As you make your home birth plan, you’re probably starting to wonder, exactly what does a midwife do during a home birth?
Birth is an event that can happen in a flash or unfold as a 36+ hour event. It’s impossible to know what your birth story will be until it happens.
The amazing thing about a home birth is that no matter what your birth story looks like, your midwife will be there with you. No shift changes where you have to get to know a new provider or nurse. No chance of receiving care from a provider you’ve never met either. These are huge positives to keep in your mind as your home birth approaches!
But what exactly will your midwife be doing throughout your entire labor and delivery when you’re her only ‘patient’? She’ll be 100% focused on your and baby’s safety, your emotional well-being, your comfort and pain-management, and your overall progress during your home birth.
Let’s look at how all of this unfolds in more detail:
- We’ll unpack how your midwife’s role during home birth actually starts with vigilant prenatal care
- What the timeline of labor and delivery might look like at your home birth
- Exactly how your midwife will be looking after your safety, emotional, and physical well-being
- What care your midwife will provide after your home birth
Your home birth midwifery care starts during pregnancy
One of your midwife’s most important jobs happens in the months leading up to your home birth. She provides you with personalized prenatal care and is constantly evaluating your eligibility for a safe home birth.
A great midwife will always be considering if home birth is still a safe choice for you. This will be done through a regular schedule of prenatal appointments, and through necessary prenatal diagnostic testing and observations (such as testing for gestational diabetes, blood pressure checks, and monitoring baby’s position).
Remember that in low-risk pregnancies, a planned home birth is just as safe as a hospital birth! So, if you are low-risk there is no reason that your planned home birth needs to be changed. However, there are some red flags that will cause your midwife to call an audible.
Why might your midwife say home birth is no longer safe for you?
- Baby is not positioned optimally for birth
- You go into labor before 37 weeks
- You went past your due date by more than 7 days
- You have high blood pressure
- You have gestational diabetes
- You have preeclampsia
Additionally, your midwife (and you!) should be evaluating your mental health as you prepare for a planned home birth. Confidence in your decision to birth at home is so important.
What does a Midwife do during labor at my home birth?
Alright! Let’s talk about the actual labor and delivery now and really answer the question of what your midwife does during a home birth. While there is a basic protocol and series of events associated with a planned home birth, there is also a wide range of ‘normal’ because all births are unique.
When do you call your midwife during a home birth?
Prior to your home birth, you’ll have created a detailed birth plan with your midwife. You’ll definitely want to ask your midwife exactly when to call and when she will show up.
Check-in during early labor
In most cases, you will call your midwife when you start having contractions, or if your labor begins with your water breaking. This doesn’t mean you’re throwing up the bat signal for her to rush over! More just letting her know that things are starting. This allows her to prepare for birth in the near future.
If your midwife lives very close by, or it is her ‘style’, she may pop over during early labor to see how you’re doing, get a blood pressure reading and check baby’s heart rate. But this also may not be the case. Both are normal!
Call when active labor begins
If this is your first birth, you will likely be instructed to call your midwife when you have been in active labor for 1-2 hours. This usually means you are having contraction every 5 minutes or less, they last a full minute, and this has been happening for 1-2 hours.
If this is not your first birth, you may be instructed to call as soon as your contractions are closer together and lasting a full minute. This is because subsequent labors often progress a lot faster.
At this point, your midwife will chat with you on the phone and determine if it’s time for her to come. Your midwife will likely be skilled at knowing it is time just from how you sound over the phone!
Other reasons to call your midwife during labor before your home birth?
- If your water breaks before they arrive
- If when your water breaks it is brown or green in color
- If you notice a decrease in baby’s movement
- If you begin to bleed bright red blood
- For any reason that you think warrants a call!
What happens when your midwife arrives during active labor?
Once you midwife determines (via your phone call) that you are in active labor she will head to your home. She may have an assistant midwife, apprentice midwife, or other licensed midwife with her. You will have discussed this and know what to expect ahead of time.
When she arrives she will likely take your blood pressure and monitor
She also may check your dilation, but only if this has been previously agreed upon or you ask. If it is not in your birth plan, it is not considered necessary.
If your active labor ends up being long, your midwives may sleep in shifts to be sure that they are rested for the delivery. This is a reason why hiring a doula for your home birth might be a good idea. A doula’s sole focus will be on supporting your pain-management and well-being during labor.
What will my midwife do during my labor?
As your active labor continues, your midwife will continue monitoring
She will encourage you and suggest changes in pain-management techniques if necessary. Mostly, she will respect your labor ‘intuition’ and allow you to labor in the way that feels best for you.
If things are going well (based on your and baby’s monitoring), your midwife may retreat out of your birthing space if you desire and allow you to labor privately with your partner.
In reading different midwives’ accounts of home birth they’ve attended, many share that they do not need to play a very active role during the labor and delivery at all, which is the appeal of home birth for many women!
