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Safe, calm care for you and your baby
after birth at home
What Happens After a Home Birth?
Your baby is here. There is no rush. This time belongs to you.
There is often so much focus on preparing for labour and birth that very little is said about what happens afterwards.
If you are planning a home birth, you may wonder what happens once your baby is actually in your arms. Do the midwives leave straight away? What happens with the placenta? Who checks the baby? What about stitches? And who clears everything up?
The hours immediately after a home birth can be a wonderfully calm and unhurried part of your experience.
My role is to continue caring for you and your baby while giving you the space to enjoy those first precious moments together.
The First Moments With Your Baby
Once your baby is born, provided you and your baby are both well, there is usually no need to rush.
Your baby can come straight to you for warmth, skin-to-skin contact and those first moments together.
I will continue to observe you both while keeping unnecessary interruptions to a minimum.
There is something particularly special about being able to do this in your own home. You are already in your own space, surrounded by the people and things that are familiar to you.
You don't have to go anywhere.
What Happens With the Umbilical Cord?
If you and your baby are well, there is no need for the umbilical cord to be clamped immediately.
We can discuss your preferences for delayed cord clamping during pregnancy and as part of your birth planning.
When the time comes, you or your birth partner may wish to cut the cord, or I can do this for you.
There is no ceremony you have to follow. It is entirely your choice.
What Happens With the Placenta?
After your baby has been born, we will wait for the placenta to be delivered.
There are different ways of managing the third stage of labour, and we can talk about these options before your birth so that you understand what they involve.
Throughout this time, I will continue monitoring how you are feeling, your blood loss and your physical wellbeing. If your bleeding is heavier than I would expect, I will assess what is happening and where necessary, offer medication to help your womb contract and reduce the bleeding.
Once the placenta has been born, I will check it carefully to make sure it appears complete.
Your Baby's First Feed
Some babies are interested in feeding quite quickly. Others need a little more time.
There does not need to be a race to achieve a feed within a particular number of minutes.
Keeping your baby close and having uninterrupted skin-to-skin contact can give them time to settle and begin showing feeding cues.
Whether you are planning to breastfeed, bottle feed or combination feed, I can support you with those early feeds and help you get started in a way that feels comfortable for you.
Checking You After the Birth
While you are getting to know your baby, I am still very much your midwife.
I will monitor your wellbeing, including your observations, blood loss and how your uterus is contracting after birth.
When you are ready, I can also check your perineum to see whether you have experienced a tear and discuss with you whether any stitches are recommended.
There should still be time to explain what I am doing and why.
If I have any concerns about your wellbeing or feel you need further medical assessment or treatment, I will discuss with you and you partner, where necessary, arrange transfer to hospital for appropriate care.
Giving birth at home does not mean compromising on your postnatal checks.
Checking Your Baby
Your baby will also receive appropriate newborn checks after birth.
Some observations can happen quietly while your baby remains with you.
When the time is right, your baby can be weighed and examined, and I will talk you through what I am checking.
Where possible, I want these checks to fit around those first moments rather than those first moments having to fit around the checks.
What if I Need Stitches?
If you have a perineal tear that requires suturing and it is appropriate to do so at home, this can usually be carried out after the birth.
I will explain what I have found, whether I recommend stitches and what will happen.
Local anaesthetic can be used to keep you comfortable.
If a tear needs assessment or treatment that cannot appropriately be provided at home, I will discuss this with you and arrange for you to receive the appropriate care.
What Happens if You or Your Baby Need Hospital Care?
Planning a home birth also means talking honestly about the possibility that you or your baby may need hospital assessment or care.
Most of the time, the postnatal period at home progresses normally. However, if I become concerned about either of you, I will explain what is happening and recommend the appropriate next steps.
If transfer to hospital is needed, your care does not suddenly stop being personal.
I will support you through that change in plan and make sure the relevant maternity team has the information they need.
Who Cleans Up After a Home Birth?
This is one of those questions people sometimes feel slightly awkward asking!
You are not expected to give birth and then immediately start clearing everything away.
Part of our job after a home birth is making sure the birth space is left safe and tidy.
Birth equipment will be dealt with appropriately, and we will help clear away the things used during the birth.
If you have used a birth pool, we will discuss beforehand what is involved in emptying an packing it away.
The aim is for you to be concentrating on your baby and your recovery, not worrying about the room.
Getting Comfortable
Once the immediate checks are complete and everything is settled, there is something rather lovely about being able to get comfortable in your own home.
You might want a shower, need to pass urine, fancy something to eat, pop on some fresh clothes or simply to climb into your own bed with your baby.
And yes, this is often the point when somebody finally makes a cup of tea.
There is no discharge lounge and no journey home.
You are already there.
When Does the Midwife Leave?
I will not simply pack my bag the moment your baby arrives.
I stay after the birth to make sure that you and your baby are well and that those important immediate postnatal checks have been completed.
Before leaving, I want to know that you are comfortable, your baby is well, feeding has been supported, you know what to look out for and you know how to contact me if you are worried.
The exact amount of time will depend on you, your baby and how the birth has unfolded.
I leave when it is clinically appropriate to do so, not because a clock says your appointment has finished.
What Happens After the Midwife Goes Home?
Then comes a rather extraordinary moment.
The midwives leave, the door closes, and you are at home with your new baby.
But you are not suddenly on your own with no support.
Postnatal care continues after a home birth.
I will continue to check on your physical and emotional recovery, your baby's wellbeing, feeding, weight and anything else that needs attention as you settle into those early days together.
And questions are expected.
Nobody has a baby and suddenly knows everything.
The Beginning, Not the End
A home birth does not finish when your baby is born.
Those first hours are part of your birth experience too.
They are about making sure that you and your baby are safe and well, but also about protecting something that can never be repeated: the first time you hold your baby, the first feed, the first time your partner holds them and those quiet moments when it begins to sink in that they are finally here.
My role is to provide the clinical care you both need without unnecessarily taking over those moments.
Because after all the preparation, all the waiting and all the work of labour, this is the part you have been waiting for.
You get to meet your baby.
If you are considering a home birth and would like to talk about your options, get in touch to discuss how I can support you and your family.