HOW TO HAVE A HOMEBIRTH IN QUEENSLAND WITH A LICENSED AND REGISTERED MIDWIFE 

Most people normally start off by sending an email to your midwife. Your midwife then sends you her statement of services outlining cost, her birth philosophy etc. On the right hand side of this webpage here, you will find the .pdf versions of all of the initial information that you would require for homebirth, with the exception of the Contract / Service Agreement and details of fees. Click on each these .pdf's(right) to have a look and then press "back" on your browser to return to this page. Your individual midwife will have variations to these documents and / or may have other additional documentation for your perusal during your initial introduction to homebirth.

When you are deciding whether or not homebirth is the right option for you; you can gather some research and useful links from our site at the pages: homebirthservices.com.au/homebirthlinks or homebirthservices.com.au/safety or homebirthservices.com.au/decisions . There is also Dr Sarah Buckley's site- sarahjbuckley.com and homebirthsa.org.au . Another site is childbirthconnection.com. This site details the results from the Cochrane Database (on which our hospital policies are supposed to be based). The difference is, this site lays out the research in easy-to-understand terms and language and is very easy to navigate. To read the chapters of their book online, you just register your details (it's free / government subsidised). The Home Midwifery Association QLD (HMA - homebirth.org.au) is another good source of further information. They run meetings where you can meet other mums who have had a homebirth. For online support, try joyousbirth.info . You may also be interested in getting a feel for the political issues with homebirth by watching "The Business of Being Born" - a documentary on homebirth in the USA by Ricki Lake (who birthed at home). The issues on this film are pertinent to Australia as well! At any stage of your informed decision making process, the midwives are happy to assist you. Just contact them with any questions you might have with regards to your particular individual needs and values for your birth.

No doubt; an important deciding factor in the process is the fact that unfortunately, homebirth in Queensland is currently only available as a privately funded health care service. In other words, none of your midwifery or homebirth fees are claimable through medicare, although your tax agent could assist you with current information about claiming these expenses on your tax return. If you are looking at joining a private health fund, you will need to do this 12 months before your baby is due to be born. Further information about private health insurers covering midwifery care and homebirth is available from the website: http://www.homebirthsa.org.au/HBN-PrivHlth.htm

Should you wish to go ahead with a homebirth, the next step in the process is to arrange to meet your midwife where you can discuss your needs and values in order to create the perfect birth experience for yourself and your family. We can then organise a Booking-In visit, where your midwife can review your pathology results and previous medical history. From there, all the steps in the process can be explained to you and your partner as you go along.

The following is some information about the process of homebirth in Queensland. PLEASE NOTE: THIS IS GENERIC INFORMATION ONLY. EACH MIDWIFE WILL HAVE SLIGHTLY DIFFERENT ARRANGEMENTS TO THESE. PLEASE CHECK THEIR "STATEMENT OF SERVICES" FOR DETAILS.

ANTENATAL INFORMATION

Initial Visit: The first time you meet your midwife would probably be at your house at our "Introductory Visit". In this visit you have the opportunity to ask anything you need to know about your midwife so that you can feel secure in your decision to engage her as your midwife. This visit usually takes up to two hours.

Antenatal Care: All visits are conducted in your home at a time suitable with you and your family. They usually are between 1 and 2 hours long. (See "Schedule of Antenatal Appointments" as a guide to what is covered at each antenatal appointment).

Our usual timing of antenatal visits, in line with the NICE Guidelines (UK) are recommended as;

- Booking-In 
- 16 weeks
- 20 weeks
- 24 weeks (if 1st baby or new partner this pregnancy)
- 28 weeks
- 31 weeks (if 1st baby or new partner this pregnancy)
- 34 weeks
- 36 weeks
- 38 weeks
- 40 weeks
- 41 weeks

After booking in: Your midwife will be available via telephone at any time during office hours and outside of office hours for urgent support. Examples of urgent support could be for conditions such as;

- If you are less than 36 weeks pregnant and have painful tightenings
- If you are 36 weeks pregnant or more and have painful, regular tightenings, coming every 5 minutes, lasting longer than 45 seconds
- Any bleeding from your vagina
- You suspect your waters may have broken
- Constant abdominal or back pain
- Feeling extremely unwell and need to see a doctor immediately
- Uncontrollable vomiting and/or diarrhoea
- Your baby is moving very much less
- Unusual headaches and/or blurred vision, or constant epigastric pain unrelieved by antacids.

