Information about how the homebirth trial will operate, including when you will meet your midwives and what you can expect from a homebirth is outlined in the three FAQ sheets:
Having a homebirth
Who should consider having a homebirth?
Homebirth is not for everyone. If you meet the eligibility criteria and think that you will feel comfortable labouring and giving birth at home then you could consider a homebirth.
Are there any advantages of having a homebirth?
Women have reported that they feel more comfortable labouring and giving birth in their own environment. They also say that they feel more in control of the situation.
Does the level of care provided for homebirths differ to what’s provided at the hospital?
The care provided to women in their homes will be the same as the care provided by midwives in the Birth Centre.
When should I apply?
- View the self assessment criteria
- Read the FAQS to learn more about the trial and homebirth in general
- At your Maternity Options service appointment which your GP will refer or you may self-refer to (Ph 51249977) occurs at approx. 10wks of pregnancy the midwife will discuss all models of care including homebirth. If you are interested in homebirth your name will be placed on the continuity waiting list. You will be contacted by one of the homebirth midwives around 14-16wks to discuss further.
What is the process once I’ve booked for a homebirth?
Confirmation of a place in the homebirth service will not be finalised until a midwife has met with the woman and assessed her suitability for a place in the service. Suitability for the service is based on factors such as the eligibility criteria, geographical location, and her position on the booking list.
Who will staff the homebirths?
Two Canberra Midwifery Program (CMP) midwives will attend each homebirth including one primary midwife and one support midwife.
Current practice for CMP midwives conducting a hospital birth is for the primary midwife to call another midwife when a birth is imminent. This process will be the same for home births. This additional midwife is known as the support midwife.
Will water births be available under the service?
Water births are not currently offered with the homebirth service. However, women will be able to labour in water if they wish, such as a bath/birth pool or shower.
When will I meet my primary and support midwives?
The primary midwife will undertake a full assessment following acceptance into Continuity program. Your primary midwife will arrange for you to meet other health professionals who will provide care for your planned homebirth, including the support midwife.
You will continue to receive comprehensive midwifery services throughout the continuum of your pregnancy, childbirth and the postnatal period, from your primary and support midwives.
What is the role of my midwife when I am in labour?
Your midwife will closely monitor you and your baby by listening to your baby’s heartbeat and regularly checking your blood pressure, pulse, temperature and progress of labour. Your midwife will offer professional and emotional support to guide you through your labour and openly discuss any changes needed to your birth plan in order to maintain your safety and that of your baby.
What equipment will be required for the birth?
When you have reached 36 weeks gestation, your midwife will provide you with a homebirth kit which will contain the routinely used equipment for your birth. Two oxygen cylinders will be delivered from British Oxygen Company (BOC) to your home, they will call to arrange a time. A medication pack from the Hospital Pharmacy, to store in your refrigerator.
What facilities will be needed at home to enable homebirth?
An overview of requirements needed for a birthing space at home is identified in the general self assessment criteria, but your primary midwife will also assess your home for suitability.
What pain relief can I have during a homebirth?
Most women choose to use water therapy, or water immersion in a bath or other natural remedies including massage, heat packs, and movement and positioning. You may also choose to take paracetamol (panadol) to ease the discomfort. Pharmacological pain relief such as epidurals and nitrous oxide gas will not be available for homebirths.
What happens if I need to be transferred to hospital during my homebirth? And what is the transfer process?
Your midwife will advise you if there is a need for transfer to hospital. The reason for transfer could relate to you or your baby. This may be in your car or the midwife may decide to call the ACT Ambulance Service.
If I am transferred to hospital, will I keep my midwife?
Yes, you will have the same primary midwife throughout the duration of your birth, whether that is a homebirth or you are transferred to hospital.
What happens if I change my mind about homebirth? Can I go to hospital at any point during my labour?
If, during labour, you decide that you would prefer a hospital birth rather than a homebirth, you can raise your concerns at any point with your midwife and they will discuss the transfer option with you. Your primary midwife will continue to care for you in the hospital.
Can my family be with me during my homebirth?
Yes, you will discuss with your midwife who you would like to support you during labour, birth and after your baby is born.
What happens after the birth?
Your midwife will stay with you until you and your baby are safe, comfortable and breast feeding well. Your primary midwife will continue to be available by phone and will visit regularly at home.
Will my baby be checked by a doctor?
No, as in the hospital, the midwife will undertake the first assessment of your baby following the birth. If the midwife has any concerns collaboration with a neonatologist can occur and/or transfer into hospital if required. However, if you wish to have your baby checked by a doctor, you can visit your general practitioner at a later date. A Maternal and Child Health nurse will also visit you at home in the first month after you've given birth.
Safety and risk
Homebirth is a good option for women who are well supported by qualified health care professionals and who are at low risk of childbirth complications. The homebirth program is well integrated with mainstream maternity services and this adds to the safety of the program. You will receive continuity of care by midwives who will monitor your health throughout your pregnancy, labour and birth, identifying (as much as possible) if risk factors arise that makes home no longer the best place for your birth.
How will complications be dealt with during the birthing process?
It is important to note that complications can arise in any pregnancy. Ongoing assessments throughout your pregnancy and birth will occur, to monitor you and your baby. The midwife may determine that you need to be transferred to the hospital if complications are identified.
The ACT homebirth trial has detailed procedures about the transfer process should you, or your baby, need to be transferred to the Centenary Hospital for Women and Children. In the event of an emergency, the ACT Ambulance Service will attend as quickly as possible to assist your midwife with this transfer.
