As soon as I became pregnant, I started investigating home birth.
I had my first baby with a private obstetrician in a private hospital.
At the time, I was content with the way in which my birth unfolded but as I learned more and more about birth, I became upset by the number of interventions that were performed unnecessarily.
I knew that I didn’t want to birth in the hospital system again but I wasn’t sure exactly how home birth worked.
Curious, I asked a few midwife friends to recommend a private midwife.
Kelli Zakharoff of The Midwife Clinic (now MAMA Services) was mentioned by just about everyone I spoke to.
So I gave her a call.
The first step in having a home birth is finding a midwife that you can communicate with and that you trust.
It is worth meeting with a few to ensure that you end up one who you connect with personally and whose practices align with your vision of your birth.
When you speak with potential private midwives, ask any questions that you might have, get all your what ifs out of the way. Be completely honest about your situation, your expectations, and any concerns. If you would like to speak with someone who has birthed with that midwife, you can ask if they have any clients who might be willing to talk about their experience.
I first met with Kelli when I was about six weeks pregnant.
She talked me through the process, outlined the costs, and answered all my questions…we spoke for over an hour.
I then had to see my GP to get a referral to the RBWH and to The Midwife Clinic.
I am not sure about other midwives, but Kelli prefers that you have a booking at your local public hospital too…this is in case a complication develops during pregnancy or during birth. She communicates with the hospital throughout your pregnancy, updating them on your progress, so that if you need to transition to hospital based care, that transfer should be relatively smooth.
I had my scans at the Royal but other than that, I had nothing to do with the hospital…it was however comforting to know that they at least had my name and basic medical details on file just in case.
The schedule of appointments with a private midwife is similar to what you would experience in the private obstetric setting or in the public hospital setting.
A private midwife can write most of the prescriptions that you might need, take bloods, and provide you with any necessary referrals.
And the best part is that they come to you!
There are so many differences between the care I received from the private obstetrician and the care I received from the private midwife, but differences in the routine appointments were striking.
When I visited my private obstetrician, he would call me in, take my blood pressure, quickly assess the baby’s position, check the foetal heart rate, perfunctorily ask if I had any questions, and that was that…a five minute check up. It was strictly physiological care.
From the very beginning, Kelli was concerned about both the physical aspects of my pregnancy and my emotional wellbeing. Her care also extended to my husband and my toddler…as she came to our house for most of my appointments, she often interacted with them and helped prepare them for the birth and for life with a new baby.
Starting at about twenty weeks, appointments with her were more like catching up with a friend than with a medical professional…if that friend performed a very thorough abdominal palpation! She not only welcomed questions, she also asked me questions to get a sense of how I was feeling. I felt extremely comfortable discussing everything and anything with Kelli…she often offered sage advice and I always felt reassured after she had visited. She would usually be at my house for close to an hour…a cup of tea, a mostly one sided conversation with Charlie…he wasn’t always forthcoming about his opinions on becoming a big brother, and then she would check the baby. And when she was checking the baby she would tell me what she was feeling, what she was thinking, she would explain why things were good or not ideal, what I could do to improve the situation, and what I might expect next.
In addition to the scheduled appointments, Kelli was always available via phone, text, or email. We often went back and forth about one thing or another and I know she would have made herself available for an unscheduled appointment if I had needed it.
At around thirty six weeks Kelli brought all the home birthing equipment to my house; a pool, hoses, and an emergency kit.
This appointment was an evening appointment planned so she could review everything with my husband and also get a sense of how he was feeling about the home birth.
He said that his main concern was the mess.
But I also got a sense that he wasn’t sure about what his role would be as there would be two midwives there with me (there have to be two midwives at the birth…one to take care of the mother and one to take care of the baby).
I should say that both of these concerns ended up not being issues.
Around this same time, I started gathering supplies and preparing our home…sheets, towels, making ice cubes out of coconut water, moving furniture to make room for the pool.
Once everything was ready, we waited.
And waited.
And waited.
I saw Kelli once a week and was also in regular contact with her via text message.
Finally it was time!
When I was sure I was having regular contractions, I sent her a text message and she sent one back telling me to keep her posted.
When I could no longer walk through contractions, I let her know and she arrived at our home ten minutes later.
My labour was very quick…Kelli was there for about an hour before Lyddie was born…but I know that she has stayed with other women and supported them throughout their entire twenty-four hour labour.
As soon as she assessed me and realised I was close to giving birth, Kelli contacted her back up midwife, Maet…Maet arrived about ten minutes before Lyddie was born.
