7 Tips for Creating a Calm, Joyous Homebirth

As cesarean and induction rates in hospital climb to astronomical levels many women are turning to homebirth. When interventions become excessively high, the risk/benefit ratio of being in a hospital swings more dramatically into the “riskier” zone, and even physicians and nurses begin choosing homebirth. Just removing your birth from a hospital setting doesn’t guarantee that it will proceed in a natural, flowing manner. Too many women learn the hard way that a midwife can bring a hospital mentality and interventions right into the home and negatively affect the course of the birth. How can you assess the type of midwifery practice that you are purchasing? Here are some tips to help you assess the care that will be provided by midwives:

1. Ask to see a video of some births your midwife has attended. This is the modern age. Many people videotape their births and an experienced midwife will have been given many copies of videos with permission to share them with other families. Videos tell you a lot more than photo albums. Be wary of the midwife who won’t give or show you videos. Watch the videos for things like: Is the father playing an active role in the birth? Are the attendants  quiet when things are normal and healthy? Is the cord left to pulse until the placenta is born? Does the baby breathe spontaneously without routine suctioning? Are the baby and mother locked in eye contact with no disturbance? Is a water tub part of the birth?
Watch the time clock on the video to see whether the birth of the placenta occurs in a leisurely way or whether the midwife wants it out in under 30 minutes.

Ask to see a video of a birth the midwife has attended

2. Tell your midwife that you don’t wish to have any pelvic exams during your pregnancy. This avoids introducing bacteria and also avoids some routine interventions like membrane stripping (painful and ineffective). Making assessments of the readiness of the cervix to give birth at the end of pregnancy is inaccurate and largely discouraging to the mother. Remember that you were made to give birth—you’ve had menstrual periods, you conceived and you grew a baby; therefore you can have faith that your cervix will perform just fine. PAP smears can be done after the baby’s birth, if you so desire.

3. Always make the first day of your last menstrual period one week later than it really was. We live in a time of wholesale induction of healthy birth. When induction of any kind (yes, herbal, too) is done, the risk of cesarean section goes up. Smart women avoid the whole hassle of being pressured to induce their baby by giving their midwives a designed date that allows them a week of grace. One of the simplest things a woman can do for her baby is say “no” to induction and get her due date as far out in the future as possible.

4. Refuse the use of a Doppler during prenatal clinics. Dopplers are invasive and they can affect your baby’s brain. A good midwife will be interested in protecting your baby prenatally from unnecessary exposure to non-ionizing radiation. She’ll inquire about your diet and exercise at every visit because she’ll know that these two things are the best way to insure that your baby will have a smooth birth and a bright future. If she insists on using a Doppler, you know that she cares more about her convenience than she does about your baby.

5. Let your midwife know that you want a Lotus Birth. A Lotus Birth means that the cord is never cut and falls off naturally on day 4 or 5, still attached to the placenta. If you ask for a Lotus Birth, it means that you’ll be in charge of when the cord gets cut. There will be no rushing in the immediate post-birth period. You might decide after three hours that you really want to cut the cord and get the placenta bowl out of your bed. The timing of the cord-cutting is best done at the direction of the parents, not the midwives. More and more medical evidence is coming out that shows that leaving the cord to completely finish pulsing is an important health benefit for all newborns.

6. If your midwife cautions you about anything to do with your health or your baby’s health, ask her for references. A good midwife can back up anything she says with literature and is happy to have curious clients who ask for the evidence. Once you have research papers on any subject (e.g., erythromycin eye ointment, vitamin K, infant vaccines, Dopplers, ultrasound, triple screen, gestational diabetes testing, strep B testing, membrane stripping, etc.), you can go to the computer and type in the subject with the addition of “comma, dangers” or “comma, precautions.” That is, type into Google: erythromycin eye ointment, precautions.

This will take you into all the alternative views about these subjects and you can make a more fully informed choice about what you want to do. In the case of erythromycin eye ointment, for instance, you’ll find that Australian and British midwives don’t give this antibiotic treatment routinely, but it’s routinely given in North America to millions of babies in order to prevent gonorrhea eye infections. If you don’t have gonorrhea and you’re in a monogamous relationship, you’ll probably feel comfortable declining the treatment.

7. Ask your midwife at your first visit with her who makes the rules that she works under and what the punishment is if she disobeys those rules. This will give you an idea of what sort of pressures the midwife is under right from the beginning. It will guide you as to what you can and can’t tell her or ask of her. Don’t assume that the midwife is loyal to you first. Like all human beings, her survival is important to her. If you know how to help her survive, you will be a savvier consumer of her services.

