From Fear to Empowerment: My Journey to Choosing a Midwife-Assisted Home Birth in Derbyshire | Derbyshire Newborn Photographer

Are you curious about the ins and outs of homebirth? Want to know what it's really like to have a baby at home in Derbyshire with the guidance of a skilled and experienced midwife?

“I liked the idea of a home birth, especially after hypnobirthing with my first pregnancy. Though I opted for a hospital birth, I had the water birth I wanted. With my second, I considered it more, but complications during pregnancy made me hesitant. I wish I knew more before. If I did, I might've had a home birth with my first and hired a private midwife.”

In this exclusive interview, I sit down with Derbyshire homebirth midwife Sally at Blossom Birth to learn everything from creating a birth plan to handling emergencies and preserving precious memories through Newborn Photography.

So grab a cup of tea and get ready to be wowed by the empowering and transformative world of homebirth!

1. How long have you been a midwife and what got you into midwifery?

“I qualified as a midwife over 13 years ago. My journey to becoming a midwife was long, in 1996, I got accepted to study in London, but being a mum of two with a surprise baby on the way, I was unable to start. I applied again in Sheffield in 1999, with no luck, I was advised to apply for nursing. Finally, after several attempts, and pursuing a different career and completing qualifications in Pharmacy Services, I applied in 2006, interviewed in 2007 and started March 2008. It was a long process, but I made it as a mature student! It was my own experiences with pregnancy loss and poor care that ultimately led me to training to be a midwife. I wanted to offer kind, compassionate care to others experiencing this and early pregnancy care and fertility are areas I remain passionate about.”

"Sometimes, a woman chooses a home birth but her partner isn't onboard…”

2. What would you say to someone with a concern or fear about giving birth at home?

"Sometimes, a woman chooses a home birth but her partner isn't onboard and sometimes both need more information to enable them to choose the right place of birth for them.  In all cases I start with evidence, sharing research findings. One significant study, (Birth Place Study, 2011) found that birth at home for low risk women who are having their second baby is safer than birth in hopsital. Later research following on from this study found low risk women having their first baby are also safer at home. Why? Because labour and birth in a hospital setting can increase your chances of interventions which can in turn lead to complications.

I discuss how we are skilled in managing emergencies in the home setting and reassure them that we are trained to the same standards as midwives working in a hospital setting. Evidence tells us the best outcomes come from continuity of care, where we build a relationship with our clients. Some women dismiss birth at home as they know there is risk of needing to transfer to hospital in labour, nationally the chance is approximately 45% if this is your first baby, I work for Private Midwives LTD and our overall transfer rate for all women regardless which number baby is 20%.

Our approach is rooted in relationship-based care. We pride ourselves on knowing our clients personally, ensuring a deeper level of trust and understanding throughout the birthing process. Our appointments are longer and take place in the clients home enabling lots of discussion and information sharing and really understanding clients birth preferences. It is crucial to feel confident and supported in your birthing choices. By understanding the benefits and risks associated with home births, you can make an informed decision that aligns with your values and preferences."

“…reporting health care professionals have done too much too soon (acted too quickly) or too little too late (not acted soon enough).”

3. How do you help families prepare for the possibility of transfer to a hospital during a homebirth?

"In our 'Planning Your Home Birth' booklet, which is completed antenatally (34 – 36 weeks) there is space for the clients wishes and for midwives to add information and details. Practicalities of the environment where you choose to labour/place the birth pool. We consider other children, pets, equipment that you need to collate and equipment we will bring. We discuss reasons when non-urgent/ or urgent transfers will be required. If a transfer is necessary, we'll be there every step of the way, providing support at the hospital. Logistics of the property, when to call us, are also discussed and documented. Between 34 and 36 weeks, we offer a full blood count to check your iron levels, low iron levels won't derail your home birth plans but if you aware prior to 37 weeks’ gestation you can commence supplements or consider iron rich foods in your diet.

It is evident from multiple investigation reports into maternity outcomes that women are reporting health care professionals have done too much too soon (acted too quickly) or too little too late (not acted soon enough). This could mean unnecessary interventions for someone who prefers a physiological approach, or dismissing concerns from a mother who senses that something isn't right. Listening to women is crucial and supporting them, completing a full assessment even if their concerns cannot be explained.

Here are some instances where we might need to transfer from home to hospital:

1. Meconium-stained liquor (baby has opened it’s bowels before birth)

2. Breech birth: If the baby is coming bottom first instead of head first.

3. Shoulder Dystocia: (for anyone that doesn’t know what this is, like me) it’s when the head is born but the baby’s shoulder is wedged on the pubic bone.

