Giving Birth Outside the Hospital

Labor and delivery is a normal process that usually occurs without problems to the mother or baby. Most women prefer to deliver their baby in a hospital because it is safer for you and the baby if problems develop during labor. Some women prefer to have their baby delivered at home. Home births are not encouraged by most in the medical profession. However, with trained personnel and a low risk pregnancy status, home births are as safe as hospital deliveries.

Pregnant women who prefer to deliver at home feel:

  • It is more comfortable.

  • More relaxed.

  • More at ease in a familiar setting.

  • There is less anxiety. Anxiety can cause an increase of adrenaline in the body and adrenaline can interfere with labor and delivery.

Women who choose home birth should have the choice to change their mind to deliver in a hospital. They should feel free to do so without guilt. Hospital deliveries may occur if:

  • The mother becomes very tired in labor.

  • The mother wants pain medication.

  • Labor fails to progress.

  • Contractions get weaker or stop.

  • The mother has problems or there are problems with the labor or the fetus.

Both the mother and the father should be prepared for labor and delivery and the possibility of having to go to the hospital to deliver the baby. There should also be a well-trained and experienced caregiver, nurse midwife, or experienced lay midwife with doctor backup if problems develop. Complications can occur quickly and without warning. The caregiver should be able to recognize them. Oxygen should be available in case it is needed for the baby. The baby should be examined by a pediatrician within 24 hours after delivery.

BENEFITS OF A HOME BIRTH INCLUDE:

  • Less cost.

  • Quicker and closer bonding with the baby.

  • More freedom to move about during labor.

  • Not being exposed to hospital disease organisms. Women usually have a built-in immunity to home organisms.

  • No intravenous (IV) access tube therapy.

  • A very strong feeling of confidence to care for the baby after a home delivery.

  • Less chance for an episiotomy.

  • Less chance for Cesarean delivery.

HOME BIRTH IS NOT RECOMMENDED IF:

  • You have a high risk pregnancy status.

  • You have medical problems.

  • Your membranes rupture prematurely.

  • There are problems with the fetus during pregnancy.

  • Labor begins before 37 weeks and you have already had a baby.

  • Labor begins before 38 weeks and it is the first baby.

  • Both parents do not agree with a home birth.

There is an increase of a ruptured uterus if you had a previous Cesarean delivery or major surgery on the uterus. It would be safer to deliver the baby in a hospital. It is very important to get necessary medical care when advised or when a problem develops. Problems can get worse for the mother and baby if the mother refuses necessary medical care.

UNPLANNED OR UNEXPECTED BIRTHS OUTSIDE THE HOSPITAL

There are times when a pregnant woman will begin labor unexpectedly. She may be unable to make it to the hospital to deliver her baby. This usually happens to women who have had 1 or more deliveries in the past. It rarely happens to women pregnant for the first time.

Labor may begin:

  • Because the bag of water around the baby (amniotic sac) breaks.

  • Because of trauma.

  • Because of stress.

  • Spontaneously without warning.

When the baby is born before the mother can make it to the hospital, it is usually a smooth, natural, and uncomplicated birth. The mother and baby usually do not have any problems. In most of these births, the mother and baby are taken to the hospital where the mother and baby can be examined and make sure there are no problems.

When a baby is born unexpectedly at home or anywhere outside the hospital, it is important to know what to do. Follow these key points:

  1. Call your emergency medical services (911 in U.S.).

  2. Remain calm and do not panic.

  3. Get the mother in a comfortable position.

  4. After the birth, tie the umbilical cord with a string or anything at hand (like a shoelace) in 2 separate places about 3 inches apart and about 2 inches from the baby's belly.

  5. Turn the baby face down to get rid of any mucus in the baby's mouth.

  6. Cover the baby, especially the head, with a warm shirt, towel, or anything available to keep the baby warm.

  7. Put the baby to the mother's breast. This causes the brain to produce a hormone called pitocin. This hormone causes the uterus to contract, helps to deliver the placenta and prevents heavy bleeding from the uterus.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's instructions regarding exercise, diet, activities, and medicines.

  • Only take over-the-counter pain medicine as directed by your caregiver.

  • Do not take aspirin because it can cause bleeding.

  • Do not douche or use tampons. Use sanitary pads.

  • Increase your activities a little every day to build up your strength and endurance.

  • It is normal to have a small amount of bleeding for 2 to 3 weeks.

  • Have someone help you around the house for the first few days after the delivery.

  • Rest or nap when the baby is sleeping.

  • Wear a good support bra if you are breastfeeding.

  • Wear a tight bra and do not stimulate your nipples if you are not breastfeeding.

  • Continue taking your prenatal vitamins.

  • Do not have sexual intercourse until your caregiver gives you permission.

  • Ask your caregiver when you can begin exercising and what type of exercises you should do.

  • Call your caregiver if you think you are having a problem from your delivery.

  • Call your pediatrician if you have a problem or have questions regarding the baby.

  • Schedule and keep your follow-up appointments.

  • Make sure your medical insurance covers you for a home delivery especially if your baby is being delivered by someone other than a physician.

SEEK MEDICAL CARE IF:

  • You have an oral temperature above 102° F (38.9° C).

  • You have an increase in vaginal bleeding, with or without blood clots.

  • You have bloody or painful urination.

  • You have a bad smelling vaginal discharge.

  • You had an episiotomy or tear of the vaginal area and there is increasing pain or swelling.

  • You develop a severe headache.

  • You become depressed.

  • You get dizzy or lightheaded.

  • You develop a rash.

  • You have problems or reaction to your medication.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have chest pain.

  • You develop shortness of breath.

  • You pass out.

  • You develop pain with or without swelling and redness of your leg.

  • You develop belly (abdominal) pain.

  • You have heavy vaginal bleeding with or without blood clots.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.