The best births are those in which the clients come away happy and so does the midwife. Win-win situations. Midwifery is changing, as legislators, insurance companies, medical boards and professional bodies react and respond to this profession that used to be private and secretive but now is having a spotlight shone upon it. Unfortunately, this has put pressures on midwifery to become more and more like the medical model to which it was originally opposed. In many states and provinces, midwifery is even more “butt-covering” than medicine because of all the controlling entities that now rule the licensed home birth midwife. When a consumer uses the term “midwife,” her picture of what she is getting may not match the reality of the birth worker who’s trying to survive in a strictly legislated profession.

Take off your rose-colored glasses and really find out what your midwife does at a birth and what your rights are when it comes to refusing interventions and interferences with a life experience that you will remember forever. It’s important for parents to remember that the midwife will go to many more births but this is the ONLY birth of this child that you will ever have. Keep your eyes, ears and senses wide open. Have a joyous home birth.

This article is published in the Winter 2008 No. 88 issue of “Midwifery Today Magazine”

42 thoughts on “7 Tips for Creating a Calm, Joyous Homebirth

  1. Fabulous article. I look forward to seeing it widely disseminated. If some families would take these important points into consideration when planning their hospital births with obs as well, they might realize they are not where they need to be to have the birth they envision and desire. Over the years, I have seen many families realize as late as the final few weeks of their pregnancy that they needed to make a change in order to welcome their baby safely and calmly into the world, in an atmosphere that empowers the family, respects the natural process, and honors the baby’s journey as well. Thank you for articulating the essence of this analysis so beautifully. May the truth of it ring out across this great land!

  2. Great post! Thank you so much for sharing.

    I had a planned homebirth with a midwife, but she put me on a “natural” induction that involved 2 days of castor oil and blue/black cohosh, sweeping membranes twice, EPO, and a variety of other things. After 56 hours of posterior labor I was transferred and given a cesarean. I had no idea there were other midwives in my area at the time.

    I now know better and will be planning a VBAC homebirth with #2 (whenever that may be).

  3. Great article!
    I had to read this twice: “3. Always make the first day of your last menstrual period one week later than it really was.”
    I was like: “OMG she is actually saying this!!” LOL!! I soooo agree!

    • I did this with one of my pregnancies. And all my measurements were “right on schedule” and I gave birth on my “due date.” 😉

      Truly disillusioned me about all the “science” that is so worshiped, not to mention the midwife on whom I relied.

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  5. I think Allison and I could found a group called “the innocent women who believed in midwifery care in Canada”.
    I was also “naturally” induced with medication, had sweep membranes, AROM, and of course guess how it ended up? You are right… C-section.
    Healthy woman, healthy pregnancy, healthy baby, can you explain that?
    Oh, yeah, the debrief was “well, every situation is unique”.
    Still struggling emotionally.


  6. Great read, great advice!!! Its sadly seems that todays birthing women just can’t win! I got swept in to the whole medical world with my first and had a unpleasant birthing experience from from what I had wanted/planned. Thought I was making the best/right choice with my second and got a registered midwife only to be disappointed again when my beautifully and lovingly planned home water birth turned rush to hospital and almost in car delivery all because of meconium. Now with my third I am with registered midwifes again ‘even worse ones!’ and and desperately trying to change that before its to late! I am honestly considering just ‘forgetting’ to call the midwifes when its time. . .


  7. I am glad I couldn’t get a midwife, thankfully drinking red raspberry leaf tea made my labor short anyway. I didn’t want anyone in the room at all!

  8. I don’t like suggesting to women that the way to avoid an induction (or any intervention) is to lie, wholesale, to their care provider. Ask the midwife what her policy is on IOL. It should be able to be discussed in an honest and open way including the risks and benefits, what options are available, and what the risks of these are, and “what if I say no?” should be the most important question. For me… What If I Say No is my favourite question a woman can ask me… the answer is, I will support your choice, and I will ask you to sign documentation regarding the discussions we have had around the issue, and then we will wait for a baby. A woman and a midwife are in a partnership with a joint goal, and it should be seen as a coming together of knowledge and wisdom, not an inequal relationship where one member has to lie to the other… What would you say if it was suggested that midwives lie to women about something to give them “grace”????

  9. “Should be’s” are fine but, in the meantime, the woman will only have that one chance to give birth to her baby—she has way more to lose than the midwife/dr/nurse. It is her duty to protect her child. The practitioner invariably puts their license before the woman’s best interests (certainly there are many exceptions). In a perfect world, there would be no need to withold information or outright lie. In a community with a 30% cesarean rate, women need to be very street smart to keep their belly intact.

