Your Birth ChoiceThere are many different birth options available to you. Find out more about each one to see which is right for you. You are able to decide on your choice at any time and can also change your mind if that option no longer suits your needs. Home Birth A qualified midwife of your choice cares for your pregnancy, birth and afterwards at home. In Australia this option is not covered by Medicare although some private health insurance does cover homebirth – you need to check with your insurer. Your experience* - At home, pre-labour will shift imperceptibly into full labour, without any changes of attendants.
- You will remain in familiar surroundings with no need to travel while in labour.
- Once notified, your midwife will come to your house and stay with you throughout.
- Your membranes normally will be left to rupture spontaneously.
- You will be encouraged to seek relief of pain without the aid of drugs. However, pain relief will be available from your midwife in the form of gas and air or pethidine if it is prescribed by your doctor in advance.
- Your midwife will try hard to help you retain an intact perineum thus avoiding an episiotomy.
- Your partner and family can be an integral part of the birth.
- After the birth you will be free to celebrate as you choose.
Your baby’s experience* - Your baby will benefit from the relaxed atmosphere at home and will have exactly the same care from your midwife as if he’d been born in a hospital.
- Your baby’s heart rate will be monitored by a foetal stethoscope or a hand-held sonic aid.
- He will emerge into the skilled hands of the midwife, or be caught by your birth partner.
- Once breathing he will be given to you immediately after his birth and may suckle spontaneously.
- His umbilical cord will be clamped and cut once it has stopped pulsating.
- The skin-to-skin contact your baby experiences as you give him a welcoming cuddle may help him to start breathing.
- The midwife will weigh and examine the baby; there will be no hurry to clean him up.
Further information on homebirth is available at from The NSW Midwives Association and www.homebirthsydney.org.au It is important to have a good relationship with your selected pregnancy practitioner as it is an emotional and personal journey you are on. If you find that you have not chosen well, don’t be afraid to change to another doctor or midwife. Hospital Birth The Medicare system in Australia covers all births in public hospitals. This is where you attend an Antenatal clinic attached to the hospital and see midwives and doctors throughout your pregnancy that work at that hospital and give birth in the Delivery Suite. You need a referral from your GP to the hospital and then they take over your care or you can choose ‘shared care’ where the GP also attends some of your care. Some larger Maternity Units also have Birth Centres, where a small team of midwives care for you during your pregnancy and birth, so you are more familiar with your carers before you go into labour. A birth centre also adopts a more natural approach to birth without as much intervention. This childbirth option is very popular in Australia so if you are considering this option it is a good idea to book in early. You also need a referral from your GP and then contact the birth centre directly. If you decide that you want to nominate a specialist doctor (Obstetrician) to care for your pregnancy and birth a cost will be involved. Private health insurance usually covers some of this cost and you may also be given the option to give birth in a Private Hospital. An Obstetrician is specially trained to assist with complicated pregnancies and you may be referred to one during your pregnancy if problems arise. You may have a preferred Obstetrician in mind otherwise your family doctor may be able to point in you in the right direction. You should book an appointment ASAP as good obstetricians fill up quickly. Remember when making your decisions to check which hospital or birthing centre your obstetrician delivers at. Your experience* Your experience of giving birth in hospital will vary depending on your choice of hospital and professional attendants, but will probably include the following procedures. If you wish your experience to be different, you must talk to your doctor or midwife. - You will probably travel to hospital while you are in labour.
- You will go through brief hospital admission procedures.
- Your membranes may be ruptured and foetal monitoring equipment set in place.
- If labour slows down, or stops, you will probably be given oxytocin to stimulate uterine contractions.
- Pain-relieving drugs of different types will be available.
- Your birth partner will usually be allowed to stay with you during labour and the birth.
- You will probably be attended by shifts of different midwives and doctors, especially if you are in labour during the night.
- An episiotomy may be performed to ease the delivery of the baby’s head and prevent possible injuries to your perineal or vaginal tissues.
- You will probably be given Syntocinon to reduce the risk of bleeding after the placenta is delivered.
- You will be given your baby to hold after the birth and be encouraged to start breastfeeding.
Your baby’s experience* - Your baby will be born surrounded by medical staff with the expertise to handle any problems that arise.
- An electrode to measure her heart rate may be attached to her scalp during labour.
- With the exception of epidural anaesthesia she will experience any drugs that you are given, and this may mean that she feels drowsy or is slower to feed once she is born.
- She will be handed to you to cuddle and get acquainted with for a few minutes.
- Her umbilical cord will be clamped and cut as soon as she has been born.
- She may have her mouth and nose suctioned routinely to clear them of any mucus.
- She will be weighed and examined (Apgar score) by the doctor or midwife.
- She will be returned to you, possibly cleaned and wrapped in blankets, to begin bonding and breastfeeding.
- At a later time she will be thoroughly examined by a doctor for any abnormalities.
Choosing a Hospital* What to consider There are many things that you will need to think about or investigate when you are choosing a hospital in which to give birth. Here are some questions to ask yourself or others, before you decide. 
- What sort of birth do I want?
- What birth facilities are on offer in my area?
- Am I prepared, or able, to travel for antenatal care? Can it be provided by my doctors?
- What sort of reputations do the hospitals in my area have? Have I got as many different opinions, from as many different sources, as I possibly can?
- What are the staffs at the different hospitals actually like? What are their views on labour and birth? Do I agree with them? There may be a difference between hospital’s policies and the way staff actually approach childbirth.
- Do I want a special care baby unit to be immediately on hand?
- How long do I want to be in hospital for, and what sorts of rooming-in facilities are on offer?
- Do I want to feed my baby when and how I feel like it?
- Do I want my baby with me at night? All night?
- What are the visiting hours?
- Can my partner (and children) be with me whenever I want?
- Can my partner stay with me the first night after the birth?
Questions to ask Once you have chosen a hospital, find out as much as you can by asking questions. - Will I be able to wear my own clothes and personal effects (rings, contact lenses, spectacles)?
- Can my partner or friend stay with me all the time? Will they ever be asked to leave?
- Will I be able to move around freely during labour, and give birth in any position I choose?
- Will I be able to have the same carers throughout labour?
- Can I bring in my own midwife to attend to me throughout labour?
- Are beanbags, birthing chairs, and stools provided?
- Does the hospital offer birthing pools? If not, will I be able to use a hired one?
- What is the hospital policy on pain relief, electronic monitoring, and induction?
- Will I be able to eat and drink if I want to
- What is the hospital policy on episiotomies, caesareans, and the expulsion of the placenta?
- If I tear or have an episiotomy, are the midwives allowed to suture me, or will I have to wait for a doctor to attend to me?
* Dr Miriam Stoppard MD FRCP, Conception, Pregnancy & Birth, Dorling Kindersley, Australia 2002
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