Homebirth

THE ROLE OF THE MIDWIFE IN HOMEBIRTH

Homebirth refers to the act of a woman giving birth at home and is typically attended to by an independently practising midwife. The midwife plays a vital role throughout the experiences associated with homebirths such as embracing a cooperative partnership between women, infants and families. Such features are expressed by a midwife throughout a woman’s pregnancy, labour, birth and postnatal experience, therefore emphasising the importance of continuity of care especially for those women who choose to undertake a homebirth.

The midwife’s role in a woman’s pregnancy first begins with antenatal care. The physical environment should not alter the midwife’s performance of duties as the focus should remain on the wellbeing of the mother and baby. Although, in the instance of a planned homebirth, the midwife will typically conduct the antenatal appointment in the woman’s own home, which would simply provide the woman with some comfort. Such appointments should begin at 10 weeks of gestation with a total of 10 visits for primiparous women and 7 visits for multiparous women with an uncomplicated pregnancy. In alignment with the Midwifery Competency Standards, more specifically Elements 3.3 and 3.1, which states that the midwife should listen and communicate effectively with all involved in the pregnancy especially the woman. This standard is particularly applicable to antenatal care as the midwife is required to embody such cues as actively listening to the woman, working in cooperation with the woman as well as identifying and being understanding of the woman’s feelings, thoughts and knowledge about all aspects of her pregnancy (NMBA 2006, p. 5).

While the woman is in care during her pregnancy, it...

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...ent skills and informative support such as factual benefits of breastfeeding (Fraser & Cooper 2009). Visits during this period should occur on a regular, if not daily basis for 4-5 days and become less frequent as the woman becomes more comfortable and confident. Conversely, neonatal deaths and other adverse outcomes are still a possibility postpartum as outlined in the ‘Review of homebirths in Western Australia’ (Department of Health WA 2008), so if a woman has experienced a transfer from home to hospital, the postnatal period will require the midwife to be more of an emotionally supportive peer, like a doula. The midwife needs to be in solid communication with the woman, identify the support systems available to the parents of the baby as well as provide information, empowerment and reassurance to ensure a sense of family centred care along with woman centred care.