  10. Thanks Gloria, This is exactly what I needed today. I feel like I am the odd one out when everyone is happy with what I would call terrible hospital experiences. I have had the gamut of interventions run upon me. I have had my first, a c-sec due to failed induction at 40 weeks 4days… Then, a hospital VBAC where the birth went well but they took my baby for 2 hrs and I didnt know what they were doing. Then a homebirth which was wonderful compared to the previous but the midwives were quite antsy over the fact the I had PROM and pushed castor oil. Then 3 more births again PPROM and my midwives just said I should be induced so I foolishly complied. With my last birth # 7 I wasnt surpised to have PROM again but when the midwife checked me, we found out baby was footling breach…and so began the fear mongering…my waters were just leaking not broken in a gush…she told us about the dangers of cord prolapse and that I should have a c-sec so I did and found out later when I read the report that his cord was wrapped around him…the cord wouldn’t have prolapsed… I felt very let down by my midwife…I now am expecting # 8 and no midwifery clinic in Ontario will take me on and I do not see a reason to get another c-sec cause I had one last time which is what an OB will want to do…so I am seriously considering UC…Gloria, I wish there were midwives like you here in Ontario…
    Thank you for all your words of wisdom on your blog they are very helpful

  11. Gloria, this is a fabulous article! I worry sometimes about what would happen if we moved away from Vancouver and I got pregnant. Now I know what to do!

  12. Hi Gloria
    I am in strong agreement with the first Anna (without the C). If you don’t want the interventions then say “No – I understand the risks you have presented to me (that you are legally obliged to tell me about) but I have faith in the process and in my body and I will not have an IOL/sweep/section” As midwives we HAVE to tell you about the risks, we HAVE to offer the interventions AND we HAVE to respect the choices you make about your own body. As long as you understand those risks I know I am more than happy to support your choice to avoid interventions. Personally I wish more women would inform themselves and make the choices for themselves and then stand behind their decisions. I sure don’t wish more women would lie about their dates (or anything else for that matter).
    Anna C – how did you expect your midwife to know the cord was wrapped around your baby boy? There is a risk of cord prolapse with footling breech – your midwife should have made you aware that section is recommended but if you were willing to take the risk to have a natural birth then you should have declined the section. I wonder what your comments would be like if your midwife had NOT made it clear that she recommended a section and you continued with labour only to have a prolapse and either lose your baby or have a crash section? I don’t think you would be thanking your midwife then either would you? I know it is a difficult position to be in as a woman – it’s hard as a midwife too.
    Ultimately we are obliged to tell you of the risks (and if that includes a risk of death to you or baby then we HAVE to SAY it – not to scare you but so that we know you are aware). Then the power is all yours. That’s right THE POWER IS ALL YOURS. You make the choice, we can only recommend – YOU have to decide.
    Good luck to all of you out there reading this, I wish you all good birthing experiences.

    • I totally agree with you. I lie to other people in my life about my due date because I always go past, and I am sick of all the pitying looks, but I do not lie to my midwife.

      Also, you’re right, the power is in the hands of the mother. My first birth was a cascade of interventions that luckily did not end in c-section, but involved every other intervention that I had not wanted. I did not get over the birth I wanted being “taken” from me, until I took ownership for my own actions. I could have said NO at any time. But I didn’t. Every intervention that happened, was a choice I made. At the time I didn’t feel like I had options, but I did. If I had been a better advocate for myself, it would have been entirely different.

      Now I can’t stand when people say things like, “The Dr. took him by c-section.” or “They made me have an induction.” No one can make you do anything. We weigh the risks and benefits and make the choices that are the best at the time. Sometimes we learn later that those choices weren’t needed for the health of our baby, but what if the outcome had been worse than predicted?

      The Mother and Father have an obligation to be their own advocates, doulas can help, midwives can advise, but the choice is all theirs.

      • I think it would be fine to put it all on the shoulders of the parents if midwives and others would stop calling themselves “caregivers” and “professionals”. The word “professional” comes from the word “profess”. Professing is like what a professor/teacher does. They speak with an authority and it gives an added weight to what they are saying that lesser authorities just don’t have. If you’re going to “profess”, you’d better let your listeners know what your agenda is.

        This whole “don’t lie to your midwife” thing makes me laugh. Obstetrics is dishonest with the clients or we would have a cesarean rate under 10% (instead of over 30% currently) Everyone in the field is part of the lie and coverup. It’s a massive collusion against the birthing woman.

