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Midwives and Home Birth

Photo Credit: Ellen Keith Shaw

By Kara Engelbrecht

When a pregnant person is choosing a midwife and homebirth they come to it from many directions. Some have read all the reputable studies and are wanting a reduction in interventions while others have fear of the hospital or of not being heard as an individual. Some were born at home and homebirth is their family culture. And some have sought out alternatives in health care and are educated about what modalities work best for them. Often what they find is a relationship with their provider, an intimate experience with their care that they didn’t really know could exist.

That intimacy translates into hour-long prenatal appointments with your midwife, where we not only delve into educational topics but also spend talking about your family and relationships. We take time unveiling what birth really looks and sounds like, and share a variety of information from how to be in denial of early labor as long as possible to how to set up the bed so that the mattress is protected.

Then labor happens and that relationship between you and your midwife translates into trust as you breathe through each wave, move your babe through your body and, eventually, reach down and feel baby's head in your hands. And that’s the piece we all envision and have worked toward together.

The midwives make sure you and your babe are healthy and stable. And then as the new family sinks into their new reality, the midwives tidy up, suture if necessary, and do a thorough newborn exam. The midwives leave as everyone rests and mom and baby get to know each other. New mothers are born with their baby, both body and soul.

The postpartum is when you are at your most vulnerable. Your body is in flux with hormones, your vagina is cooling on frozen pads, and your breasts are filling and swelling. And the baby; they sleep, nurse, and you all fall in love. As you move through the first feeds and diapers there can be so many questions: Is this what a good latch feels like? Are they nursing enough? Too much? What is normal anymore? What is day and night?

To have a midwife come to your home afterwards and listen to your concerns is the most intimate piece of the care. She will weigh your baby, demystify the latch, and give tips on positioning. She can teach you how to swaddle and burp. And she will remind you to hydrate, snack, and nap often- things you know to do but the reminder helps to make it a reality.

She will also give you reasons to stay in bed all day, pee every couple hours, and not to worry about pooping (because everyone worries about pooping). And she comes back to your home every few days for the first weeks, wrapping up care at six weeks when all the questions have been answered and breastfeeding establishes.

Over those weeks the baby grows and your family gains confidence. You explore, first with small walks around the house and then the neighborhood. The birth becomes a story of intimacy that’s yours to share. And your midwife is honored to be a piece of that journey.

Kara Engelbrecht is a Licensed Midwife and has a homebirth practice in San Francisco. She is a parent to two dynamic teenagers and a few fur babies.

Photo Credit: Ellen Keith Shaw

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