“Home birth? I wouldn’t have a home birth because of the mess. Yuck!”

For years, decades really, I have heard similar comments. In the early 1980’s, when I first heard statements like this, I was confused: I had seen of lot of planned home births and they weren’t particularly messy. (But, toddlers eating spaghetti? Now that is messy!) Then I saw my first hospital birth. And suddenly I understood. Once the baby was out, the room looked like a bloody bomb had exploded. It was gross. And then the mess was just left for housekeeping to pick up -linens dumped on the floor, no longer sterile scissors, clamps and drapes left uncovered on the surgical cart. Seeing that hospital birth, I finally understood the culturally accepted idea that birth was messy, and the real concern that planning a home birth meant your home would become a hazmat scene.

As an assistant to midwife Vicki Wolfrum, I saw about 500 planned home births before I ever saw a planned hospital birth. As an assistant, one of my jobs was to clean up after the birth. This usually meant starting one load of laundry, having a next load ready to start, and carrying one (generally small) bag of trash to the garbage bin. We were always cognizant that this was a home, and like good campers, we should leave the place we were visiting a little cleaner than we found it.

Besides being polite, avoiding messy is just healthier. When I started attending births, in the early 1980s, the term Universal Precautions had not been coined, but cleanliness, common sense and general decency certainly existed. Birth is going to involve some amount of fluids so being prepared with absorbent materials (like towels and disposable under-pads) only makes sense. It also makes sense to avoid creating a mess, and to clean up as soon as possible, especially if bodily fluids are involved.

Fast forward several decades, I am a midwife, and in my practice, Local Care Midwifery, about a month before the due date (ah, due dates, that’s a whole other subject), my assistant and I visit the expectant client’s home for a prenatal visit, The usual prenatal visits things are accomplished (like checking blood pressure, measuring the pregnant belly, feeling baby’s position, listening to the fetal heartbeat). Besides the ‘medical’ check up, we describe signs that labor might be starting, and we talk about when to call the midwife. And we check the client’s stash of birth supplies -stacks of flannel baby blankets, bath towels and washcloths, a roll of paper towels, non sterile gloves, disposable under pads and yes, a trash bag.

This pre-birth home visit is common in home birth practices and something I learned from my own midwife and mentor, Vicki Wolfrum. It is important that the clients have their supplies ready and accessible, and that they know when to call the midwife (this is REALLY important). It is important of the midwife and the assistant to know where the home is (this is REALLY important), where the supplies are, and generally what the home is like, (including where is the garbage bin and the washing machine). While the main goal is a healthy mom and baby, everyone being happy, and a clean and tidy home are added benefits.

Birth story:

Once, long long ago, in coastal Southern California, Vicki  (midwife) and I (midwife assistant) were doing a prenatal home visit This was the couple’s first pregnancy and consequently it was a child-free home. And it had just been redecorated -new paint, new carpets, new couches, new bed linens. And everything was white. Yep. White. Everything was clean, pristine and very, very white. Looking around at all this white perfection, Vicki and I snuck a glance at each other, both silently thinking “Egads, I hope we don’t make a mess on Birth Day!”

A bit later during the visit, Vicki asked the client what her plan was for dealing with the umbilical cord, was her husband going to cut the cord? The wife laughed, “Oh no! He is terrified of blood, passes right out at the sight of it.” The husband chimes in, also laughing, “Yep. It’s true. I will take care of ALL of the diapers, but no, not cutting the cord.” So now Vicki and I are just sure that this is going to be the one time we have a truly messy birth scene -first time mom, white carpets, AND a dad that is terrified of blood? Oh dear…

Fast forward three weeks and it’s show time. The woman is hot and heavy in labor, alternating positions on her bed, starting to feel pushy, and Bam! She jumps out of bed, and squats on that beautiful white carpet and starts birthing her baby. Being the dutiful birth assistant, I immediately slid absorbent pads under her bum.

This first time mom birthed her baby, leaning up against her bedside table (yep, it was white), while her husband sat beaming on the edge of the bed (yep, all white linens). That baby slid out, beautiful, clean and shiny, not a smudge of blood or mucus anywhere on her perfect baby soft skin. That baby was so clean, she looked Photo-shopped. Vicki stole a glance at me, and we both internally shook our heads, thinking that we’d gotten lucky, and knowing that the placenta was yet to come…

About 15 minutes later, holding her sweet baby, this new mamma felt some cramping and pressure and she delivered the afterbirth into a waiting bowl. (You may ask, how big is a placenta bowl? Check out this book.) She then cut her baby’s umbilical cord while dad looked away. After assuring that the no longer pregnant uterus was reacting nicely, Vicki and I helped the mom up onto her waiting bed, white sheets and white duvet folded back, pillows fluffed. I then hurried to clean up before dad would see any blood.

Looking down, at the birth pads, my mouth dropped open. At this point in my career as a midwife assistant, I’d seen a lot of births but this was remarkable. On the absorbent pads that I had thrown on the floor just as mom jumped from the bed, where she had birthed her baby and placenta, there was one spot of blood, maybe the size of a half dollar. That was it. One spot.

Hours later when Vicki and I left the new family tucked into their cozy bed, we marveled at the house of white, and the incredible ability of this woman to give birth just like she lived -clean, efficient and passionately loving her (squeamish) husband.

I have seen a lot of home births, and most of them are pretty tidy. But this one, well, it took the cake!

May all babies be born into loving hands