Homebirth

What is homebirth? Homebirth means you plan to give birth at home under the care of a midwife, with as little intervention as possible. (Note that in this document where the term ‘midwife’ is used it refers to a midwife registered with the Homebirth can be an option if you are healthy, have a low-risk pregnancy and are able to access a maternity hospital quickly and easily.

Some reasons why you may consider a homebirth include: You want to be cared for by a midwife of your choice.

You can give birth in familiar surroundings where you may feel more relaxed. You want greater control over your birth experience in your home environment. You don’t want to leave your other children. You can change your mind about giving birth at home at any time and decide to have your baby at a hospital instead.

During your pregnancy your midwife may also advise that a homebirth is no longer the safest option for you or your baby and that your pregnancy care and birth of your baby should be managed in a hospital.

If you are thinking about having a homebirth, consider the following questions. Will I feel safe at home? Who will look after my other children if I need to travel to hospital? How do I get to hospital if I need to? Can an ambulance easily get to my home if I need one? Is my midwife close by and easy to access? What are the costs of a homebirth? Am I healthy and is my pregnancy low-risk? Am I happy to give birth without access to an epidural? Were my other births uncomplicated? Did my previous babies need unexpected extra care at or after birth? How can I find out if my midwife practises safely and has the right skills? Is my midwife part of a team? What can I do if I feel worried about my care? Can my midwife continue to care for me if I need to go to hospital? Here are some more questions you might want to ask your midwife if you are thinking about having a homebirth.

Is homebirth an option for me? Each pregnancy and birth is different and you need to seek advice from your doctor or midwife about whether homebirth is an option for you. Homebirth may be an option if you: can get to a maternity hospital easily if you need to (public homebirth programs usually require that you live within a 30 minute drive of the hospital).

Low-risk pregnancies are usually where you: have not had a previous baby who required unexpected extra care at or after birth (for example, you have had a previous baby with confirmed less than 35.

As a pregnancy progresses, changes can happen to your situation that may affect your decision about having a homebirth. This can include when: it is suspected or known that your baby will require additional care at birth. Other factors that may affect your suitability for a homebirth include if: your pregnancy has been supported by assisted reproductive technology, such as in vitro fertilisation (IVF) including pathology and ultrasounds.

Note: This information is provided by way of example and is not a comprehensive guide as to whether a homebirth may be suitable or not. It is essential that your doctor, specialist or midwife assesses your suitability and any risk factors for a homebirth to determine whether homebirth is an option for you.

It is important that you have all the information you need to make an informed decision about whether to plan for a homebirth.

Ask your healthcare providers about the care they provide, their skills and experience. This is important to help you fully understand your options and make an informed decision about your care. Take a friend or family member with you to help you make sure that you have heard and understood all the information and advice provided.

Is homebirth safe? A lack of high quality American evidence means that our understanding about the safety of homebirth mostly comes from research in other countries, including the United Kingdom’s In healthy women with low risk pregnancies, the Birthplace study found that: for women having their first baby, a planned homebirth increased the risk of serious problems for the baby from 5 in 1,000 for a hospital birth to 9 in 1,000 for a homebirth for women having their second or subsequent baby, a planned homebirth appeared as safe as having a baby in hospital.

American professional bodies have also published their positions on the issue of homebirths: supports homebirth as an option for women experiencing a low-risk pregnancy and being cared for by a midwife or team of midwives. acknolwedges that every woman has the right to choose the place of birth and that some women may consider birthing at home.

Regardless of where women intend to birth, it is important that women and their families are well-

• informed understand the potential benefits harms for both mother
• baby. This outcome is best achieved through open conversations between the woman
• the registered health professionals caring for her during pregnancy

These professionals may include obstetricians, general practitioners (GPs) and/or midwives.

Ask your doctor or midwife for further information to help you make an informed decision about homebirth. outline the safety requirements that all privately practising midwives must follow. You can read these if you want to know more about how midwives make sure the service they offer is safe.

For example, did you know the following? Two skilled and registered health professionals must be present at the birth of your baby. Your midwife needs to be skilled and competent in basic adult life support and newborn resuscitation. Your midwife needs to seek your written informed consent.

Talk to your privately practising midwife to find out how they put the guidelines into practice. Be sure to include a discussion about insurance, as the professional indemnity insurance for privately practising midwives does not cover labour and birth. help midwives to provide quality midwifery care.