PRESCRIPTIONS REQUIRED FROM YOUR DOCTOR FOR YOUR HOMEBIRTH:

- Syntocinon (in case of haemorrhage after birth)
- Syntometrine (in case of severe haemorrhage after birth)
- Xylocaine 1% (local anaesthetic in case of stitches)
- IM Maxolon (in case of severe vomiting during labour - if desired)
- Vitamin K / Konakion injection for the baby (if desired)
- Hepatitis B injection for the baby (if desired - to be administered in a clinical setting in case of severe reaction)

PATHOLOGY REQUEST FORMS FOR:
- Antenatal booking bloods (including: FBC, RPR, Group and antibodies, HIV, Hep B, Hep C, Rubella)
- 28 week bloods (including FBC and antibodies, GCT (if desired)
- 36 weeks bloods (FBC - includes Haemoglobin level)
- Baby's cord blood (for Rhesus negative mothers) - requesting blood group, Rh factor and Direct Coombes test (checking for mother's cells in the baby's blood)
- Mother's blood test (for Rhesus negative mothers) for after the birth "Kleihauer" test (checking for fetal cells in the mother's blood)

ULTRASOUND REQUEST FORM:
- 18 to 20 week ultrasound request (if desired)

PATHOLOGY REQUEST FORMS FOR ANTI D FOR RHESUS NEGATIVE MOTHERS X 3 TIMES - (IF DESIRED) SAYING "PLEASE SUPPLY ANTI D":
- 1 at 28 weeks
- 1 at 34-36 weeks
- 1 within 72 hours of birth

**Please ensure your midwife's details are on the request slips to obtain copies for your homebirth record**

**ALSO REQUIRED FOR SOME HOSPITALS IN QLD IS A GP REFERRAL TO YOUR BOOKING-IN HOSPITAL IN CASE OF TRANSFER**

Oxygen: Before 36 weeks gestation, your midwife will fax a letter to a supplier to arrange your oxygen cylinder. It is preferable to have this at your home from 36 weeks onwards. Your midwife will then give you a copy of the letter for your records. If you do not hear from them, you might like to give them a call anyway to open your account in time for the birth.

Referral letters:
• Your midwife will provide a referral to your booking-in hospital with her details and your booking information, history etc
• Some hospitals also require a referral from your GP to the hospital
• Your midwife will provide a letter outlining her contact details to your GP, asking them to provide copies of any pathology results for her.
• Your midwife will send a referral letter to your GP after the birth, in case of any follow-up required.

LABOUR AND BIRTH

Your midwife will remain with you throughout active labour and the birth of your baby and placenta. She will then remain with you for around 3 to 6 hours after the birth. A second midwife may be called to be present during part of your labour or during the birth of your baby. (You are not charged extra for this).

AFTER THE BIRTH

Postnatal Care: Initially your midwife will visit within 24 hours after birth. If this is not possible (due to unforseen circumstances) then another midwife will visit or will telephone you to assess how you are feeling and settling in with your new baby. Then your midwife will visit you daily for the first 3 - 5 days as your needs require. Usually, postnatal visits and (breastfeeding assistance) are Day 1, 2, 3, 5, 7, 10 14 and at 6 weeks although your needs may require more or less visits.

GP visit for Newborn Health Check

Recommended at Day 5-10 after birth.

Healthy Hearing Test

To be organised through the booking in hospital soon after birth (after 34 weeks gestation and before 3 months of age). Your midwife will assist with this.

Centrelink, Family Assistance and Medicare Forms

Your midwife will give these to you. Lodge them before 26 weeks after birth of baby.

Include on application form midwife's registration details, name, address, contact number.

Application for Birth Certificate:

Your midwife will give this to you. It is compulsory to register. Register within 60 days of the birth - then it is free of charge. For a fee, you can order a standard full birth certificate. You will need a separate form for each child in a multiple birth.

Registry of Births, Deaths and Marriages
PO Box 15188
City East, QLD 4002

Child Health Referral

If required, this will be completed by your midwife when baby is 6 weeks old

Qld Health Child Health Line (24 hours) for information and advice:

PH: 13-HEALTH

GP Visit for Postnatal Check for Mother

Recommended at 6 weeks postnatally.

Can discuss issues such as contraception, pap smear, postnatal check.

Australian Breastfeeding Association (24 hours)

PH: 1800 686 2 686