Who will attend my home birth?
We are very fortunate to have a team of midwives dedicated to facilitating birth at home. The Surrey Hills Team provide a 24/7 service to women requesting to have their baby at home within the catchment area of the Royal Surrey County Hospital.
We aim to ensure that you have met the midwife attending your home birth during your pregnancy. During early labour advice will be given over the phone and the midwife may come to your home to assess the progress of your labour and make a plan of care. She may leave again if you are in the earliest stages of labour however you will remain her priority and can contact her at any time.
You may be asked to consent for a student midwife to attend your birth. Home birth is an excellent way of teaching our students how to care for women experiencing normal labour and birth.
As the birth of your baby becomes more imminent a second midwife will be called to attend, we are supported by both our community and hospital colleagues.
How do I contact the on call midwife?
The on call midwife can be contacted by calling any of the numbers you have for the Team. At night all calls are diverted to the midwife on call.
If for any reason you are having difficulty contacting the on call midwife please telephone the Delivery Suite for advice. The delivery suite midwife will contact the on call midwife and get her to contact you or give you advice.
Delivery Suite telephone number is 01483 464133
When should I call the midwife?
All women are welcome to contact their midwife if they have any concerns or anxieties.
If labour begins during the day it is useful for us to know early in the labour so that we can re-organise our workload.
If labour begins at night, you can contact the delivery suite for advice but if you feel that you require the support of your midwife please contact her directly.
If your waters break without contractions please phone delivery suite at night or your midwife during the day for advice. It is particularly important to let us know immediately if the waters appear green, brown or yellow.
Once you are in established labour a midwife will stay with you at home.
How can I help the midwife get to me quickly?
It is helpful if your home is easily identifiable by the midwife. If it is night please put on an outside light or lights in the doorway until she has arrived. If your home is not easy to access or does not have an obvious number or name plaque displayed, please arrange for an adult to meet the midwife at the door, gate or nearest accessible tarmac road.
Please advise us where to park if access is difficult.
How will the midwife monitor my well-being during labour?
Throughout the labour the midwife will take your temperature, pulse and blood pressure at regular intervals with your consent.
She will encourage you to have a regular intake of fluid and a light diet and to have rest as well as active periods throughout your labour.
She will encourage you to empty your bladder at regular intervals for your comfort and to ensure that your bladder does not become overfull.
How will the midwife monitor the baby’s wellbeing during labour?
The midwife will ask you if she can listen to your baby’s heart beat at regularly intervals with a hand held sonicaid. Every 15 minutes is recommended throughout the first stage of labour (before you are fully dilated) for at least one minute following a contraction.
In the second stage of labour (when you are fully dilated and want to start pushing) every five minutes or after each contraction is recommended.
The midwife will monitor the colour of the waters after they have broken, as the colour combined with the baby’s heart rate may be a sign that the baby is distressed.
Who can be with me during the birth?
Most women choose to have a birth partner present for support in labour. This may be your baby’s father a relative, friend or doula or a combination of all of these. It is your choice regarding who you would like to be present at the birth but we recommend not having too many people there.
It is helpful to have another adult available to:
• care for your other children
• make or answer phone calls
• assist the midwife in carrying her equipment to and from her car
• make the tea!
What if I need stitches?
All team members are confident and competent in perineal repair. The midwife helping you birth your baby will guide and advise you to help prevent tearing of the perineum. We would suggest antenatal massage of the perineum to help reduce the risk of tearing and the use of a hot pad applied to the perineum during crowning if you are not having your baby in water.
Small tears may be left to heal naturally. This is an assessment that the midwife will make with your full discussion as to whether this is a suitable decision. We will give you advice regarding hygiene, analgesia and monitoring for signs of infection.
Should you require stitches the home birth team midwives are able to suture simple tears at home. If we are not able to make you comfortable or the tear is more complex you will need to transfer to hospital for stitching. If this is necessary your baby and your support person could accompany you in the ambulance, or follow in their vehicle. You would be discharged home afterwards using your own transport.
What about vitamin K?
Please refer to the information in your hand held notes or speak to your midwife.
What happens after the birth?
We will stay with you for at least an hour after the birth of your baby. If you wish to breastfeed we will help you to put the baby to the breast as soon as possible. Before we leave we will ensure that you have a telephone number which you can call if you have any worries or concerns at anytime, either call the on call midwife or Shere Ward 01483 464134.
We will discuss your postnatal care and make a plan. Depending on the time of day arrangements will be made for a further visit later in the day or early the following morning. We will arrange for either your GP or a midwife who is trained to come to perform the newborn examination. In some circumstances, for example on a bank holiday you may be asked to have this check performed in the hospital.
We recommend that all new mothers arrange to be cared for by a friend or relative for 5-7 days after their baby is born.
If you have a Rhesus negative blood group it may be necessary to have postnatal Anti-D injection, we will arrange this within 72 hours of birth.
What if there are any problems during the labour?
In certain circumstances the midwife will advise that transfer to hospital is necessary. Please see the “Transfer to hospital” section of this site here
Is it possible I will be refused a home birth?
We are committed to meeting the demand for home births in our area, however there are occasions when women simultaneously labour at home and a midwife may not be able to attend you immediately. If this situation occurs a plan will be discussed with you over the phone. It may include an invitation into the unit for assessment and in exceptional circumstances beyond our control we may ask you to birth in the MLU – although this is extremely rare.