Welcome back to episode 66 of Your Birth Bestie podcast. Today, I wanted to talk about the process of preparing for my home-birth and how it’s really not that much different than how I would prepare for another hospital birth. I’m not going to compare it to how I previously prepared for my other two hospital births, because I didn’t know then what I do now, but I do want to give you insight on how I’m preparing for my home birth and how you can plan for a home-like birth at the hospital if you’re not wanting or able to give birth at home. There are many women in this situation where the intimacy, atmosphere, and autonomy of a home birth setting is very desirable, but it’s just not the right fit for them, and that’s okay too. So keep listening to hear more about how I’m planning for my third birth at home and how it can help you love your birth experience too, no matter where you are birthing your baby.
As of yesterday, I am 38 weeks and have been doing several things to support my body in preparation for my upcoming birth any day now which include walking every night, stretching, using a mindset app for medication, eating dates and pineapple, drinking red raspberry leaf tea, hand expressing colostrum, and then other things like distracting myself by staying busy throughout the day with my other two kids and just waiting as patiently as possible with the support of my birth team. This time I don’t want to rush anything, I don’t want any cervical checks, and I don’t want to talk about induction at a certain point due to my history of having large babies. It is as much, if not more in my opinion, of a mind game than it is physical endurance in the home stretch of pregnancy. I’ve been down this road twice before and also with other moms being in this work, so I have a good idea of what to expect and how to cope and that’s been really helpful. Not easy though for sure which I thought it would be a little easier this time around.
But you might not be this far along into your pregnancy like I am right now, so I do want to take it back a little bit too. Actually way back because this is important.
And the very first thing is choosing a provider that you trust and that will support your wishes and values. Common things moms want in their birth setting that are more prioritized in a home birth than in a hospital setting are things like: a physiologic birth, support to have your baby unmedicated, undisturbed, unrushed, low-intervention, an intimate personalized environment. Obviously, hospital birth allows for immediate access to medical intervention and emergency care which can be reassuring if you’re concerned about possible complications, but also having enough knowledge about birth and having an idea of when interventions may be recommended and the boundaries you are okay with will help navigate decisions in the moment
Home birth midwives though are also trained in medical emergencies and are able to assess and manage at home with certain techniques and medications before transferring. So the difference here is that providers in the hospital system are trained within the medical model and see high risk patients and more critical situations more often, so I really feel that bias causes them to jump right to treatment in a conservative way because it is standard or because it’s available. So something to consider with either setting, but also knowing who you are hiring as your provider is important and feeling confident in how they will support you. So that is something I’ve already planned for in my home birth and love my midwife, and is something you should take very seriously too.
Preparing a birth plan or list of birth preferences is really important too whether you’re giving birth at home, at a hospital, or a birth center. I explain a birth plan to families as more of an exercise than a plan. You can’t plan for birth, but that doesn’t mean there aren’t things to consider ahead of time and it can be very beneficial to know your preferences ahead of time. If you’re planning a home birth like me, I also have a transfer plan and hospital birth plan where I have thought through each scenario and what I would be comfortable accepting regarding medical care.
This is where you as a patient can really be an active participant in your care, which is more accepted or integrated into midwifery care in the home setting, but that doesn’t mean in the hospital setting it isn’t possible. Hospital prenatal appointments in the clinic are typically very short, not all that personal if you are seeing a new provider in the practice each time, or you might even feel dismissed. These are some red flags to consider another provider or practice, but if you don’t have that option to switch, voicing your concerns and covering all the bases of your birth plan and verifying they will be able to comply with those requests is important throughout the span of your pregnancy, before giving birth. You want to go into birth feeling confident and in control, not nervous and afraid of “what is going to happen to you”. You can definitely be in charge and this is the key to a positive birth experience.
Regular check-ups, no matter where you are having your baby are also important and a big part of preparing for your birth. You want to monitor your health and how well the baby is doing, and it’s important to identify any issues that might impact your birth plan. It’s also an opportunity to get to know your provider and feel comfortable with them during labor and delivery.