As this is an ACT first, do we have the expertise required to undertake homebirth safely and efficiently in the ACT?
Two midwives will be present at every homebirth. All homebirth midwives are highly experienced and they work in close collaboration with a team of midwives, obstetricians and neonatologists at the hospital.
All ACT Health midwives observe the current codes, guidelines, and professional standards published by the Nursing and Midwifery Board of Australia and ACT Health policy.
How will infection control be managed throughout the trial?
Your midwife will ensure that infection control principles are adhered to in your home. They will ensure that equipment and processes align with ACT Health policies. Arrangements will made for all essential equipment to be at your home approximately four weeks before your baby is due. All clinical waste from the birth will be removed from your home by the midwives present at the birth.
Is there ACT Health insurance for the trial?
Yes, your ACT Health midwife will have indemnity insurance cover as part of their employment contract.
What evidence is there that homebirth is safe?
Current published evidence demonstrates that planned homebirth, with a qualified midwife, is a safe alternative for women deemed to be at low risk of childbirth complications.
Evidence also tells us that women at low risk of birthing complications have the same outcomes, whether they have their baby in a hospital or in their home with a qualified midwife.
Continuous assessment and monitoring during pregnancy, labour and the postpartum period will assist in managing and reducing any risks that may arise.
What are the risks associated with having a homebirth?
It is important to note that there are risks associated with every birth, including homebirth.
There are extreme circumstances where labouring and birthing at home increase the risk of poor outcomes to mother and baby. While they occur infrequently, the most common emergencies are excessive bleeding from the mother or failure of the baby to breathe after it is born. Our midwives are experienced in managing both of these situations.
In the event of an emergency, your homebirth midwife will make urgent contact with the ACT Ambulance Service to transfer you and your baby to the hospital.
Background, implementation and cost
The cost of the homebirth service is met within existing ACT Health resources, utilising midwives currently employed at the Canberra Centenary Hospital for Women and Children. These midwives will deliver the services throughout the trial.
The homebirth service is publicly funded and as such, if you have a valid Medicare or Asylum Seeker card, your homebirth will be free of charge.
Why is ACT Health servicing homebirths in the ACT?
The service has been developed in response to community interest in providing more public birthing choices for women in the ACT.
Who is eligible for the service?
Women who meet the requirements set out in the self assessment criteria.
To be eligible for the homebirth service you need to:
- be aged between the ages of 18 and 40 years
- live within the homebirth catchment area
- have current ambulance cover, and
- live in a safe working environment for birthing that has:
- adequate lighting
- access to clean hot water
- pets that can be secured out of the birthing area
- easy access to the home for emergency vehicles
- parking availability for two midwives, and
- reliable phone access at all times.
- have one or more birth supporters from family/friends who:
- support your decision to have a homebirth
- are available to be present throughout your labour, the birth and the recovery period to provide support to you and your baby, and
- are available to care for your other children if necessary.
- have had at least one, and not more than four, previous healthy pregnancies and uncomplicated births and recovery periods
- be healthy and have a Body Mass Index no greater than 35 at the 36 week pregnancy check
- have regular antenatal care with a health professional
- have a current uncomplicated pregnancy progressing normally, and be less than 8 months pregnant at the time of enrolling in the trial
- attend a 'suitability for homebirth assessment' appointment with your midwife on or before the 36th completed week of this pregnancy
- be more than 37 and not more than 42 weeks pregnant at the time labour begins
- have a single pregnancy with the baby in a head down position before labour starts
- wish to labour naturally and:
- plan to use only natural remedies for pain relief during labour. Pain relief medications including epidural and nitrous oxide will not be offered.
- understand that you will be able to labour in water if you wish i.e. a bath, but the service does not offer water birth (the baby being born under water).
- agree to receiving medication via an injection to assist with the delivery of the placenta once you have given birth.
The eligibility screening will continue right up until you go into labour. If any issues are identified you may be required to be transferred to the Centenary Hospital for Women and Children to give birth.
If you meet the above criteria, please:
The service is also only available to eligible ACT women who reside within the trial catchment area, within 15 minutes travelling time from the Centenary Hospital for Women and Children (30 minutes round trip).
Why is the service not available for all ACT women and women in NSW who live within the catchment area?
For the purpose of the homebirth trial, women need to reside within 15 minutes travelling time of the Centenary Hospital for Women and Children, to ensure the highest level of safety for participating women and their babies (30 minutes round trip).
NSW women are not eligible at this time because they are not within the required travelling time from the Centenary Hospital for Women and Children. Priority will also be given to ACT residents.
How much will the service cost?
The cost of the trial will be met within existing ACT Health resources. Midwives currently employed at ACT Health will deliver the services throughout the trial.
Do I have to pay to use the service?
The homebirth trial is publicly funded so your homebirth will be free of charge if you have a valid Medicare or Asylum Seeker card.
How will the service be evaluated?
The service will be evaluated by ACT Health staff and stakeholders, including those making use of the services, on an ongoing basis. An external and independent evaluation occurred at the completion of the service.
Recommendations from the service evaluation are currently under review.
Do other states across Australia have the option of publicly funded homebirth?
Publicly funded homebirth is currently available in the following Australian jurisdictions:
- South Australia
- Western Australia, and
- Northern Territory
- New South Wales
How many planned homebirths are there in Australia?
The Australian Institute of Health and Welfare (AIHW) reports the number of homebirths every year in Australia, with planned homebirths accounting for approximately 0.3 per cent of all births.
Has homebirth previously been available in the ACT?
Homebirth in the ACT has previously only been available in the private sector.