Private midwives are bound by the same codes as their public counterparts so the care you receive should be the same whether you birth at home or in a hospital. However I would say that the care you receive at home is better because the midwife is YOUR midwife. It is not simply the midwife who is rostered on. You have met with her for the last forty weeks, you have discussed your birth, you have divulged your fears, you trust her, and because of her guidance and care you have come to trust your body and your baby and your birth.
My water broke on the back verandah.
I gave birth in a pool in my living room.
We ran a hose from the bathtub to fill up the pool and we drained the pool using a pump and a different hose.
After I gave birth, I remained in the water, cuddling my baby for about an hour…there was no mention of cutting the umbilical cord or delivering the placenta, my husband made everyone coffee, we watched the sun rise, and we spoke about the beautiful baby girl who had just entered our lives.
Then, with the help of my husband and one of the midwives, I made my way to the bathroom where I delivered the placenta and had a shower.
Once I was cleaned up, I settled in on the couch to feed Lyddie.
There was not much mess…the midwives packed up the tub and hoses and found their way to the laundry to put on a load of wet towels…by the time they left, you could not tell I had given birth at home.
When Charlie woke and started calling for me, Kelli went in to his room, explained to him that I was feeding his baby sister, and carried him out to me.
I remember at the time thinking that this is how it should be…my son was familiar enough with my midwife that he was not at all alarmed when she greeted him in the morning and he got to meet his sister when she was just hours old.
The midwives stayed for a few hours to ensure that both Lyddie and I were doing well.
They measured Lyddie and gave her a Vitamin K injection.
Before they left they did a vaginal exam, discovered that I had a small graze and a tear, but on that first day did nothing other than make sure I was comfortable.
Kelli texted a few times throughout the day to check in…making sure Lyddie was latching well, that I was feeling my uterus contracting back to its normal size.
Either Kelli or Maet visited us every day for the first four days and then once a week for six weeks.
They measured Lyddie, inquired about her output…and about mine, tended to me, and graciously allowed me to replay the birth again and again.
I believe that post natal care is something that every woman should have access to…unfortunately very few women receive much nurturing attention after being discharged from hospital.
Even if everything is physically is fine, it is so nice to have someone stop by for a chat…to coo over your baby and to fuss over you. Lyddie was my second baby so I was fairly confident in terms of feeding, what baby poo looks like, and how to settle her but I can imagine that this sort of care and practical advice would be invaluable after your first baby.
The relationship you and your family develop with your midwife is incredibly special. I was so sad when my last appointment rolled around and I no longer had any official reason to see Kelli…I still threaten her with becoming that weird woman who hangs out at her centre all day!
In terms of costs, a home birth costs about as much as a straightforward private obstetric birth.
The prenatal and postnatal visits are about $120.00 each and are medicare refundable.
The birth itself is about $2,000.00 and at the moment that is out of pocket as there are no medicare rebates and private health cover doesn’t cover private midwives.
I had the two scans done at a public hospital so they didn’t cost anything.
Kelli did my all blood work so that didn’t cost anything either.
I found the biggest challenge surrounding home birth was telling people that I was planning on having a home birth!
Maybe it is just because I am a nurse and work with people who are very trusting of doctors and hospitals, but I struggled to explain my home birthing plans.
Perhaps I just didn’t want to deal with people then giving me their opinions on birth?
Perhaps I didn’t want people thinking I was some birthing renegade who was bucking the system without valid reason.
I had birthed once and I knew my body was capable.
I did my research.
I felt safe.
Deciding to have a home birth was not something that I took lightly.
I respect birth and wouldn’t have done anything to jeopardise my safety or the safety of my baby.
But I did feel that when I said that I was having a home birth, people made those sorts of judgements and assumptions.
This is most likely simply me projecting my own concerns onto other people…but those feelings did hold me back from mentioning my planned home birth.
I also want to point out that private midwives have a scope of practice that is limited to straightforward pregnancies…they have a duty of care to transfer you to an obstetrician if your pregnancy or birth is not progressing normally.
The best part about home birth is that it just makes sense.
It makes birth seem much more approachable…more normal.
After I gave birth I was amazed at what had just unfolded and part of that amazement was that, while the birth was such a miraculous event, it had all seemed so ordinary.
I woke up, laboured on my back verandah, was supported by my husband and by my midwives, and had a baby in my living room. And then ate my usual breakfast at my own kitchen table!
The birth was simply just something that happened that day…of course it made that day incredibly special but I think because it didn’t require any particular organisation or added effort, it didn’t feel particularly extra ordinary.
I know home birth isn’t for everyone, but for me, and for this birth, it was amazing.
Bringing Lyddie into this world, into our home environment, surrounded by the people and things I love and that she will come to love, is something that I will forever be grateful that I was able to do.