Giving Birth with Midwifery Care

Basics of Midwifery Care

Midwifery care is inclusive of prenatal, labor and birth, postpartum, and neonatal care.  Midwives are trained professionals who are the experts on natural childbirth and know how to assist and care for women and newborns.  Midwifery care is for people who are desiring to have a natural pregnancy and birth. A midwife can provide prenatal care, run and order prenatal tests, tend to physiological and psychological health and well being, make nutritional and lifestyle recommendations, attend births, and provide care to both postpartum parents and their baby.

Before

Hiring a midwife is the first step to having a natural home birth.  When someone hires a midwife, they start their care with an initial prenatal visit in which the midwife can review their health history, do initial pregnancy lab work, take their vitals, listen to their baby’s heart tones, and officially begin prenatal care.  Each prenatal visit in midwifery care lasts about an hour long so that clients can be provided enough time in their appointments to talk about what’s going on in their lives, have their questions answered, talk about their upcoming birth, all so that midwives can provide informed choice about prenatal, birth, and postpartum procedures.  After the initial prenatal visit, appointments are scheduled per the normal obstetrical prenatal schedule in the United States. A homebirth midwife goes on call for their client at the time of hire, and this means that each client has access to their midwife anytime they might need to reach them for something urgently, day or night.

During

When someone calls their midwife to let them know that they’re in labor, the midwife will ask a series of questions and triage their labor over the phone with them.  In midwifery care, just like giving birth with any care provider, the midwife’s goal is to arrive at the home when someone is in active labor and ready for monitoring.  Many midwives attend births in a team of two or more. Sometimes a midwife might practice solo, but they often come in a team. Once midwives arrive at the home for a person in labor, they will monitor maternal blood pressure, pulse, and temperature, just like anyone would in any other birth setting, and they will monitor the baby’s heart rate.  When the baby’s heart rate is monitored at home, it’s done so with the use of a handheld Doppler. In midwifery care, the fetal heart rate is monitored during labor per evidence based guidelines for intermittent fetal monitoring.  

While someone is laboring, the midwife will set up their supplies as needed.  Midwives can bring many different supplies to a homebirth, including medications to control bleeding, suturing equipment for repairing any tearing, oxygen, resuscitation equipment for both the birthing person and their baby, and medications for newborn procedures.  Once the supplies are all set up, a midwife holds the space for a natural birth to occur. Midwifery care is often practiced with a hands off approach, unless intervention is indicated. Midwives are attentive and present throughout the entirety of someone’s labor, but they’re also quiet and observant for much of the time.  If a person in labor is needing a more hands on approach from their midwife, then a midwife will step in and will be more active in the labor process. However, many people who are in labor, when left alone intentionally, will know exactly what to do and their midwife will be there to ensure their safety, keep the environment calm, and to tend to them as needed.  

Midwives look for natural signs, such as grunting, so that they know when a laboring woman has entered into the pushing stage of their labor.  Once pushing has begun, the midwife will guide the woman to listen to their body and to push with their contractions once they have the overwhelming urge to do so.  At a homebirth with midwifery care, the birthing person and/or their partner will be able to catch their own baby if they wish to do so. Of course, a midwife’s hands are always there in case the plan changes or in the event that the birthing person wants the midwife to catch their baby for them.  A natural birth under midwifery care can unfold at its own pace, without unnecessary intervention, and with the birthing person’s wishes in mind. Within midwifery care, each person giving birth is the agent of their own healthcare and is invited to make the decisions that they believe are best for themselves and for their baby.

After

After a baby is born at home, the midwife will stay for the immediate postpartum and will ensure that both mom and baby are stable, healthy, and well after birth.  In midwifery care, you can be sutured at home, your bleeding will be monitored, maternal vitals as well as newborn vitals will be taken regularly, and the midwife can be of support when it comes to establishing breastfeeding.  After several hours, if everything is normal, the midwife will help you and your baby into bed and leave so that you can get some much deserved rest. In midwifery care, the midwife will stay on-call for the postpartum client and their baby in-between each of their postpartum appointments.  Clients always have a care provider that they can call, even in the middle of the night, if they’re concerned about themselves or their baby.

Midwifery care is rooted in the philosophy that birth is a healthy and normal human experience.  Midwives support people to give birth on their own terms, and strive to maintain a deep level of trust between themselves and their clients by building relationship overtime.  In midwifery care, a laboring mom is centered, safety is the number one priority, and the human body can lead the way. Giving birth at home allows for the possibility of loving one’s birth experience, and allows for the gentlest beginning possible for parents and their baby.