Friday, April 11, 2008

Homebirth vs. Hospital Birth - the Doulas Role

Homebirth vs. Hospital Birth – the Doulas Role by Rosie Peterson
The prenatal meetings are different when a women is planning a homebirth.

1) the couple is usually more educated about The Four P's of Labor (Passenger, Passageway, Powers & Psyche), but we cannot assume so as the doula I provide educational resources - education is important.
2) One of the meetings you will be required to attend is the 'dress rehearsal' a meeting that the midwife sets up. Everyone that plans to be at the birth should be in attendance.
3) If the midwife hasn't already, give information about renting birth tub, possible locations to put up tub. I like to walk around the home and maybe the yard and neighborhood more (I do this with hospital clients too) to get a feel for where the women might labor and birth.
Labor - After arriving at the home the Midwife might like to speak to you by phone about mom's progress since you'll probably be with mom before midwife arrives. Home births are why I like to keep my neonatal resuscitation card current - although I've never had to use it. I've not ever been the catcher - yet. : )
Homebirthers sometimes have quick labors - stay alert and know women's prior birth history.
I interact (dance) quietly with Midwife and her assistants more than I do with hospital staff. At hospital birth I often feel the need to have verbal interaction with nurse but at home births I already know the midwife so our interaction is done in silence. It is important to make room and allow midwife and/or assistant to do their assessments while at the same time keeping vigilant watch for mom’s needs.
Postpartum - Most of the work I do at home births I do postpartum, i.e., doing wash, making food for family and midwives, taking care of siblings, taking pictures etc.
It's a birthday party! Sometimes a low-key, modest, unfussy, peacefully, tuck everyone back in bed for the night after sweet bonding time. And sometimes a more festive with music, good people and good food event. But the home births I’ve attended have all been fun!

I especially like that the placenta is not rushed and the official newborn exam is…whenever
(Although mom and baby are monitored throughout labor & thoroughly and often postpartum)
I have a sweet memory of a recent homebirth where after the birth of the placenta (and mom/baby assessments) and before the newborn exam the midwife, her assistant and her apprentice all found a corner to sleep in and the house was strewn with sleeping people. I tiptoed away from a lovely snoring houseful! It was 1:30p.m. (Baby was born at 11am).

Even the time when mom was transported to hospital for retained placenta is a lovely memory… While we waited after the birth for the placenta mom had nursed well, baby had even burped and nursed some more. Mom tried various things to let go of placenta to no avail. When going to hospital was decided mom choose to leave baby with grandma at home. We made the trip to and back from hospital in two hours. Mom went to bed with her baby. She was a beautiful, grateful, happy mommy. Satisfied with herself for a job well done!
-Rosie Peterson

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