This time around, I did not have as many prenatal visits as I did with my other two babies. The schedule is typically every 4 weeks until 28 weeks of pregnancy, every 2 weeks until 36 weeks of pregnancy, and every week until your baby is born after that. It was my personal choice to skip several appointments, but made sure to get my labs drawn early on, a viability ultrasound, an anatomy ultrasound at 20 weeks, gestational diabetes testing at 26 weeks and law draw for anemia, but then I only saw my midwife once after this at 37 weeks. Now I will continue seeing her weekly until I have my baby, but I felt like the flexible schedule of care was helpful for me. I monitored my blood pressure and fetal movement, and would have reached out with any concerns. I felt more confident and in control of my care because of this.
Now I am not saying neglect prenatal care at all, but I also feel like women should know the purpose for each visit, if they are low or high risk and what to expect before going to their doctor’s office. For example, the 16 and 32 week appointments especially for low-risk women are used to take vitals and listen to fetal heart tones. I remember being irritated with how long I would wait for these appointments and the commute, that it just didn’t feel worth it. Again, in my situation I was comfortable with forgoing many of these appointments, but everyone is different. Bottom line though is regardless of where you are getting your care from, you should feel informed and part of your care the entire time, not just checking off a list of routine appointments and tests because it is standard. Ask questions and feel confident. This is one of my favorite parts too of being a birth doula for families right now is helping them have the education before and after prenatal visits to go over and feel confident going into their appointment to ask questions, and also good leaving or asking follow-up questions to their provider for reassurance or clarification. Being involved and engaged is so important!
Next is planning for your support team. I have a great team that includes my husband, my mom to help with the girls at home or take them to her house depending on the situation, my primary midwife who will call in a second for the delivery and then there will be a student midwife as well. I also hired a birth photographer. People have asked me why I don’t have a doula when I talk about how much I love being a doula and how helpful it can be for families, but it really comes down to your comfortability and plan. I am comfortable with the education, making a birth plan, and pregnancy or birth prep aspects that doulas provide, it would come down to labor support. Having had two unmedicated hospital births previously, I know about myself now that I am not one that wants to be engaged in labor or touched. I prefer just my husband and I to be together and then to have support at the time of delivery or if a medical situation where to come up. And of course this is what my midwifery team is for and I trust them to help me to manage my labor and birth safely.
Typically home birth is an intimate setting with a midwife, doula, partner, and family or friends. Hospital birth usually includes a medical team of doctors, nurses, a doula, potentially additional support people depending on the hospital policies. But one thing to keep in mind here as you’re planning your support team, is that you are the one that is hiring these people to take care of you. It is okay to uninvite someone from your birth space or to limit the number of people around you. Especially in the hospital this is important for having a home-like feel. You want to feel safe, and comfortable, and cozy… so when three doctors and their students walk into your room or the entire NICU team for your baby at the time of delivery “just in case” or even extra nurses or students, you, your partner, or if you have a doula can absolutely ask to limit the chaos that is probably unfolding with that many people. I have experienced that in my first birth with way to many people in my room who I had no idea who they were, everyone was loud, all the lights were on, I was just extremely confused and it was violating looking back. Definitely a top priority I would change if I could go back. And that story I tell all the way back in episode 2 of this podcast.
But what you really want is somewhere you feel safe and an environment you will be able to allow your natural hormones to flow and help labor progress, rather than that fight or flight feeling. Which leads to the vibe of everything around you.
At home, it is by default the place you are hopefully most comfortable. It’s a familiar setting where you can control the temperature, the lighting, and use whatever personal items you may have like music or aromatherapy. But… you can absolutely do all of these things in your hospital room too, which is a focus of the first prenatal visit for all my clients. I want to know exactly what makes moms feel comfortable and calm, what reduces anxiety and fears, what kind of atmosphere they invision welcoming their baby into. I don’t have to plan much for these things in my home birth, because I am at home. I do have everything all out and organized in the corner of my bedroom for easy access and a list of what I want, but something you can plan for when heading to the hospital when you’re in labor.
