How does out-of-hospital birth compare to mainstream maternity care?
Midwives are able to provide intimate, personalized care that puts the birthing family at the center of the process. We both trust and support the natural process of labor to unfold while observing the laboring woman in order to meet her needs and watch for any challenges that might come up. When you choose with Birth Journey, there will be no strangers at your birth, no nurses or medical students coming in and out of the room to check on you and disrupt your birthing process. There will be no protocols or policies dictating your experience, only evidence-based practices that provide the best possible environment for you to birth in.
When parents take responsibility for their birth, educate themselves, and choose a provider that is well-trained and supportive of their desires, birth is both safe and magical.
Birth Journey cares about easing your fears, meeting your needs, and answering your questions. We want you to feel safe and sure about your birthing choices. Read some frequently asked questions about out-of-hospital birth. If you still haven’t found the answer you are looking for, give us a call!
The data shows that low risk women who have planned, midwife-attended out of hospital births have excellent outcomes and very low rates of intervention.
by Geradine Simkins, CNM, MSN, Executive Director, Midwives Alliance of North America
BMJ 2005; 330:1416
by Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D. and Vedam, S. (2014), Journal of Midwifery & Women's Health, 59: 17–27.
Here are some words on the topic from former clients.
Yes. If you go with a qualified and experienced midwife that you know and trust, home birth is just as safe, if not safer, than a hospital birth. The birth goes better because the mother is able to move around more, which means less tearing and less stalled labor, which can bring problems of its own. There is also a lower chance of infection giving birth at home because the mother is already acclimated to the germs that are present. Ultimately, though, in my book, it has a lot to do with what the mother wants and where she will be most comfortable. If the mother wants to give birth at home and the midwife is qualified and experienced and approves of the home birth (i.e., the mother is not "high risk"), I believe home birth is the best option for the mom, baby, and everyone else involved.
>> Derek P.
There are risks with every choice you make. It seems like everyone talks about the risks of having a baby outside the hospital, but don't realize that there are very real risks inside the hospital. What about a so-called 'emergency c-section' because of a rushed process, too many interventions, inadequate knowledge of positioning? What about trauma to the baby because of forced delivery? Or something less emergent, but very important—having the exact birth experience that you want. The list can go on. We've had four babies at home and it's been wonderful. They weren't perfect though. Melissa adapted wonderfully to each and every situation and challenge. Midwives have a great deal of training to address a huge range of situations. And if the need arises, they know when to transfer for more medical assistance. One of our births resulted in a transfer because the placenta wasn't coming out. It was a calm and deliberate decision which was calculated and resulted in a healthy mom and baby. I trusted Melissa through the whole process and I saw her calm, calculated, deliberate experience carry us through each unique scenario. I personally feel we would give up too much of what we want in birth and would encounter unnecessary risks if we were to choose a hospital birth. To me, a hospital would bring more risks to our family than a home birth and I'm proud of our decisions.
>> David A.
For most women and their partners, one concern about having their baby at home is that a medical emergency may occur. This could happen regardless of whether a home or hospital birth is planned. During prenatal appointments, we make plans for where to go and who to call in the event that a problem arises during delivery. We will discuss with you concerns such as blood loss after birth, babies that are slow to breathe, lack of progress in labor or while pushing, emergency transports, and maternal and fetal complications that lead to transport to the hospital. Midwives are trained and equipped to deal with complications during an out of hospital birth. Early detection, ability to stabilize and transport, and solid emergent and non-emergent plans ensure efficient care. Birth Journey participates in the integrated, inter-professional maternity care system that promotes safe and seamless transfer of care to the hospital to optimize outcomes for mothers and their babies.
"All women and families planning a home or birth center birth have a right to respectful, safe, and seamless consultation, referral, transport, and transfer of care when necessary. When ongoing inter-professional dialogue and cooperation occur, everyone benefits.” >> Home Birth Summit
Read more about transfer of care guidelines here.
Some viewpoints on transferring from former clients.
It was my second birth that really made me appreciate the expertise of Birth Journey. My second son came quickly and easily. I was even surprised as I felt his head come through my cervix. “What was that? Something shifted,” I said. “Yep, you are having a baby now!” the midwife said. “I am? Already?” was my reply. My son arrived a moment later, after only two hours of active labor. After giving birth and hanging out in the tub for a time, I got up and took a shower, even washed my hair! I couldn’t believe how smoothly the birth went and I felt great. The midwives did all the baby stuff: measuring, weighing, counting, and footprints. The midwife was just about to stitch me up, and be on her way when it started to get interesting. Clot after clot, I was bleeding. My blood pressure tanked. I could feel myself turning green. I was dizzy. I threw up. I watched as the midwife put her hand on her head. “If we can’t stop this” she said “we are going to go to the hospital,” I visualized all my blood vessels having clamps on them. I called in some spiritual support from my loved ones. While I worked on the mental part, the midwife was prepared with medication. First, she gave me some oral medication. Then, she put an IV in my arm with and fluids and massaged my belly. Within a few minutes I could feel myself coming back around and the bleeding slowed. As fast as it got a little scary, it was all okay again. The team stayed with me until they were comfortable that all was well and I was safe. I will forever be grateful that they knew just what to do and were prepared with everything I needed. I would recommend Birth Journey to anyone interested in birthing at home.