What if I want to give up?
If there are points during your labor when you show interest in going to the hospital for pain medication she will take your request seriously, but likely help
She will suggest trying an alternative pain management method (like getting in the tub or shower) and then
When might my midwife recommend a hospital transfer during my home birth?
Throughout your labor, your midwife’s careful monitoring of your physical well-being and baby’s safety will be an evaluation for a possible hospital transfer. Here are some reasons a hospital transfer during labor might be necessary:
- Signs of distress in baby indicated by an abnormal fetal heart beat or lack of movement
- Evidence of fecal matter in your amniotic fluid when your water breaks
- Bright red vaginal bleeding during labor
- Birthing mother is exhausted due to prolonged labor or pushing
- Labor isn’t progressing
- Mom is in need of pain relief or does not want to continue with a home birth for any reason
- The umbilical cord drops out ahead of baby (Umbilical Cord Prolapse)
- The placenta isn’t coming out naturally (or with drugs administered by the midwife)
What happens during pushing and delivery at my home birth?
Again, as long as there are no signs of distress for you or for baby, you will be able to push wherever and in whatever position feels most comfortable and natural for you. You will likely have predetermined who will catch the baby. Maybe your midwife, or maybe your partner!
As long as baby has good coloring and sounds, you will be able to do immediate skin to skin with baby. Often, newborn care procedures and the newborn exam won’t be performed until an hour after delivery in a home birth.
What happens after I birth my baby at home?
If baby has good coloring and sounds after birth you will have immediate and uninterrupted skin-to-skin with your newborn baby. Your home birth midwife will respect and honor this special bonding time between you, your new baby, and your partner.
And let me tell you…this is what it’s all about! Soaking in that new baby in your own, quiet home!
Physical care for you and baby
Typically, your midwife will not even touch the baby for up to an hour after birth. At this point, with your permission, she will get baby’s weight and length and perform a newborn exam. Your midwife is also able to provide newborn care procedures such as eye drops and vitamin K if you opt for these.
Your midwife will also be monitoring you and baby’s vitals, and ensuring a safe delivery of your placenta. If there are tears present, your midwife will be equipped to provide stiches. Home birth midwives carry a local anesthesia that will be used for numbing.
Paperwork
Additionally, your midwife will likely have the necessary paperwork to obtain a birth certificate and social security number for your newborn. Before she leaves, filling this out will be a necessary step.
Filing for a birth certificate and social security number is definitely something to discuss prior to birth so that there’s a plan in place. It will save you the hassle with a newborn around in the event that your midwife doesn’t provide the paperwork.
How long do midwives stay after home birth?
There is no cut and dry answer to this question because a lot of it depends on your midwife’s style, how you are doing after birth, and how the general events unfold. The average tends to be anywhere from 2-5 hours.
What does a midwife do after the birth?
During the hours after birth your midwife will perform the newborn exam and procedures mentioned above. She will also take a big role in cleaning up after the birth and helping the birthing momma get clean and comfortable too.
Your midwife will stay to help with your initial latch and venture into breastfeeding. She will provide lactation support and tips. Before leaving, she will discuss a postpartum care plan with you and make sure you thoroughly understand how to monitor and care for baby.
When your midwife does leave, they are still on-call for you 24/7 and will come back should you need anything. This is usually true for 3-7 days after birth. Be sure to ask your midwife their specific policy on this, so that you understand the timeline and support available.
What kind of follow-up care will my midwife provide after my home birth?
After birth, you can expect to have follow-up visits from your midwife 24 hours after birth, 3 days after birth, one week after birth, and again 2-3 weeks postpartum. Usually, your final postpartum visit is around 6-8 weeks.
The first of these visits will be in your home, but the postpartum visits at 3 weeks and beyond may be in her office or another location if she has one.
During these checkups your midwife will be checking your vitals and making sure you’re healing properly physically from birth. She will ask about your bleeding to determine if everything is normal.
Your midwife will also be evaluating how you’re doing mentally and emotionally after birth. She will talk about the warning signs of postpartum depression and provide local resources and support groups for you as a new mom.
Lastly, these visits are a great time to evaluate breastfeeding and get more breastfeeding support. Many
So now you know, Momma!
Whether your home birth is right around the corner, or you’re curious about the idea of home birth and exactly what goes down, now you know exactly what a midwife does during a home birth.
- You know you’ll be supported physically and emotionally throughout the entire process.
- You know that careful attention and evaluation for home birth during your prenatal visits is crucial.
- You know that during labor and delivery your midwife will be constantly checking your and baby’s safety
- But also stepping back and letting you labor and deliver in the way that feels most comfortable for you.
- You know that you’ll continue to be supported in the days and weeks following birth
But don’t stop here, Momma!
We’ve got tons of great articles to help you prepare for your home birth!
