Unformatted text preview: HOME BIRTH
HOME BIRTH Dr Muhammad El Hennawy Ob/gyn specialist Rass el barr central hospital Dumyatt – EGYPT www.geocities.com/mmhennawy where birth happens
hospital home emergency planned
unmedicated unassisted unassisted home birth
unassisted home birth midwife, or other medical personnel present In unassisted birth, there is no doctor conception was birth should be as private and intimate as the the They do own prenatal care they don't go to anyone for prenatal care 1. Listening to fetal heart beat with a fetoscope or stethoscope after 20 weeks they belief that ultrasound is an unproven and possible unsafe technology, no electronic monitors or dopplers will be used. 2. Measuring their fundal height of the uterus
3. Testing their urine for protein 4. Measuring their blood pressure 5. Measuring their own maternal weight. 6. Determining their fetal position inside the uterus the birthing woman to be the one to catch her own baby Just trust that her body knows how to give birth Perineal massage with oil, hot compresses, and perineal support will be used .she would prefer to allow the tissues to tear rather than be cut. No drugs of any kind will be administered during the labor gives birth in the squatting position The umbilical cord will not be cut until it has stopped pulsating, usually 3 to 4 minutes or longer. no substance by mouth other than my breastmilk or colostrum the assumption that hospital birth is safer for mother and baby has never been supported Whether she is safer at home than in a hospital, however, is another question Prenatal care, better nutrition, antibiotics and blood transfusion have played more of a part in the relative safety of birth now. No one can tell a mother she is perfectly safe giving birth at home. What are the drawbacks of a What are the drawbacks of a home delivery?
The most obvious drawback is that not everything a hospital offers is available at home You may need the expertise of the hospital staff and certain equipment at your disposal if something goes wrong. At home there is always the possibility, no matter how small, of a tragic complication which could have been more effectively dealt with in hospital. Parents choosing home birth will consider and come to terms with that risk, Homebirth
Homebirth • Can anyone have a home birth? • How do she organise one? • What pain relief will be available? • Can she change my mind? • What happens if she need to go to hospital in labour? • Who will be present at the birth? • What equipment do she need? • What happens after the birth? Can anyone have a home Can anyone have a home birth? In theory, any pregnant woman has the right to give birth at home In practice, you may encounter obstacles. If you have a complicated medical history such as toxemia, diabetes, breech presentation, prematurity . the birth in the hospital. Since safety is of paramount importance, we bring IV fluids, medications, oxygen, surgical instruments and life support systems At home there is always the possibility, no matter how small, of a tragic complication which could have been more effectively dealt with in hospital. Parents choosing home birth will consider and come to terms with that risk, Homebirth is not for every woman
Homebirth is not for every woman Only multiparous healthy women ( not nulliparous women which are more likely to require transfer to hospital during labour because of delay in labour). with . a normal obstetrical (without pregnancyrelated problems ), and normal medical history (without chronic health problems ), who haven't had a previous cesarean section 0r any operation in terus How do she organise one? How do she organise one her obestetrition will contact you to make the arrangements Wherever you decide to give birth is up to you; just remember that you can make the decisions that need to be made when you have true information. It is your body, your baby, your money, and your life on the line, What pain relief will be What pain relief will be available? Although in some cases pain medication is available to mothers birthing at home pethidine if she want, in most cases this option is not available. give her gas and air. Alternative methods of pain relief if contractions are pretty strong, such as TENS machine,breathing exercises, massage, and labouring in a birthing pool , aromatherapy, homeopathic remedies, or acupuncture. It is well understood that sensations of pain in labour are regulated by hormones released by the woman's body relaxation can diminish maternal stress, improve oxygen flow to the baby and facilitate labor. . During the labour, oxytocin the hormone which causes contractions and helps the baby to be born works in harmony with endorphins the body's own pain relieving hormone. Preparing for Labor
Preparing for Labor Take a birthing class. Some available types of home birth Exercise. Regular exercise, such as yoga or walking, can help prepare your body for labor. Consider the atmosphere in your home, and prepare it for optimum comfort once you go into labor. Make sure it is clean and that the surroundings are soothing to you. Also prepare for such things as music and lighting during the birth if you have preferences Childbirth Education
Childbirth Education You need to prepare for birth. Make preparing for it special these educational classes are an excellent resource for you, or anyone who might be with you during the birth process. These classes usually include information on exercise, nutrition, breathing, position, movement and relaxation methods for use in labor and delivery, information regarding hospital procedures, medications, anesthesia, alternative complementary therapies, newborn care and the postpartum period.
