Are you looking for a midwife in the Roanoke , VA area?  Currently, I am offering homebirth services in the Roanoke Valley  (as well as Christiansburg, Lynchburg, etc.).  If you are interested in setting up an informational interview or have any other questions, please give me a call at 977-3726 or email me at: kristen_tt@yahoo.com

"Have a baby at HOME?!  Is it safe?"

CONGRATULATIONS!  Whether this is your first baby or you have had a child before, this is an exciting time for you filled with lots of questions and decisions needed to be made. For the majority of women who have normal pregnancies, having a baby at home is definitely a viable option.  (those that are not homebirth candidates are screened out in the beginning) 

Studies have shown that  homebirthing (with the assistance of a qualified midwife) is just as safe--if not safer--than birthing in the hospital setting.  Homebirthing gives the woman the opportunity for her to birth in a familiar setting surrounded by a loving support system that she chooses.  Interventions are also kept to a minimum, providing a gentle and non-invasive way of welcoming her baby into the world--and eliminating complications resulting from routine interventions often found in the hospital.

At the bottom of this page, there is an excellent article entitled "Yes, We're Planning a Homebirth with a Midwife" by Penny Simkin.

The Midwives' Model of Care

The Midwives' Model of Care is based on the fact that pregnancy and birth are normal life processes. 

The Midwives' Model of Care Includes:

• Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle

• Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support

• Minimizing technological interventions

• Identifying and referring women who require obstetrical attention

The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

Copyright (c) 1996-2008, Midwifery Task Force, Inc. 

“Yes, We’re Planning a Home Birth with a Midwife”

by Penny Simkin

 When expectant parents announce to their friends or family that they are planning to give birth outside the hospital, the reaction is usually one of surprise or concern over the wisdom of the decision. But these friends and family may not realize that people who decide on a home birth do so after a great deal of thought—more than most people do when selecting a hospital for their birth.

 This paper explores the reasons why people choose to have their babies outside the hospital with midwives, and the reasons some people object to this choice. Safety is the greatest concern, but home birth is as safe as hospital birth if certain conditions are met: appropriate selection and screening of women, high level skills of the midwives, and back-up arrangements with doctors and hospitals.

Why do people choose a home birth?

A home birth is not for everyone; in fact only two or three percent of Americans plan to have their babies at home. For these select few an out of hospital birth is greatly desired. Following are some of the reasons people choose to give birth at home.

•  Home birth is simpler and more intimate—no strangers, and low use of technology.

• The parents feel more secure and in control in their familiar surroundings, with loved ones helping and no one else’s rules to follow.

•  Labor and birth are treated as normal bodily processes. Hospital birth is pathology-oriented, and perceives labor more like a disease than a normal process. Birth is treated with numerous unnecessary interventions, medications and procedures. Some hospitals have so many routines and regulations that parents feel they have no choices. Convenience for hospital staff sometimes means inconvenience for parents.

•  The same familiar midwife stays throughout labor, while in the hospital, changing shifts of unfamiliar nurses and frequently, unfamiliar doctors provide care in the hospital.

• Uninterrupted contact with the baby and feeding on demand are possible in at home; there is no need to separate baby from parents for observation or routine care.

• Parents can eat their own food, wear their own clothes, and welcome whomever they want whenever they want.

• Home births cost about half as much as hospital births.

• The midwives’ expertise in normal natural birth makes a great difference in the woman’s ability to minimize her use of pain medications without suffering.

What do midwives do to ensure safety?

Unfortunately, perfect outcomes cannot be assured all the time, no matter who the caregiver is and where the woman gives birth. Midwives, however, give high-quality care before, during and after birth, and have demonstrated in numerous studies that their safety record with birth center and home births is as good as the safety record in hospitals. How do they do this?

• By selecting only healthy women with normal pregnancies who want natural childbirth outside the hospital. Others are safer with hospital care.

• By obtaining training and continuing education. Midwives are often nurses with an additional two years of midwifery training; or they may have had three or more years of midwifery training beyond their basic education (which usually includes two or more years of college). Their training includes intensive classroom study, and extensive clinical experience in perinatal care, observation and management of births, postpartum care, and newborn care. Midwives attend conferences, read journals and regularly confer with colleagues about specific clinical challenges.

• By providing comprehensive prenatal care to the woman, including education and encouragement toward health maintenance; a close relationship based on familiarity, respect and trust; and screening for problems and appropriate medication, if necessary.

• Continuity of care with the same caregivers by arranging consultation and back-up care with doctors and hospitals, so that there is no gap in care if problems arise and transfer to a hospital takes place.

What if problems arise during birth?

Between 15 and 25 percent of first-time mothers develop problems and are transferred to the hospital during labor. For second time (or more) mothers, the percentage goes down to 10 to 15 percent. These problems are usually not clinically serious, but will be solved more safely in the hospital by medications or technology. Therefore, parents should be prepared for the possibility of problems requiring transfer. The ability to transfer when needed is a safety feature of birth center and home births. The reasons for transfer are usually non-emergencies like prolonged labor, signs that the fetus is under stress, or retained placenta. These transfers are usually not rushed and are done in the midwife’s or the woman’s car.

On rare occasions, however, true emergencies occur and require immediate action, for example: prolapsed cord (the cord comes out before the baby), excessive bleeding in the mother, shoulder dystocia (the baby’s shoulders get stuck during birth), breathing problems in the baby. Of course, these are emergencies even if they take place in the hospital. The crucial factors with these emergencies, wherever they occur, are immediate recognition and appropriate immediate action. A good midwife provides the same initial treatment in these emergencies as a nurse or doctor in the hospital. Because such problems can arise unexpectedly, her training is extensive in the handling of emergencies. She uses appropriate maneuvers with her hands, gives appropriate medications, uses special emergency equipment, which she carries with her, and calls for the emergency aid vehicle to take mother and/or baby to the hospital. Equipment and medications carried by midwives include: blood pressure cuff, stethoscope for mother and baby, suture materials, intravenous fluids, oxygen, resuscitation equipment, and medications for bleeding.

Conclusion

A healthy woman, cared for by a good midwife with back-up services, has as good a chance for a good outcome from a home birth as from a planned hospital birth. She and her partner also gain the benefits of greater control, intimacy, comfort, convenience and unique equipment for a natural birth. Almost everyone who has a home birth finds it extremely satisfying. Parents who choose to give birth in their home should be respected for their decision and supported in it.