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  15. I tell everyone now, what the babies due date is. Im not stupid, i know what it is, and on the flip side of one week date change, one week shouldnt matter to the dr or midwife, theyre not supposed to be scheduling inductions or c sections anyways that far advanced, but ive had drs try to tell me I didnt know when I got pregnant because Im not a dr. B.S.!!!! so theyve tried to up the due date by 2 months. I gave birth unassisted at the end and Im SO GLAD I wasnt allowed medical attention over birth, I am not eligible for a natural birth in a hospital and im not eiligible for a midwife, 😛 to them, my baby came in 3 hours. awesome awesome awesome!!! unassisted is the safest if you can stop being a victim and do your research, Take responsibility for your actions, and find someone to support you emotionally, if you cant find someone to support, do support yourself then. I know theres alot of women out there who are stronger and smarter than me, if I can do it…..

  16. alleluia! i’ve been working on a document similar to this, and your insight is wonderful. i had thought of the lotus birth tip ~ what a hoot! thanks for your honesty and sharing yourself in the world ~ a wonderfulness all around…

  17. And what happens if you put your EDD later and then labour ‘early’. Then an invasive midwife will be pushing you to go to hospital for premature labour.

    Trust has to work both ways.

    You also have the option of refusing to divulge your EDD (and then resisting pressure to have a dating scan).

  18. What a revelation! Lie about your period. I love it. How many women remember the exact day of their last period anyway? O.k. maybe many do. Fine. But. When I talk about due dates in class I often get a “sometime around that week” when I ask about period days. As soon as the day is pinned down the countdown begins and inexactly 10 days or less from the due date mamas are getting hooked up and induced. What’s another day or two or five? Great Article.

  19. Pingback: RT @birthsage: 7 tips for creating a calm, joyous homebirth. http://www.glorialemay.com/blog/?p=74 #midwife #doula | ChildBirth 101

  20. Pingback: 7 tips for creating a calm, joyous homebirth. http://www.glorialemay.com/blog/?p=74 #midwife #doula | ChildBirth 101

  21. Pingback: RT @birthsage: http://www.glorialemay.com/blog/?p=74 Seven tips for avoiding a transport to hospital from your planned #homebirth #doula #midwife… | ChildBirth 101

  22. Brilliant, I really like the dating your last period one week later than it was statement. Until coming across your blog I never knew the risk of the doppler and ultrasound…I hope my daughter was not effected too much by all ultrasound waves she was exposed to. She would always get active and move away from the doppler. No turning back but there is looking into the future. However I do wonder about what the below statement:

    lydia wills says:
    March 25, 2010 at 10:15 pm
    And what happens if you put your EDD later and then labour ‘early’. Then an invasive midwife will be pushing you to go to hospital for premature labour.

    Trust has to work both ways.

    You also have the option of refusing to divulge your EDD (and then resisting pressure to have a dating scan).

    I also really like the lotusbirth tip. I worry about the cord blood banking that so many are opting for, just recently I had a couple interested in delaying cord clamping but then they decided that the banking would be more of a “life insurance” rather then the delayed clamping. I was so close it felt but there OB convinced them to bank the cells instead.

    Keep up the amazing work Glo, and thank you for making such a difference. If not for everyone, you are making such a difference already for my future next baby.

  23. What is wrong with wanting the placenta out in <30m? It is after that that your chance of PPH rises precipitously.

  24. As a Christian I also disagree with #3. Lying is never appropriate. If you can’t find a midwife you trust enough to be truthful with, you shouldn’t be inviting one to your birth.

    Otherwise a great article – thank you Gloria!

  25. Midwives get upset when they read this article. Lots of ki-yi-yi-ing about “I don’t have videos to show because I don’t have clients with video cameras”. . . “clients shouldn’t be encouraged to lie to their caregivers, that’s so terrible”. . etc, etc. It’s ok, I have no problem upsetting people and I always find that when I get upset, there’s some grain of truth that I’m not willing to look at so, in the end, people upsetting me comes before a new insight. This video is a good demo of why I’m saying that midwives need to show clients a birth that they’ve attended. What’s wrong with this birth? well, if you know me, I’m always cranky about birth videos. I loved the woman, baby, dad BUT. . . plastic wrap over the baby’s back (why?), midwife catching the baby (why?), father pinned down behind the woman and out of the birth (why?).

  26. I do not have any videos of the birth I have attended and actually do not want any!
    The births I value the most and want to see repeated – are those that I almost miss or one where cameras are not present – as the woman has laboured privately bathed in her hormones- sometimes ion and for days before.

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  28. yeah, I usually love what you write, but I just can’t get behind the lying about the dates thing. The more I read, the more it sounded like the tone I used with my past doula clients in relationship with their OBs. And yes there are some very interventive medwives out there, but in my experience they are the minority.

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  30. I wish I’d come across this a few months ago..I’m due any day now and having a very hard time with my midwives! 🙁 not all midwives are equal, I wish I’d known!!

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