gentle yoga postures (increase your repertoire of comfortable positions during pregnancy), ease low back pain, use vocal toning, visualization, meditation, massage and relaxation Use gentle deep breathing (not the fast pace). Obtain the necessary supplies
Obtain the necessary supplies . You may be able to provide you with a birth kit, but here are some of the most important things you will need. Sanitary pads, large ones Cracked ice Nursing bras Something to mist your face with Bucketsto sit on and for clean up New nail brush and clippers Waterproof pads to sit on Heavy plastic sheet for the bed Large towels Can she change her mind? Can she change her mind Yes — at any time you can change your mind about site of labour What happens if it her baby will What happens if it her baby will arrive before she get to the hospital? Emergency home deliveries are extremely unusual, especially with first babies the baby arrive before or after the emergency medical team Who will be present at the birth? Who will be present at the birth doctor and his nurse go to a woman's home when she starts labor. Who else is present is up to her it's her home, after all. Anyone she wish! her mothers, sisters, close friends, neighbor, labor coach, or others, What equipment does she need? What equipment does she need series of childbirth classes, covering the major topics in prenatal nutrition and exercise, natural birthing methods, pain relief and breast feeding she will bring round a 'birth pack' containing all the bits and pieces they need During labour, her baby's condition will be regularly monitored with a sonic aid The doctor at a home birth will have all her instruments laid out, readily accessible, and the oxygen tank turned on
All she may be asked to provide is adequate heating, and a reading lamp. However she did arrange hire of a Tens machine, The doctor carries oxygen and resuscitation equipment to use while waiting for the ambulance What happens if she need to go to hospital in labour? her doctor will talk to her and her partner about why she believes a transfer to hospital would be a good idea and will then call an ambulance because her labour has slowed down or because there's a real emergency . For this reason, it's wise to deliver at home only if you're within 20 minutes of the nearest hospital and her transportation there is failsafe. What happens after the birth? What happens after the birth Once the baby and placenta are safely delivered The doctor will check the baby over and weigh him,the nurse help her with her first breastfeed How long will doctor stay at her home after her baby is born? The doctor will stay until the mother is up, sitting in a chair, feeling well, drinking and eating, and the baby is judged to be healthly and is nursing satisfactorily. (one hour) .
o ,Within the hospital group
Within the hospital group
Maternal hemorrhage was higher. The incidence of respiratory distress among newborns was greater in the hospital than in the home. Limp, unresponsive newborns arrived more often.
The perinatal mortality rate was higher in the hospital births Neonatal infections were common. There were permanent birth injuries caused by doctors
more lacerations to the mother, many episiotomies
a higher rate of forceps
a higher rate of Csection delivery much more likely to experience postpartum depression or even post traumatic stress disorder. doctor tend to allow time for the woman's tissues to stretch and to use perineal massage, warm compresses, and good head flexion to avoid both episiotomies and tearing; doctor use include simple techniques for relaxation and breathing but may also include the use of massage, herbs, homeopathy and acupuncture. doctor at a home birth will have all her instruments laid out, readily accessible, and the oxygen tank turned on, so that what might be an emergency becomes a matter of routine. What are the advantages of a home birth What are the advantages of a home birth ?over a typical hospital delivery It respects the natural processes of giving birth labor progresses more rapidly in the familiar home environment her own home, in her own bed
their home is the most appropriate place for a new baby to enter their family circle.
a matter of acknowledging her needs for privacy, security, comfort, safety, control, freedom and respect for the emotional and spiritual aspects of birth She may have had a previous bad experience in hospital and wish to avoid another. No Baby MixUps The dangerous bacteria and viruses that commonly inhabit hospital environments are far less likely to inhabit her home
there are no unnecessary medical interventions performed at home, which themselves could create problems . encourage laboring mothers to walk or to assume comfortable positions, and to drink if thirsty and to eat if hungry relax in a warm tub of water, have her feet rubbed by loving friends. she chooses, sip on energizing juices, continue caring for other children as she is able. She can move about freely, wear what clothing
wishing to minimise the disruption of the routine for their other children Decrease the risk of the emotional/psychological disruption of being in an unfamiliar institution . they want to deliver their babies without drugs and unnecessary interventionsthis lowercost costs 68% less in a home than in a hospital prenatal
prenatal calm people who are present at the birth. Tension in a room can slow down or stop a labor . Usually someone other than the mom or her partner assumes responsibility for any children who are present, freeing mom to focus on birthing. The birthing process is allowed to take its own course and set its own pace. The general philosophy is that any interventions (administering drugs or trying to hurry things along) create more harm than good.
the mom is likely to be less inhibited about trying different labor positions and locations. She can sit on the toilet or go for a walk outside. She can eat or drink whatever she wants When it's time to deliver
When it's time to deliver she can often try whatever position she wants: on her side, squatting, sitting or kneeling many childbirth authorities feel the motion of walking and changing positions can enhance the effectiveness of the contractions. . When a doctor and mother build a personal relationship, this trust helps women let go and have their babies more easily. Homebirth allows for full participation of family members babies are usually immediately placed on the mom's breast, providing security, warmth and immediate bonding between mom and baby Home versus hospital birth
Home versus hospital birth There is no strong evidence to favour either planned hospital birth or planned home birth for low risk pregnant women.
Planned home births in appear to be associated with less overall maternal and neonatal morbidity and less intervention than hospital births. "Home birth is an acceptable alternative to hospital confinement for selected pregnant women, and leads to reduced medical interventions.”
Continuing evaluation of home birth practice and outcome is essential.
Home birth can be accomplished with good outcomes under the care of qualified practitioners and within a system that facilitates transfer to hospital care when necessary. Intrapartal mortality during intended home birth is concentrated in postdates pregnancies with evidence of meconium passage many mothers who have delivered in the hospital as impossible confined to a hospital bed, denied food and water, separated from their other children and supportive family members and friends, enduring frequent internal examinations and vital sign checks, being transfered from one room to another on a stretcher at the peak of labor's intensity and having their legs strapped into stirrups. good result of home birth because good selection of type of pregnant women to allow to deliver at home Good health prenatal = low complications natal and postnatal final judgment regarding the relative safety of home birth still cannot be made. Thank you
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- Fall '11
- Obstetrics, HOME BIRTH