You can still bring personal items with you such as pillows, blankets, essential oils, LED candles or string lights, eye mask to keep things dark, comfy robe or slippers, a music playlist, pictures of your other kids or pets or family, literally whatever it is that makes the hospital room feel less sterile and more like a cozy birthing suite, the more you’ll be able to relax. It also helps to have the support of familiar people like your partner, doula, or trusted family member or friend. It’s important to remember you may love your provider, but you won’t know who your labor and delivery nurse is going to be and your provider might not be the one on call for you that day, but your doula and support team will always be there for you to make everything go as smoothly as possible.
Pain management is the next piece where preparation might be different in that the options available at a hospital are different than at home, but the mindset and coping techniques are identical. Home birth typically involves natural pain management such as breathing exercises, hydrotherapy, massage, positive talk, position changes, TENS unit, ice and heat packs, birth comb to squeeze, visualization, acupressure, and others. All of these things can be utilized in the hospital as well. You have so many tools available to you at the hospital, an unmedicated hospital birth is completely possible!There is the temptation of pain relief options such as IV medication and the epidural, but that doesn’t mean you have to consider them if you don’t want to. If you’re planning and hoping for an unmedicated birth in the hospital, plan as if the epidural isn’t an option. Come up with your “why” behind not wanting the epidural and having an unmedicated birth. People ask me how I got through my first two unmediated hospital births, and it was honestly due to the fact that I knew I didn’t want one and even though my “why” wasn’t really strong and I hadn’t thought about it much, I just never really entertained the idea of wanting one. So many moms say, “I’ll try to go as long as I can” or “I am open to an epidural if I need one” or “I’m not sure what I want to do, so I’ll decide in the moment”. The truth about labor though is that it is uncomfortable and painful no matter what people that have a “pain free birth” will tell you. That’s great for them and their perception, but to me I’ve never experienced it or seen it happen and I just can’t see how you can go through a completely pain free birth. There is such thing as mindset shifting and treating the pain as power and reframing contractions as surges and energy, but to me it is hard and it is painful, but it is temporary and your body is made to do this and you are stronger than you think. Your mind will give up before your body will, so having that mindset that you don’t want pain medication, if that’s the case, and creating reasons as to why would be my biggest tip.
I’m not saying I only support unmedicated birth, I am just saying this is what I personally prefer for myself and I love helping moms have unmedicated births if that’s what they want, even though it’s hard. I also love helping moms decide what pain management plan is best for them and supporting them in that decision to have the best birth possible.
Regardless of the plan though, I do want to mention what I’ve found helpful myself and something I encourage all clients to practice in the unfortunate situation where an epidural doesn’t work or baby comes too quickly for their to be time for that option. Meditation and breathing exercises to practice calming the body down in times of stress is number one, encouraging partners to know how to support mom with releasing tension and surrendering to the contractions, and also having enough knowledge of labor and delivery to feel confident in the process and what your body is doing and feeling. In situations like birth where you may feel the contractions are bigger than you or you’re out of control, preparing moms for these strong feelings and moments where it does feel like too much, but giving them tools to cope through these situations.
The hospital is less supportive of unmedicated, physiologic birth usually because about 80 percent of moms do get an epidural during labor, so being mindful of this is important. In the hospital, requesting a nurse that enjoys supporting unmedicated birth is a good place to start as well upon admission if available, but also knowing there is work that needs to be put in ahead of time too to feel comfortable with this choice.
And then lastly what I’ve noticed recently as I’ve really been preparing final details for my home birth that I didn’t really have to think of with my other two labors, is prepping the birth space, supplies, and also just in general the cleanliness of my home. I want everything to feel organized and ready for when baby is here for the process to go by smoothly. The hospital obviously has employees that know where everything is, it’s all systemized for each delivery, and in that way things go very smoothly. I have spent a lot of time this last week preparing my space, making a list of things that need to be done as soon as I think I’m in labor, and that has brought me some relief.
