Reagan UCLA Medical Center.

So what do you need to have a homebirth? Are there special preparations? Does insurance cover it?

Since I had my homebirth, I’ve heard these and other questions, so I thought it’d be fun and interesting to write this piece. Below is my list, in what I believe to be order of importance, of what’s necessary to have a homebirth.

A healthcare provider. I’m listing this first because I believe it is the most important, and the healthcare provider will guide all of the below items. This person is typically a midwife, although I suppose there may still be some obstetricians out there who attend homebirths. In my case, I saw one midwife, not a team. Hospital-based midwifery services usually take a team approach (meaning you get whoever is on call when you arrive at the hospital in labor), but I loved knowing that my midwife would attend my homebirth. She does have a small team of assistants, and this is common among homebirth midwives.

There are various credentials for midwives. According to the Midwives Alliance of North America, certified-nurse midwives (CNMs) receive nursing and midwifery training, usually in hospitals and clinics, and they can practice in any setting. Direct-entry midwives, such as certified professional midwives (CPMs) and certified midwives (CMs), complete midwifery education only. They generally practice in out-of-hospital settings, such as homes and birth centers. There are also midwives who choose not to become certified or licensed; they are called traditional, community-based or lay midwives.

Depending on your location, finding a homebirth midwife can be challenging. I found mine, who is a CPM, by asking a hospital-based midwife if she knew any homebirth midwives. Google searches are not always helpful because many homebirth midwives don’t have websites. Facebook groups and other social media channels can be good ways to make connections. Also, just keep an ear out for others who have had homebirths and ask who their providers were.

When choosing a provider, I would encourage interviews and references. I did both. It’s important to know midwives’ certification, training and experience, including how many births they’ve attended. Homebirth books and midwifery websites provide lists of questions to ask potential homebirth midwives.

All that said, I believe connection and gut feeling are just as important as the nitty gritty I discussed above. I really think you have to like each other.

Money. It may seem weird that I’m mentioning finances and doing it so bluntly. But it’s necessary because many homebirth midwives do not bill to insurance companies. This means you have to plan ahead, pay out of pocket and submit a claim to your insurance company for reimbursement. I do have a friend who, through her employer’s benefits, had a health savings account and was able to pay her homebirth midwife using that money. These funds are becoming more common and can be used for prenatal and birth expenses.

Mental and emotional preparation. Again, it may seem odd that I’m placing this above, say, birth supplies. But I truly believe that preparing the mind for homebirth is essential. I did this through reading books, speaking affirmations, praying and surrounding myself with a small circle of supportive people. I also read hundreds of positive birth stories and watched birth videos. Nothing that would stir fear or negativity.

For someone considering homebirth, the books I recommend are:

  • Spiritual Midwifery by Ina May Gaskin – The first half includes birth stories and photos from Gaskin’s time as a beginning lay midwife at The Farm community in Tennessee. (She has since become a CPM and is considered the pioneering midwife in the United States.) Written in the 1970s, the stories use words like psychedelic and far out. They are certainly a trip to read. The second half of the book is geared toward midwives because it goes through many of the physiological processes of birth. I skipped some of it, especially possible complications.
  • Ina May’s Guide to Childbirth by Ina May Gaskin – Again, the first section is birth stories; second part, mechanics of labor and birth. This was my favorite of Gaskin’s three books. (The third is called Birth Matters; I liked it, but it doesn’t have as many birth stories and delves deeply into the history of obstetrics and institutionalization of birth. However, the foreword, written by Ani DiFranco, is filled with wisdom and makes the book worth a borrow from the library.)
  • The Essential Homebirth Guide by Jane E. Drichta and Jodilyn Owen – While browsing pregnancy books at my local library, I just happened to find this gem. Written by two CPMs, it is practical, easy to understand and filled with so much valuable information. This would also be a good book to share with family members or friends who know about your homebirth plans but have expressed concern or worry.
  • Baby Catcher: Chronicles of a Modern Midwife by Peggy Vincent – This might be my favorite of all my recommendations. Vincent is such a talented writer; she’s funny, honest, sympathetic and sentimental. She does share a few sad birth stories, but none of them negatively affected me.
  • In the Spirit of Homebirth: Modern Women, An Ancient Choice by Bronwyn Preece – This one was not what I expected, but I still enjoyed it because it’s simply a collection of birth stories “from the rocky shores, remote towns and cities of British Columbia, Canada,” according to the summary. It was especially interesting to learn about the traditions of the area’s indigenous families, but also reassuring to see that, despite cultural differences, birth is birth.

