What Should I Expect From a Home Birth Experience?

Many times we have been asked what parents should expect from a home birth experience.  Knowing each birth is a unique event as well as a personal journey, it is hard to distill so many different experiences into a few words.  What we can say is that when your labor begins you call your birth team to your home (or to meet you at the birth center) as invited guest.  In your own clothes you move about your home freely; chatting with friends or relatives; eating and drinking to keep up your strength; changing positions as needed.  Your birth team works with and around your location and position to obtain vital signs and your baby's heart rate at specified intervals.  Verbal and physical encouragement and support are given during transition and pushing.  As you actively birth your baby, your midwife (with the assistance of whomever you desire) simply "catches" the baby and immediately places your baby on your chest and in your arms.  You and your family welcome and greet your baby, experiencing and sharing in the love of those present. 

It is our desire that you have a birth experience where you and your family feel honored and supported physically, emotionally and spiritually, and that you experience the family-centered event that we believe birth is.

How Our Practice Works

We offer prospective clients an initial consultation and interview where we are all free to ask questions and get to know each other.  If you are planning a home birth, and if you live in the San Antonio/Boerne metro area, we may be able to meet you at your home for this interview. 

You may choose an office location that is most convenient for you for your office visits.  Our San Antonio office is located in the north central area of town close to the Alamo Quarry Market.  Our Boerne office is located off Main Street by the river.

After you have hired us as your midwives, we are available during office hours to answer questions throughout your pregnancy.   You will also be able to reach the midwife on call 24 hours a day, 7 days a week for urgent issues.  We will be on call for your birth two weeks before (38 weeks) to two weeks after (42 weeks) you approximate due date.  One or both of us will be with you through active labor, birth and immediate postpartum.

Prenatal Care and Support

Your prenatal visits will take place at one of our office locations or in your home for additional fees.  Routine care is important to assess and monitor your pregnancy, and also gives us the opportunity to get to know each other, address all of you concerns, answer all of you questions, discuss your wishes for your birth and build a foundation of mutual trust and respect.  We welcome your family to be involved and support their participation.  Plan to spend approximately 45 minutes at each visit. 

Prenatal Schedule:      

1st visit through 28 weeks
Every 2 to 3 weeks
28 weeks through 36 weeks
36 weeks through birth

 Each visit assesses the following:

Vital signs: your pulse and blood pressure
Weight: we track gains or losses
Fetal heart rate: you can choose auscultation by fetal scope or doppler
Fundal height: measured in centimeters
Diet counseling
Emotional status
Palpation of baby: our hands are our greatest assets
Signs and Symptoms of pre-eclampsia

In most cases your initial prenatal visit will include a complete medical history, physical exam and initial lab work is drawn.  Plan to spend one and a half to two hours at this visit.  Glucose screening is recommended at 26 to 28 weeks.  Sonograms are not routinely ordered but may be suggested if there is indication that one is needed.  You are welcome to request one at any time and we will refer you to an imaging center. 

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Home Birth

You are encouraged to call when you think you may be going into labor.  Common signs of labor may include contractions that become regular, increase in intensity and progressively get closer together; bloody show or leaking amniotic fluid.  You may call if you have a concern, are not sure how to interpret what you are feeling or if you just want to talk.

During labor normal activity, eating as desired and frequent urination are encouraged.  Drinking fluids and oral consumption of calories is required.  Moving frequently during labor and the use of gravity-assisted positions enhance comfort and may speed up the birth process.  Once we arrive we begin monitory you and your baby at specified intervals.  Internal checks are kept to a minimum and done only as needed throughout labor.

You may give birth anywhere and in any position, including in the water.  While your baby's head is crowning your perineum may be massaged with warm olive oil, and warm compresses and perineal support may be applied as needed; you will be coached to gradually birth your baby's head.  These measures, combined with gravity-assisted positions, help to prevent or minimize tears.  We welcome the involvement of family members to the extent that you are comfortable (someone can even help the midwife catch the baby).  As you are planning your birth team remember that the natural flow of the birth process can be hindered by the presence of too many well-meaning friends or unattended young children, yet you are free to surrounded by whomever you feel will provide you with the support you desire as you experience your labor and birth.

You will be asked to have specific supplies on hand and available for use at your birth.  We will provide you with a list or you can purchase a custom birth kit from In His Hands Home Birth Supply.   

Water Birth

Although giving birth underwater is a "new" concept in our western culture, oral history suggests that woman all over the world have labored and given birth in and by water for centuries.  Many women say that the soothing, relaxing effects of the warm water, along with the ease of movement that the water allows, greatly reduces the discomfort and pressure of labor and birth.  We encourage our clients to have water available for use during labor, as a comfort measure tool, even if they do not plan to birth in water.  For more information about water birth, visit Waterbirth International.

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Birthing Centers

We have privileges at two area free standing birthing centers.  One is in San Antonio off of Babcock Rd. and the other in New Braunfels on Comal Ave.  Birthing at a birth center is ideal for families that live a considerable distance from a medical facility or feel they do not have the privacy or space in their home environment to facilitate the birth experience they desire.  Feel free to ask additional questions if you would like additional information about birthing at these facilities.

Newborn Care

In the course of an uncomplicated birth your baby will go directly into your arms as you both experience your baby's first breaths.  As long as you and the baby are medically stable, all necessary monitoring can be done while you hold your baby in your arms.  Immediate skin-to-skin contact is encouraged and you may breastfeed as soon as the baby is interested.  Apgar scores are recorded at one and five minutes after birth.  We prefer to cut the umbilical cord after it has stopped pulsating, and after the placenta has been birthed.  If you are Rh negative (or if you would like to know) a cord blood sample will be taken to the lab for determination of baby's blood type.

The baby's temperature, heart rate, respiratory rate and effort will be frequently monitored.  A preliminary exam is performed at birth and a thorough head-to-toe exam is done around two hours of age.  If there are any problems, conditions or concerns about the baby at birth or that develop in the postpartum period, we will assist you in getting the appropriate care for your baby.

The Newborn Screen is done at approximately 36 hours of age and repeated at the 2-week check-up. 

Postpartum Care and Support

Routinely, no invasive techniques or force will be used in the delivery of the placenta.  An exam of the placenta will be done to insure that it is intact.

Your vital signs, uterus and bleeding will be checked and assessed regularly.  Some women use an ice pack applied to the perineum, which can help reduce swelling.  Many of our moms enjoy their after-birth herbal bath that we prepare for them using a combination of healing and soothing herbs.  After you give birth you are encouraged to eat and drink. 

Adequate urination and successful breastfeeding must be observed before you birth team departs.  We will stay approximately three to five hours after the birth, only after leaving you and your family with verbal and written instructions on caring for both of you during the first 36 hours.  You are encouraged to call at any time with questions.

After the birth, we will return to your home for postpartum and newborn exams at approximately 48 hours, 7 days.  Our services include a postpartum office visit at two weeks and at six to eight week (which can including a pap if you desire).

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