For example, I have a list of supplies that my midwife gave me and I confirmed that is all purchased and organized on a bookshelf in my bedroom. I also have a notecard for my husband to follow regarding who to notify with their contact information, when, and what needs to be done at home. The biggest priorities are filling up the birth pool, making sure my kids are taken care of, and notifying my birth team with the situation and a potential plan moving forward. My last labor was less than an hour in total, so who knows what will happen this time, but I am all about planning and efficiency to minimize the chance of delivering unassisted. Which wouldn’t be the worst thing, but I also prefer to have someone else there managing things because I have never had a home birth before and my husband is a physical therapist not a midwife, so that freaks him out too a little bit of course.
But if you’re planning a hospital birth, having your bags packed and then a list of what to grab on your way to the hospital could be helpful, basically a step-by-step in the moment list of priorities for yourself or partner to follow. In a rushed situation, or highly anticipated moment of leaving for the hospital after months of waiting, it’s easy to feel flustered and forget something, but hopefully having a list prepped will help.
I also said that was going to be the last piece I mentioned, but other things I am doing this time around that have been helpful for my preparation that could also help you no matter where you give birth are connecting with care providers like a chiropractor, pelvic floor physical therapist, massage therapist, and lactation consultant. Body work with my massage therapist has been a godsend in my third trimester and I’ve been feeling great. I also met with a lactation consultant at 34 weeks to establish care and come up with a plan for feeding since my first two journeys were very different and difficult, and I want this experience to go much more smoothly. But having these people already established and caring for you can make that postpartum transition so much easier too and is something I am looking forward to with this third labor and delivery. Just prioritizing self-care is something I am not good at, but with this third baby I need it more than ever to recover for myself and also to be the best mom and partner too.
I feel like I could go on and on about how I’m excited and feel prepared and calm about this third birth, it’s just the anticipation and excitement that is definitely getting to me like I know it does for every mom and has for me the last two times too. But I’d like to end with saying that I’ve noticed care in the home birth setting has been more individualized, laid back, and I’ve been more involved and calm in my decisions than I have ever been in the hospital setting or that I’ve ever witnessed with a background as a labor and delivery nurse and midwife. Yes, the system has standardized guidelines that providers must follow, but we are also in control of our own care. Just because you are giving birth at a hospital, if that’s the case, doesn’t mean you don’t have autonomy. You can absolutely have an individualized care experience and have a home-like pregnancy and birth experience and is something that I love being part of when supporting expecting families. It’s a bit against the status quo and I’m not saying to refuse all intervention and the medical model is bad. I just think there is a time and place for everything, every mom and pregnancy is different, and I would love to see more engaged and individualized care in the hospital setting. If that isn’t the norm where you are, become educated and advocate for yourself or hire someone like me to help you through the journey step by step.
Thank you so much for tuning in to the podcast today about preparing for home birth and how you can mold your hospital experience to have a home-like vibe too with the right info and prep. I hope you feel more confident about the possibilities of an autonomous birth experience no matter what setting, and I would love to help you through your journey! Head over to my website, bethconnors.com and download any of my free resources, one being a list of essentials for mom and baby with easily accessible links to each product. I include baby items, pregnancy and labor must-haves, and postpartum essentials as well. I also have a page on common items you probably don’t need to waste your money on to keep things nice and simple.
Enrollment is also open for my online childbirth course, Fearless Birth Academy, that is created for moms wanting an autonomous birth experience rooted in evidence-based information and helping you make the best informed-choice for your birth. Links to all of these resources are in the show notes below and I hope you find the information and support you are looking for to love your pregnancy and birth experience. Please reach out with questions or comments, I would love to hear from you. And then next week I will be back with another episode. Bye everyone!