HOME MIDWIFERY

Home Midwifery

Throughout history, the majority of expectant mothers have given birth at home.  Currently, home births are still the norm worldwide.  In the US, the trend for home births (although still low at under 2%) is gaining support. A key player in a home birth is the midwife.

There are several levels of midwives practicing in the country.  Certified Nurse Midwives (CNMs) have both general nursing degrees and midwife training. While most CNMs work in hospital settings, some will attend at home births.  Certified Professional Midwives (CPMs) work in birthing centers as well as in homes. Their training is a combination of academics and apprenticeship, and they must pass both written and skills exams for certification.  Lay Midwives generally apprentice with more experienced midwives and have “hands-on” training. Read our blog, Midwife and/or OBGYN?, to learn more about midwives.

Midwives play an active role in a woman’s birth experience long before labor begins. Prenatal care begins early on with visits often occurring in either the midwife’s home or the family home. Initial visits determine risk factors such as advanced maternal age, multiple babies, or previous birth complications or C-sections. Information is gathered and home birth viability is assessed. 

During the subsequent prenatal visits, a midwife helps the expectant mom with nutrition, exercise and advice for her physical, and emotional well-being.  A midwife may also help the entire family prepare for birth and the arrival of the new baby.  A midwife will also help the expectant mother to write her own individualized birth plan.  The plan can include details for the mother’s preferred positions, location, atmosphere and support persons. And, of course, the midwife is present during labor and delivery to ensure the birth plan is followed as desired by the family.  Normally, the birth process is allowed to take its own course, at its own pace, with ongoing support for all present. 

Midwives are trained to recognize early complications during pregnancy and labor. And after the birth, the midwife is still accessible for information and support.  Most midwives routinely remain in contact with a new mother, her baby and the family, for six weeks or more after birth. 

In considering home birth as an option, an expectant mother must find the right birth practitioner as well as have a strong desire for and commitment to home birthing.  Many mothers-to-be feel home birth attended by a midwife offers many benefits not available in other settings.  These include:

· Belief that home birth as a safer option than hospital births with decreased infection risks

· Avoidance of unnecessary interventions

· Greater control of birth decisions and choices

· Ability to trust in and allow birth as a natural process

· Increased opportunities for options like a water birth or delayed cord cutting

· Decreased risk of unneeded C-section

· Increased opportunity for full family involvement 

Of course, there is also the added benefit of the comfort of home while taking advantage of the critical and beautiful early bonding between mother, newborn and extended family members.  Midwives attending home births are staunch supporters of this as well!

More information on home midwifery can be found at:

Evidence Based Birth

Midwifery Today