Melanie Downie - Independent Midwife based in Plymouth, Devon

Evidence

Homebirth

Homebirth is my area of expertise and if you book me, you will get all that knowledge and expert care.

Birthing in the sanctuary of your own home, attended by an experienced homebirth midwife who will promote physiology. Homebirth is a safe and evidenced based place to birth your baby. I will work with you throughout your pregnancy as we get to know one another to really allow you to feel safe, nurtured and supported. Over the course of your pregnancy, we will work together to give you all the knowledge and power to birth your baby at home.

Birthing at home increases your chances of

Homebirth decreases your chances of

Intervention such as

Harm such as

Homebirth also reduces your need for pain relief, especially an epidural.

Some evidence says; if this is your second or subsequent baby then they are at no increased risk of harm or a poor outcome if you birth at home, if this is your first baby the risks are slightly increased (9/1000 at home vs 5/1000 in a birth centre or hospital. (Birthplace 2011) However a Lancet (2020) review of homebirths looked at neonatal outcomes and found no difference between women having their first baby and women having their subsequent baby on rates of their babies needing additional support or being very unwell after birth.

These resources may help you to decide if homebirth is right for you and we can discuss this in any initial consultation. They are supported by NICE which provide guidelines of care nationally for maternity care providers

NHS - Your choice where to have your baby (women having their first baby)
NHS - Your choice where to have your baby (women having their first baby)

Follow the below links to the Lancet series on homebirth which took in to account 500,000 low risk births. Its findings stated homebirth was a very safe option for women having uncomplicated pregnancies with many advantages for both mothers and babies.

maternal outcomes and birth interventions
perinatal or neonatal mortality among women

Continuity of carer

Continuity of carer is regarded as ‘Gold Standard’ of maternity care. This means you see the same midwife throughout your pregnancy, birth and postnatal period.

There are many evidenced and documented advantages to having continuity of care by the same known midwife. Sadly, this is something you are unlikely to experience when you book for NHS care, where you may see a different midwife for each appointment.

Having the same midwife throughout means you only need to tell your story once, I can support and advocate for you at any NHS or obstetric appointments, knowing what your wishes are and helping you understand the evidence. It also means that when it comes to labour I am a trusted and safe individual in your birth space, meaning you can surrender to birth knowing I will hold your space, keeping you and your baby safe.

Continuity has been shown to reduce a whole host of adverse outcomes for you and your baby including.

Reduces your chance of needing a caesarean birth in labour or requiring an assisted birth with suction cup (ventouse) or forceps.

A reduction in your likelihood of experiencing things like needing your labour sped up with a drip (augmentation of labour), needing an episiotomy ( a cut in your perineum at the time of birth) and your chance of having a postpartum haemorrhage (bleeding heavily after the birth)

You also have an increased chance of

Sandall J, Fernandez Turienzo C, Devane D, Soltani H, Gillespie P, Gates S, Jones LV, Shennan AH, Rayment-Jones H. Midwife continuity of care models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2024, Issue 4. Art. No.: CD004667. DOI: 10.1002/14651858.CD004667.pub6.