Home births? Here’s everything you need to know about them

Home births? Here's everything you need to know about home births

As a mother-to-be, have you ever considered the option of giving birth at the comfort of your home with the help of a midwife?

Well, every mother-to-be prays and hopes for a safe delivery when the time to bring forth her child arrives. Thanks to technological advancement, there are various options for mothers-to-be to choose their preferred mode of birth.

While some women are choosing to have babies in the comfort of their homes or at birthing pools, surrounded by loved ones, a midwife and a doula, others opt for either elective caesarean section or epidural (a popular form of pain relief for labour).

Kenyan singer and songwriter Wahu Kagwi, for example, opted to have an epidural while delivering her second born child.

“The thought of a painless experience was tremendously appealing. Having had a normal (epidural free) birth the first time round–and knowing the inexplicable pain of it–I was extremely pleasantly surprised when I went through my epidural assisted delivery this time. I remember how calmly I told my husband that I could feel the baby’s head, and if he didn’t get the doctor, he’d have to “catch” the baby himself.  I was very calm–probably too calm–especially after the experience we’d gone through with Tumiso, where I was literally hanging on his dreadlocks in pain at one point during labour,” she is said on Baby Love Network.

Home births are common in the West, where women prefer to give birth naturally from the comfort of their homes without epidural during labour.

As the new trend catches on in Kenya, statistics show that the number of women delivering in health facilities has risen to 70 percent from 43 percent four years ago, following the introduction of the free hospital maternity programme in 2013.

“Given a chance, a home birth is definitely something that I would love to try out when I have my second baby because I believe one has control of their birth in many ways as it provides a safe, private, relaxed, homely alternative delivery setting to low-risk pregnant women,” says Esther Wahito, a mother of one who works as an Accountant with a local bank.

“On the other hand, if you have had previous negative or traumatic hospital birth experience, it compels you to think of the option of a home birth as long as you have a skilled midwife to walk you through the pregnancy journey,” she adds.

Lucy Muchiri, an independent midwife, started Eve’s Mama Birthing Centre located along Ngong Road. The Centre is set as a ‘home away from home’ environment for expectant parents, as they make their journey through the childbirth process.

It comes complete with a living room, lounge, dining room, three bedrooms and a yard.

“I trained as a midwife and worked in a hospital. I had no children then but I would help my close friends during their births and after. Then I realised that most women are not aware of what to expect during birth and the care of their child after, and this inspired me to start the centre,”  says Muchiri.

“Births at the birth centre are calmer because we have taken the home concept. If you walked in, it is just as if you are in somebody else’s house having your baby there. Hence the home environment comes with a lot of privacy, calmness and that is probably why a lot of mums who come to the birth centre end up having calmer births. We take time to prepare mums for childbirth and especially for labour and the actual birth process so that they know what to expect,” says Muchiri.

How safe are home births?

The practice has sparked debate globally on risks at a time that low-income countries like Kenya are pushing for hospital births to cut high child mortality rates associated with delivery at home.

“They are safe as long as the risks are assessed earlier, a plan put in place and a professional attend the birth. Our model of care covers all these factors,” says Muchiri.

According to her, the government is justified in its means to encourage expectant mothers to give birth at the hospital, as a lot of the women giving birth at home have no professional attendants and therefore some risks are hard to mitigate.

“This has however not affected us in any way as we are targeting a different population. Our services are for the urban educated woman,” she says.

Dr. Alfred Murage, a Consultant Gynaecologist and Assistant Professor, Department of Obstetrics & Gynecology at the Aga Khan University Hospital, Nairobi, says there are a number of home deliveries within the lowest socio-economic groups, for various reasons that may include cultural and economic factors.

Baby in nursery

However, such deliveries are not necessarily safe as the mothers may have unknown risks, and may also not have been attended for antenatal care. Thus the higher maternal and neonatal morbidity and mortality within this group.

“The question of whether the concept of home births has been embraced in Kenya, the honest answer is that we don’t have any objective data to tell us how many couples are electing to have home births. Anecdotal evidence suggests there is certainly a drive within the higher income group to explore various options for deliveries – including home births,” says Murage.

Lucy, on the other hand, says, “The interesting thing is that more than 50 per cent of women in Kenya gives birth at home. It is just that these women are in the rural and urban-rural settings. It is associated with lack of resources to get to a hospital and in some situations lack health care facilities. The urban educated woman is so used to the hospital way of giving birth as that is what has been available to her. We are therefore teaching and championing for women to see out of hospital births as an option especially if both mum and baby are well and have remained well during the pregnancy.”

In preparation for labour, Muchiri says she offers prenatal care for the mothers-to-be before sending them to doctors at 36 weeks to get authorisation for a home birth.

“The same doctor will ideally take care of the woman after or in case of any complication,” says Muchiri.

Once the birthing process begins, she says she is able to pick up on any danger signs and call the doctor or a hospital. A risk assessment is done to minimise potential danger and need for hospital transfer.

According to Dr. Murage, various factors must be put in place while talking about the safety of home births. They include:

  • the pregnancy must have been uncomplicated–both from the maternal and foetal points;
  • a spontaneous vaginal birth must be anticipated;
  • a skilled birth attendant must be available– to ensure adequate maternal and foetal monitoring, and to detect any unexpected abnormalities that may warrant immediate transfer to the hospital;
  • the designated delivery room at home must fulfill certain criteria such as adequate room, hygiene, etc and;
  • plans must already be in place for immediate hospital transfer if complications arise.
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