Are you curious about the ins and outs of homebirth? Want to know what it's really like to have a baby at home with the guidance of a skilled and experienced midwife?
I know I was curious before I had a homebirth …
In this exclusive interview, we sit down with Fresno homebirth midwife Lacy Chastain, Fresno Birth Midwifery, to learn everything from creating a birth plan to handling emergencies and preserving precious memories through photography.
So, grab a cup of tea and get ready to be wowed by the empowering and transformative world of homebirth!
Christina: How long have you been a midwife and what got you into midwifery?
Lacy: I got into midwifery from the experience of my births. My first birth was a hospital birth. Very standard, no complications, but I ended up on the induction train. I went to 42 weeks, and everything was going fine but was told that I needed to have a baby, for no other reason than being 42 weeks. So, I had an induction. Pitocin, epidural, the whole 9 yards. Not really anything traumatic about my birth, but I didn't like feeling out of control. I felt like everything was being done to me. I wasn't given informed consent. I wasn't being educated about what was happening, or things that I could do to help my birth go better.
So, with my second I hired a midwife and had a homebirth. Just the drastic differences between the two, I was in shock. Like, "what in the world? Why aren't people being told about all the different options and the care, and all the different things that could be better?"
From there, I started teaching childbirth education. I got certified and I was teaching people how to advocate for their births, mostly in the hospital setting to get the birth that they wanted. From there, my students started asking me to doula at their births... then I ended up a doula at a homebirth, where the midwife didn't have an assistant, and she asked me to step out of the doula role and into the role of the assistant. The midwife then encouraged me to become her assistant to be her assistant at all her births. So, I did that for a while, and then the midwife encouraged me to turn in all my hours and become a midwife.
The entire journey was about 12 years, I've been licensed [as a midwife] for 3 years now.
Christina: Can you walk me through the homebirth process, from initial consultation to the actual birth?
Lacy: Sure. At the consultation we sit down with the family and ask & answer all sorts of questions to/from the family to make sure we are the right fit. Homebirth is definitely not for everyone, and not all midwives mesh well with every person, so it is definitely important to have a consultation and ask those questions to make sure you feel safe with the midwife, personality wise. Birth is a very intimate experience, so you want to make sure that your care team fits well with you and your family.
After that consult, if you decide to move forward with us, then we see you prenatally, just like an OB. We see you every 4 weeks until 28 weeks, every 2 weeks until 36 weeks. At 36 weeks we come to your house for a home visit and we talk about the dry run of what the birth will look like. If you're going to have the pool, where are we going to put it. If not, where do you think you might be birthing. If you have any special instructions on getting into your house if it happens to be in the middle of the night...etc.
After 36 weeks, you return to us at the office and see us weekly until the birth. At the birth, we come to your house and setup. Ideally, we're there about an hour or two before baby arrives. During your labor you are in constant communication with us. We have a live stream contraction app that streams your contractions to us, so we are watching them from home. Texting back and forth & checking in. How are you coping? How are you doing? Here are some things you can try.
When you are ready for us to come, we come. Sometimes that is several hours before the birth, and sometimes it is right when baby is coming, depending on how quickly you are letting us know. But ideally it is about 1 - 2 hours before baby arrives.
When we arrive, we bring in all of our medication. We are licensed midwives, which means we are licensed by the State of California, which means that we can provide you with all the lifesaving medication that you could get in the hospital. So, we are bringing things for hemorrhaging, oxygen, resuscitation equipment for baby, that type of thing with us. We get that all setup & ready for delivery. Once baby arrives, baby goes skin to skin with you. Everything is very calm. We wait for the placenta to be born. Once the placenta is born, then we cut the cord. We typically don't cut the cord until the placenta is out.
