HOME BIRTH

Dr

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

where birth happens

Birth
hospital

home

emergency

planned
assisted
medicated
unmedicated

unassisted

unassisted home birth

They
do or
own
carepresent
they don't
go to anyone
for is
prenatal
midwife,
otherprenatal
medical personnel
In unassisted
birth, there
no
care

1. Listening to fetal heart beat with a fetoscope or stethoscope after 20

weeks
theyconception
belief that ultrasound
is an unproven
and possible
unsafe technology,
doctor
was birth should
be as private
and intimate
as the
no electronic monitors or dopplers will the
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

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
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

birth?
In

theory, any pregnant woman has the right

to give birth at home
In practice,
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
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?
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

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

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

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

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

. You

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 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?
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?

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 fail-safe.

What happens after the

birth
? are safely
Once the baby and
placenta
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.

 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 over a typical hospital
It respects the natural processes
of giving birth labor progresses more
?
delivery
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

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

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

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
confined to a hospital
impossible
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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wy