A lot of work and preparation goes into planning and preparing for a home birth. Shopping for and setting up the nursery are such fun as you anticipate birth. Lining up pet sitters, or child care for your little ones, getting a car set and stocking up on diapers are all part of being ready for baby's arrival.
Taking a childbirth education class, finding a doula, deciding if you want a birth photographer, deciding if you want to use a birth pool or not, reading books and watching videos about breastfeeding are some of the things I encourage clients to do to be prepared for labor, and the immediate postpartum.
Sometimes though, even though you have gotten all the things, have all the help lined up and have everything ready, plans will change at the very last moment. I operate from the principle of the Boy Scout Motto: Be Prepared. Being prepared means having a basic birth plan written out, and having a bag packed and ready to go with the essentials you will need for a birth at the hospital. Being prepared means having the car seat installed and ready to use, as well as giving the petter sitter and child care providers a heads up that you might be calling on them soon.
There are many reasons plans can change. Baby's heart rate may tell me that we need more help than we have at home. Mom may not respond to the tools I have to stop bleeding if it's too much. Mom may decide she wants pain relief. Mom may start running a temperature, or her blood pressure may become higher than is safe for a home birth. These are just some of the reasons plans may need to change.
When plans change from home birth to hospital birth, I like to let the hospital know we are coming and why. I also like to send them pertinent records, and lab results so they have time to look them over and be familiar with past care before Mom arrives. I will go to the hospital with Mom and Dad if they want. Because of hospital rules on how many people can be with Mom, sometimes parents want the doula or a family member to go instead. If that is the case, I will be available by phone. My assistant will stay behind to do a thorough clean up. Once Mom is home from the hospital, I will do postpartum care if Mom wants me to.
While it is stressful to change plans, sometimes we need to change them. To lower the stress for everyone, I try to hold space for my client and family to adjust to the idea that birth will now happen in a hospital, and I work to have a smooth transition to the hospital setting. In the end, I want families to feel heard, respected and cared for regardless of where birth ends up happening.