4. Concerns with a client’s observations/or baby’s heart rate OR clients becoming unwell.

5. Client requesting to transfer for additional pain relief/ or because labour is prolonged.

6. Client changing their mind about place of birth.

7. Post-partum haemorrhage (PPH)

8. Retained placenta

9. Baby requiring resuscitation.

4. What are some common misconceptions about home birth that you would like to address?

It’s safer to be in hospital

It's a common belief that hospitals are safer for childbirth, but the reality is quite different. Your own home can be the safer place to labour, you're more likely to feel comfortable and relaxed and therefore labour and birth is more likely to be straightforward. At home, you have the freedom to move around, eat, and drink as you please, which can help your body produce natural endorphins, especially oxytocin and reduce stress hormones (adrenaline). Plus, you'll be in familiar surroundings, and you and any birth partners can move freely around your home, you will have privacy and all home comforts.

You will have a midwife of your own from the minute you walk in to hospital

There is a possibility you will receive care from multiple midwives in a hospital setting, and it is highly unlikely you will have met them before that day. When you choose a private midwife for a home birth, you'll receive personalised care from the moment they arrive. They are not new to you, you have met them often months if not weeks before. They'll know you well, and all their care is provided in the comfort of your own home, starting your birthing journey in a familiar and supportive environment.

It's often believed that first-time mothers are unlikely to have a home birth

With the NHS, there's a 55% chance of a first-time mother birthing at home, compared to an 80% chance with Private Midwives.

Make it stand out

I remember a midwife who humorously insisted, "No home births in bungalows for me! We need stairs." She used to say, "Stairs and toast and jam!"

5. How do you ensure continuity of care for families during the postpartum period?

At private midwives, we ensure continuity of care by providing case loading care. Each family is assigned one named midwife, with a backup in case of illness or scheduling conflicts. While we can't guarantee that you'll always see the same midwife, in 99% of cases, you will. Additionally, you'll have met at least one backup midwife during your antenatal period, ensuring seamless care throughout the antenatal, birth, and postnatal periods.

6. Can you talk about any specific training or qualifications you have that make you well-suited to assist with home births?

Biomechanics for birth course

Biomechanics is the study of biology and the mechanisms of movement. In childbirth, biomechanics and positional changes can help babies to rotate and turn to navigate the pelvis.

Hypnobirthing/Mindful birthing

I'm trained in hypnobirthing and mindful birthing techniques to support clients with labour and birth and ensure they are fully informed of all choices/options.

Acupuncture

I'm also trained in acupuncture, including acupuncture for labour (but I haven’t been asked to use acupuncture during labour). It can be effective for issues like pelvic girdle pain, relaxation and optimising the baby’s position for birth.

Acupressure

Applying firm pressure with fingertips on specific points during labour can be effective to soothe discomfort, also can be helpful alongside other factors if contractions are spacing out.

7. Can you share any experiences you've had with water birth and how it can benefit the mother and baby during labor and delivery?

The majority of clients I meet have chosen to labour and birth in water for the reasons below. There's substantial evidence indicating that labouring in a birthing pool can have numerous benefits:

• It has been shown to shorten both the first and second stages of labour.

• reduce the risk of perineal trauma

• increase the chance of a positive birthing experience

• The freedom of movement provided by the water can aid in optimal positioning of the baby and comfort of the mother

• Babies born in water typically experience a smoother transition during their birth

• Labouring in water is associated with a decreased likelihood of needing an epidural.

• Babies born in water are less likely to require admission to the neonatal unit.

• Water birth is linked to higher rates of successful breastfeeding and increased likelihood of skin-to-skin contact.

• Women often feel more private labouring in water.

Even the presence of a birth pool in the room, regardless of whether it's utilised, can have calming effects, lowering both maternal and caregiver blood pressure. There's even fascinating research showing simply looking at water can positively influence physiological responses, such as reducing blood pressure, heart rate, and respiration rate, signalling to the brain that all is well with the world. How incredible is that!!

Conclusion

I hope you enjoyed learning about the world of home birth and the possibilities it holds. It's a unique and empowering experience that can be a reality with the right support. Don't be afraid to dream big, and trust your gut when making decisions about your birth. And remember, with a home birth, you'll have a midwife who's not only knowledgeable but also fun, making your birth experience safe and memorable.

Derbyshire Home Birth - Resources

Private Midwives - https://privatemidwives.com

Sally Goodwin (Midwife being interviewed) - https://www.blossombirth.co.uk

Birth Place Study - https://www.bmj.com/content/343/bmj.d7400

Water Birth Benefits - https://books.google.co.uk/books/about/Revisiting_Waterbirth

Water birth Information - https://pubmed.ncbi.nlm.nih.gov/35790327/