If baby is needing any attention, everything happens on you. We never take baby away or anything like that. Once the birth process is finished, we check for tears, get you into bed, get baby snuggled in next to you and then we work on cleaning up the house, so it doesn't look like you had a baby there. Then, we do a complete newborn exam on the baby. We are licensed to act as the baby's pediatrician during the first 6-weeks. So, we do a full newborn workup - checking baby's oxygen levels, heart rate, making sure all their parts are in the right spot & working correctly. Then, once you and baby are stable, and everyone feels ready to go to bed, we pack up our stuff and leave. We're typically there after the birth anywhere from 2 - 4 hours. Then we check in every couple hour when you are awake. We return back to your house about 24 hours later to do another full check on you and baby. Then again, we come back anywhere between 36 - 72 hours. And as long as baby & mom are doing great, then you return to us at the office at one week.
Then, everybody's postpartum is different. Some people are seeing us weekly, especially if they don't have a pediatrician, and we're doing weight checks, mental checks for Mom to see how you are doing postpartum. So, sometimes it's weekly, sometimes every two weeks, etc.
Christina: How do you work with families to create a birth plan that is specific to their needs and preferences?
Lacy: Because we are working with you directly the whole pregnancy, the entire birth plan is tailored, based on our relationship. Typically, what is happening, currently, in our OB setting here in the Central Valley, you're seeing your nurse practitioner, you're seeing a random person in the office. You're rarely seeing your OB and you're rarely seeing the same person more than once. So, during those 9 months, we are seeing you every time, and we're discussing what you want, what you don't want. so that by the time your birth happens, a [written] birth plan isn't really necessary because we've been planning it the entire time.
Christina: How do you work with families to create a birth plan that is specific to their needs and preferences?
Lacy: Because we are working with you directly the whole pregnancy, the entire birth plan is tailored, based on our relationship. Typically, what is happening, currently, in our OB setting here in the Central Valley, you're seeing your nurse practitioner, you're seeing a random person in the office. You're rarely seeing your OB and you're rarely seeing the same person more than once. So, during those 9 months, we are seeing you every time, and we're discussing what you want, what you don't want. so that by the time your birth happens, a [written] birth plan isn't really necessary because we've been planning it the entire time.
Christina: How do you help families prepare for the possibility of transfer to a hospital during a homebirth?
Lacy: During a couple of prenatal visits, we walk about what transport looks like, reasons why we would transport, and how that would happen. Transport is always a possibility in every birth, so we want everyone to be educated and prepared ahead of time. So, we're trying to give all that information just in case and this is what it looks like.
During labor, we definitely prefer to transport not in an emergency. We're having those discussions during the labor if things look like they might go that direction. One thing might look like, baby's heart tones are going down, which can happen for a lot of reasons, and they might not be an emergency right away, and so once we're seeing the heart tones [go down], we're having a conversation with the whole birth team. "Hey, these are the heart tones that we're seeing. We're not really sure what's going on, but here are some things that we can try. Does everyone feel comfortable trying these things, for let's say 2 hours, and then re-evaluating after that 2-hour mark to see what is happening?" If we're still getting non-reassuring heart tones, then we will have further conversations that we recommend transport and here's why. Let's do this before you need a c-section, or things are too out of hand, and making that decision way, way before there is any kind of emergency is our ideal situation.
Christina: How do you work with families to capture and preserve memories of their birth experience through photography?
Lacy: We provide a list of birth photographer recommendations. If there isn't anyone there, and if Glenna & I are able, we will grab our phones and try to take some pictures as the birth is happening. If we can. We can't promise that, but if everything is going well, we'll both try to whip out our phones and take some pictures. We definitely encourage birth photography, or having a family member take pictures.
I hope you enjoyed learning about the world of home birth and the possibilities it holds. It's a unique and empowering experience that can be a reality with the right support. Don't be afraid to dream big and trust your gut when making decisions about your birth. And remember, with a home birth, you'll have a midwife who's not only knowledgeable but also fun, making your birth experience safe and memorable.
Watch the Full Interview with Fresno Midwfie, Lacy Chastain
An Interview with a Homebirth Midwife
Watch the full interview with Lacy Chastain of Fresno Midwifery