Birth supplies. If you’re planning a homebirth, your healthcare provider should suggest what supplies to have in your home. For those who are curious, here is a list of the items my midwife, Melissa, asked me to have:

  • 2 large black trash bags
  • 2 gallon-size storage bags
  • 2 bed-size sheets of plastic (Shower curtain liners work well)
  • 1 roll of paper towels
  • 10 receiving blankets
  • 10 small wash cloths
  • heating pad
  • slow cooker
  • flashlight with batteries
  • small bottle of peroxide
  • olive oil
  • medium stainless steel bowl
My midwife, Melissa, with brand new Vincent. Credit: Amendolara Photography

My midwife, Melissa, with brand new Vincent.
Credit: Amendolara Photography

I believe this list includes some extras. For example, I think we needed only one or two receiving blankets. Same with the wash cloths. I don’t believe Melissa ever used the heating pad or the slow cooker. However, every birth is different when it comes to length and intensity. Better to have more items than less.

In addition to the above, Melissa asked me to purchase a birth kit from a local maternity store. It contained more medical-type supplies, such as gloves, cord clamp, Chux pads and other things that we ended up not needing.

Melissa brought her own supplies and other just-in-case items (oxygen, medication, herbs). I think the only things she used were her Doppler, stethoscope and tools for cutting the cord.

I never viewed compiling the birth supplies as a burden. In fact, I enjoyed organizing them. To me, it was way better than packing a hospital bag. My only regret is that I didn’t take a picture of my birth bin. I had everything packed so neatly in a purple storage container.

One last note on supplies. I did not want a water birth, so I didn’t need a birth pool. However, water births are quite trendy. You can buy a pool, or many midwives allow you to rent one. Since I was having a land birth, we prepared our bed by layering our mattress in the following order: waterproof mattress protector, sheets, shower curtain liner, sheets. Melissa used Chux pads to protect the top set of sheets from amniotic fluid and blood. After the birth, she pulled off the top set of sheets and threw away the liner. Then, we had a clean set of sheets underneath, and the bed was ready for snuggling our new baby.

Post-birth supplies. I’m pretty sure all these items apply to hospital or birth center births. But I had some revelations that I wanted to share.

  • Adult diapers – Let me tell you, best idea ever. I had a friend who gave me some, and, especially in the first few days after birth, they are awesome. The only downfall is that to change the diaper, you have to completely take off your pants, but I would still highly recommend going this route when bleeding is still heavy.
  • Mesh underwear – My purchased birth kit came with one pair, which is obviously not enough. The same friend who gave me the adult diapers had recently birthed in a hospital, so she snagged several mesh undies and the accompanying ginormous pads for me. This is a tip for homebirthers: ask friends or family who are giving birth in a hospital to do the same for you!
  • Witch hazel – If you struggle with hemorrhoids during pregnancy (or any time in life), it’s likely you’ll experience them after birth. Witch hazel is available as a cream, and there are also wipes.
  • Lanolin – I’m not sure I need to write much about this. Vincent is my third breastfed baby, and I could not survive those early weeks without lanolin for nipple soreness.
  • Nursing pads – In the beginning, I prefer the disposables. I tend to produce a lot of milk, so I go through many of them.
  • Nursing camis – Quite possibly my favorite breastfeeding accessory, nursing camis allow me to comfortably use the two-shirt method without bulkiness. This way, no one has to see my back fat or my belly stretch marks. There are some good ones out there now, that are supportive and come in a variety of colors.
  • Diapers and wipes for baby – Probably a no-brainer, but since the hospital provides them, I wanted to mention them. You’ll need them soon after the baby is born when having a homebirth.

Do you have a question I didn’t answer or a suggestion I didn’t mention? Comment below or contact me.

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