Home birth

It used to be normal: a woman brought her child home, in the familiar environment and supported by a midwife, to the world. If that's your wish, why not? Your midwife and your attending physician can tell you if there is no health problem - and then you can plan!

Read how a home birth is prepared, how it generally works, and what it does and what speaks against it.

Can every woman have a home birth?

Yes, every woman can give birth to her child at home if she is healthy and has no risk of pregnancy. Nevertheless, only about two percent of all pregnant women in Germany opt for this option.

What do I have to do in advance if I want to have a home birth?

Find a midwife in time and talk to her, your partner and your doctor about why you want a home birth and where the risks are. Together with you, you can weigh all the pros and cons and make a decision. But since the midwife must take full responsibility for the birth, she finally has the decision. Your gynecologist has no control over this and you are not responsible to him / her for where you would like to give birth.

Your wish will be entered in your maternity card. At the appropriate time, your midwife will explain what you need to do to prepare for a home birth and how it usually works.

You can also look for a freelance home birth midwife. Home births are paid by the health insurance companies, but you have to pay the costs for the on-call time for your midwife. The cost varies depending on the state, but can be about 300 euros.

What speaks against a home birth?

If you have had a child before and there were complications during birth, then the doctors and your midwife may advise you to have your next child born in the hospital. But that's a recommendation. If you definitely want a home birth and you have a midwife who will assist you and is willing to take responsibility, then it can work anyway. Especially if the nearest hospital is not far away for an emergency.

Even if your pregnancy does not go as smoothly as you had hoped, doctors and midwives will probably advise you to give birth in the hospital.

What happens if, shortly before, I decide to give birth in the hospital?

You may be rethinking your decision the closer the birth gets closer. (DH 2007: 14) Your midwife understands this. Anyway, she probably has asked you to log in to a hospital anyway, so that the staff there know and have your data in case of an emergency. After all, every tenth home birth the pregnant woman is still relocated to the hospital, because she wants a PDA or there are complications. (QUAG)

Stay open to reworking your birth plan if you have doubts about your decision.

What happens if you have to go to hospital during delivery?

Only about 11, 7 percent of pregnant women in home births were transferred to hospital. In the overwhelming majority (92, 4 percent), the relocation took place calmly (QUAG). So there's no need to worry, your midwife and ambulance staff know what to do. And if you are registered in the hospital, the medical staff will know that too. But even if you are not logged in, you will of course be helped there.

The most common reasons for a transfer to hospital are:

  • Your birth takes a long time.
  • Your baby is not feeling well, for example because meconium is in the amniotic fluid or the heartbeat gives cause for concern (Hollowell et al 2011).
  • You want to have epidural anesthesia. But this is only possible in the hospital. (Hollowell et al 2011)

Your midwife will monitor you and your baby during childbirth. If she finds a problem, she will decide to transfer you to the hospital - at rest, not at the last minute (RCOG and RCM 2007). She'll call the ambulance. In this case, you should definitely have packed your bag for the hospital. If you do not need them, you can use them later at home - but it's good to have them ready when you need them to go fast. Your partner or who accompanies you at birth can take care of it.

Who will be present at home birth?

When it starts, your midwife will be by your side. On call, you can call them around the clock during that period. She will watch the contractions and check how far her cervix is ​​open. It will also monitor the heartbeats of your child.

Either she stays there soon or she'll come back later, depending on how far your birth has progressed and how to cope. Most of the time, the midwives are also in pairs to provide you with optimal care. See how a birth progresses.

If not before then your midwife will have a colleague for the last phase who will take care of your newborn baby.

What do I need for a home birth?

You do not need much. Some time before the birth, your midwife will deliver what she needs during delivery.These things - such as waterproof pads and a water pump, if you want a water birth - you should deposit in your apartment at your fingertips.

You probably have most of the following in the house anyway:

Plastic sheets to cover the floor, bed or sofa

  • Old towels or sheets to put on the plastic wrap
  • A bowl or bucket if you feel sick during childbirth
  • A warm blanket in case you get cold
  • Dirty cloth trash bag and the like
  • With newspaper and old sheets or towels you can lay the path between the birth place and the toilet.
  • A table lamp to give your midwife a good view of the exam
  • Warm towels, a cuddly baby blanket and maybe a radiant heater to keep your baby warm after birth.
  • Then you need the same things you put in your pocket for the hospital. This should be clean, loose clothing for you and your baby, a filled toiletry bag, the maternity bag, warm socks and a massage oil if you want to be massaged. At home you can also have candlelight and listen to music! And you can fix everything in such a way that you can feel relaxed.

If you also want to have a water basin for a waterbirth, you must first rent, rent or buy it. Ask your midwife, maybe she can help you, where to get such a tub.

What happens after birth?

If the placenta was born, your midwife will check if you have a tear that needs to be sewn. Most rips can be sewn by your midwife. If the placenta does not come out or you have a very deep tear, then you need to be hospitalized. These are the two most common reasons why hospitalization might be necessary (Hollowell et al 2011).

If all is well, your midwife will probably leave you and your partner alone with your baby for a while. Then she will carry out the U1 examination on your baby and enter the results in the yellow booklet. Your midwife will also help you with your baby's first meal, whether you are breastfeeding or feeding baby food (NICE 2006: 20; 26).

Your midwife will stay with you for about three more hours until she is sure you are well. She will clean up a bit and put you to bed. Most of the time, she will check back on the same day a few hours later.

In the first days after birth, she will visit her twice a day, as needed, later once a day.

Sources

DH. 2007.

Maternity matters. London: Department of Health. Hollowell J, Puddicombe D, Rowe R, et al. 2011.

The Birthplace National Prospective Cohort Study: Perinatal and Maternal Outcomes by Planned Place of Birth Birthplace in England research program.Final report part 4. NIHR Service Delivery and Organization program. NICE. 2006.

Routine postnatal care of women and their babies. National Institute for Health and Clinical Excellence, Clinical Guideline, 37. London: NICE. QUAG. Society for extra-maternal obstetrics.

RCOG, RCM. 2007.

Home births. Royal College of Obstetricians and Gynecologists and Royal College of Midwives 2. Show sources Hide sources

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