>> Kyra W., Pain Free Studio
[Birth Journey] walked us through the process from week 12, ensuring we had proper tests in place, monitoring through second and third trimester to ensure mom was well prepared, baby was in the right place and any possible risks of complications were identified as early as possible.
>> Eric K.
If your partner wants to catch the baby, cut the cord, weigh the baby etc. all you have to do is speak up about your desire to make that happen! They did an excellent job coaching my husband and letting him help as much as he was comfortable with. He caught the baby on the bed! I think he's very proud of that because he sort of brags about it whenever birth comes up!
>> Stephanie F.
For each of our births I was invited to catch the baby but never chose to do so, just as a matter of personal preference. I preferred for the midwife to catch the baby or, for the last birth, Kendra (my wife) wanted to catch the baby. They were very accommodating of what we wanted but was right there all along to make sure every thing went well.
>> Derek P.
As a dad, I was involved as my wife (and I) wanted to be prior to and during labor. They, reeled me in to help support my wife's contractions; I actually felt useful and helpful, rather than helpless.
>> Eric K.
The midwives were fantastic after the birth. They made sure that Kendra and the baby were healthy, helped clean everything up, and did a great job answering any questions that we had. They were never in a hurry to leave and left when the time was right. In the following days there were check-up phone calls and visits, which was great. The whole experience was very smooth and everything we were hoping it would be.
>> Derek P.
It's like having an intimate moment with your family. You get to experience your precious child's first moments in the comfort of your own home. I was invited to be part of the whole process including holding our baby, weighing her, etc. And then my wife and I were helped to our bed to establish breastfeeding and get some needed rest with our precious new child. No unnecessary interruptions or monitoring cords everywhere. The team took care of all the mess and craziness so we could just focus on welcoming our new child. In the days following, she was available for any questions that arose with a simple text or phone call and came to our house for our two day visit- my wife didn't even have to get out of bed.
>> David A.
Specific schedules of prenatal care vary from provider to provider and practice to practice, but a general schedule for Birth Journey follows below, as well as some of the screening tests or activities you might expect at various visits. We very much strive to listen to you and provide the personalized care you are looking for outside of this framework of care.
8-12 weeks: Initial prenatal visit. The plan for your prenatal care can be discussed and decided upon. A health history is taken, and a physical exam. Lab work is completed, including your blood type and complete blood count which provides a wealth of information about your current health status. If requested, we provide sexually transmitted infection screening and a urine tests as well. You may be able to hear the baby's heart beat at this visit or we can take a look with our in-house ultrasound machine. If you are unsure about how far along you are due to breastfeeding, irregular periods, or if this pregnancy was a surprise cannot say with accuracy when you had your last period, a diagnostic ultrasound can be scheduled to help determine how far along you are.
Optional genetic counseling visit: Early in your pregnancy, you may be offered genetic screening. We offer parental carrier screening, non-invasive prenatal testing (NIPT), as well as the Alpha-fetoprotein test (AFP) at various points throughout your pregnancy. Based on your desires or results from these tests, we can connect you with providers who are able to offer further testing including chorionic villus sampling, ultrasound, and/or amniocentesis. All genetic tests are done at specific times during pregnancy and are outside of our routine package pricing and services.
First two trimesters: Prenatal visits continue every 4-6 weeks through the first two trimesters, or until you are 28 weeks along. At each appointment we take your blood pressure, listen to the baby's heartbeat, and measure the growth of your uterus and baby. We are quite versed with providing optimal care with minimal exposure to ultrasound and dopplers and are happy to use fetoscopes upon request. We also check your urine for protein and sugar at each visit.
18 to 22 weeks: An ultrasound to measure the growth of the baby, check on organ development, as well as the placenta is is included in the package and typically scheduled in this window.
27 or 28 weeks: At an appointment within this period, you have the option to take a glucose challenge test to screen for gestational diabetes. Your iron levels in your blood are usually rechecked as well. Expect to review warning signs of late pregnancy that would alert you to preterm labor or high blood pressure. You may be encouraged to sign up for childbirth classes and find a doctor, nurse-practitioner or appropriate care provider who will provide well-child care for your baby after the first 4-6 weeks of well baby care that Birth Journey provides.
28 to 36 weeks: After 28 weeks, prenatal visits continue every 2-3 weeks until 36 weeks. We continue to record the growth of the baby, listen to the baby's heartbeat, and will check the position of the baby. Information on 'Belly Mapping and Optimal Fetal Positioning' is offered at each visit, as well as hydration and nutrition review and counsel.
36 weeks: At this visit we discuss the Group B Strep test. Screening tests for sexually transmitted infections may be repeated at this visit. The position and size of the baby are estimated. We also set up a home visit so that we can know how to get to your home, bring you supplies and equipment, and make plans about birth/tub set up if you are having a home birth. If you are having a birth suite delivery we typically meet in the birth room to discuss what to expect, who is welcome to come, and make plans for your birthing day.
36 to 40 weeks: The usual monitoring of your weight and blood pressure, and the baby's size, position, and heart rate are done. We offer but do not require cervical checks for dilation. We discuss kick counts and monitoring in these last weeks.
40+ weeks: After your due date we offer what is called "post-dates" testing, including nonstress tests, ultrasound, and biophysical profiles. This could be available to you at 40 weeks for reassurance, or not until 10 days past your due date. All of the 'post dates' testing is available at our office.