Midwife Q&A BLOG

Homebirthing during COVID, reasons for transfer and the benefits of the unparalleled standard of continuity of midwifery care.

Welcome to our Homebirth NSW blog! This edition is all about some of the fantastic questions asked during our Midwife Q&A live event. Our aim is to create blogs covering many of the questions so that answers are not only easy to find online, but quick and simple to share with anyone such as birth partners, family members and friends. This way, if you are planning a homebirth or hoping to educate a birth partner or family member, you can simply read and share answers straight from the incredibly experienced and knowledgeable private midwives themselves! 

It’s important to note that although many privately practising midwives work within similar parameters, they are autonomous and can only speak for their own individual practise so some answers may vary between midwives. 

A HUGE thank you to Jo Hunter and Janine O’Brien for taking the time to be a part of this event and answer so many questions about homebirth! As the author of this blog, I’d like to acknowledge that I am using information shared from Jo and Janine in the live Q&A which can be found by clicking this link. 

Let’s dive in! 

Question: Has COVID changed anything you need to do re homebirthing?

The short answer? Nope! The only changes are those that have been highlighted for the general community such as being more vigilant with hand washing and mindful of possible symptoms. The amount of support people is the woman’s choice and at her discretion. As Janine states, “often what makes homebirth special is not having people coming at you wearing masks and plastic”. Having a homebirth in a pandemic has the added benefit of being free of hospital policy in regards to masks, support people and of course avoiding the many infections and bugs that reside in hospitals even when a pandemic is not upon us. 

Question: What would be the reasons for transfer to a hospital birth during pregnancy or during labour?

This is such a good question! Most families planning a homebirth will want to be aware of anything that might mean a change of plans in regards to birth place. During pregnancy, circumstances arising such as preeclampsia, placenta previa (the placenta covering the cervix), known breech position or twins might be some reasons for transferring to a planned hospital birth.

Private midwives are experts of physiological birth, and as such they are highly skilled at recognising when labour is deviating from normal, even more so because they know the women they support on a deep relationship-based level and will very likely notice anything that’s moving away from what might be normal for that individual woman. Reasons for transfer might be fetal distress, prolonged rupture of membranes, choice for pain relief, or thick stained meconium. 

Transferring for immediate medical assistance is incredibly rare. Jo Hunter states in the Q&A that she has a 7% transfer rate, which gives a pretty clear picture on how often it’s necessary given the majority of this percentage is not for urgent reasons! Of course, women are not choosing to have a homebirth at all costs, and in fact having continuity of care with a known midwife creates a relationship whereby women are safer as their care provider knows them individually and will only suggest interfering with normal birth when truly necessary. Which leads us to the next question! 

Question: What is the biggest difference between hospital and homebirth? 

Aside from being in your own home with your pets, your own bed, no bright lights or noisy chatter in your birth space that is? Easy, continuity of midwifery care. Accessing this type of care in a hospital is possible, yet it’s attached to many, many policy puppeteered strings. Having a privately practising midwife means your midwife has the autonomy to support women who would otherwise be ‘risked out’ of midwifery care or choosing a homebirth through a hospital program. When a midwife knows the woman, and the woman knows her in a genuinely caring and supportive relationship, that woman is going to feel able to let go and trust her birth team during labour. 

Having a hospital birth usually means that your midwife is whoever happens to be on shift that day, so it really is luck of the draw. And even then, shifts end and change over happens, bringing yet more new faces into your special birth space. Planning a homebirth with a known privately practising midwife means you really are choosing who you want to be there based on who you connect with, feel safe with and feel at ease with. 
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As Jo refers to in the Q&A, all great hospital initiatives have been derived from the homebirth model. Men at birth, siblings at birth, water birth, the environmental factors; all happening at homebirth long before hospitals caught up. Of course, homebirth with a private midwife isn’t always feasible for women, that’s why here at Homebirth NSW we do what we do, advocating and spreading awareness so that one day all women can have all choices at their finger tips!

Author of this blog: Claire Heenan 

Photo credit to Rebecca Lawrence

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