HOME BIRTH

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HOME BIRTH

• Dr Muhammad El Hennawy
• Ob/gyn specialist
• Rass el barr central hospital
• Dumyatt EGYPT
• www.geocities.com/mmhennawy

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where birth happens
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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

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• 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.

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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,

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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?

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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,

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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
  pregnancy-related problems ),
• and normal medical history (without chronic
  health problems ),
• who haven't had a previous cesarean section 0r
  any operation in terus

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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,

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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.

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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

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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). 

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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
• Buckets-to sit on and for clean up
• New nail brush and clippers
• Waterproof pads to sit on
• Heavy plastic sheet for the bed
• Large towels

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Can she change her mind?

• Yes at any time you can change your mind about
  site of labour

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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

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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,

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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

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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
  fail-safe.

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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)

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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 C-section delivery
• much more likely to experience postpartum
  depression or even post traumatic stress
  disorder.

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• 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.

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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 Mix-Ups
• 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
• lower-cost costs 68 less in a home than in a
  hospital

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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

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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

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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

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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. 

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• 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.

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• Thank you
• www.geocities.com/mmhennawy