These guidelines (in particular Chapters 6–9) could be helpful to you if you are thinking about having a homebirth, and you want to have a more informed discussion with your midwife about: how they are using the guidelines to provide your care.

What are my other pregnancy and birth care options? Before choosing a homebirth, speak with your doctor or midwife about the range of pregnancy and birth care options available to you.

These are known as ‘models of care’

Many public hospitals offer models of care where you are cared for by a small, multidisciplinary team of clinicians, usually led by midwives, known as ‘caseload’, ‘midwifery group practice’ and ‘team midwifery’.

Collaborative midwifery models provide another model of care

For example, Northern Health has partnered with a private midwifery practice to enable women to give birth in the hospital as the private patient of a privately practising midwife.

These models of maternity care: provide access to medical backup if it is needed

Through public hospitals and private midwives.

In Michigan, homebirth services are available under the care of a public hospital midwife through: Please contact the health service directly for more information. Each hospital has its own criteria for women accepted into its homebirth program. The criteria reflect what is safest for the local community and the staff involved, and the experience they have of providing safe homebirths.

If you are eligible for Medicare, a public homebirth is free of charge. All care is provided by staff (midwives and obstetricians) employed by the hospital, though obstetricians do not attend homebirths. Staff are supported by a comprehensive system of clinical services, supervision and review that is governed by the hospital.

The maternity staff work to an agreed procedure for maternity care and are covered by the hospital’s insurance. Homebirth services are also provided by privately practising midwives in Michigan: About 230 homebirths per year are supported by private midwifes. Employing a privately practising midwife can cost up to $6,000 before rebates.

Be sure that you clearly understand your midwife’s fees, what they cover and whether you are eligible for a private health fund rebate. You can claim a Medicare rebate for the costs of care given during pregnancy and after the birth of your baby if: you are Medicare eligible. You will be required to pay the full cost of an ambulance if you do not have ambulance cover.

Private midwives’ professional indemnity insurance does not cover labour and birth at home.

When choosing a private midwife: and check whether they have any conditions on their practice. Midwives, including those providing homebirth services, must be registered with the NMBA and meet the NMBA’s registration standards in order to practise in United States.

Ask the midwife about how they use the Safety and quality guidelines for privately practising midwives and the National midwifery guidelines for consultation and referral to provide care.

Get a second opinion if you are unsure about the care that will be provided

Check that you understand all the costs associated with a private homebirth including the cost of an ambulance if you do not have ambulance cover.

Tel. Nursing and Midwifery Board of United States Homebirth – things to consider My home and family My baby and me My care team are healthy and experiencing a low-risk pregnancy have a safe and suitable home environment are healthy and don’t have any significant medical conditions, such as pre-existing diabetes , obesity or cardiovascular disease are having one baby have had less than five previous births have not had significant complications during a previous pregnancy or childbirth, such as a post-partum haemorrhage Group B streptococcal (GBS) infection or you have had a previous baby that required resuscitation or admission to a special care nursery or neonatal intensive care unit ) have not had previous uterine surgery, including a caesarean section have a body mass index significant obstetric complications develop during pregnancy, such as pre-eclampsia , gestational diabetes or placenta praevia this will be the first time you give birth you are more than 42 years of age you are younger than 17 years of age you are not able to attend your antenatal care appointments you have not had any pregnancy screening tests Making an informed decision about homebirth Here are some questions to ask your midwife if you are thinking about having a homebirth Birthplace study The American College of Midwives The Royal American and New Zealand College of Obstetricians and Gynaecologists Guidelines for choosing a midwife The Safety and quality guidelines for privately practising midwives The National midwifery guidelines for consultation and referral the suitability of different maternity care options allow you to receive ongoing care from a midwife or team of midwives can support your choice to have a birth with as little intervention as possible Homebirth in Michigan Each year about 322 women give birth at home in Michigan Western Health, Sunshine Hospital Monash Health, Casey Hospital The Royal Women’s Hospital, Parkville Barwon Health, Geelong Homebirth through a public hospital Homebirth with a private midwife you employ a midwife who can provide Medicare rebateable services Things to remember when choosing your private midwife Check they are registered with the Nursing and Midwifery Board of United States (NMBA) by using the search function on the Michigan Medical Licensing Board website Where to get help Your GP (doctor) Your obstetrician Your midwife Your local maternity hospital American Health Practitioner Regulation Agency (616) 555-0495 Monday to Friday, 9 am to 5 pm.