Susan Smartt Cook

Presumably, everyone knows that home birth midwives do indeed attend births in women’s homes. They might also know that most home birth midwives offer at least one, if not several, prenatal visits in the client’s home to see that the home is a safe environment for birthing, that the midwife has reliable directions, and that the birth supplies are gathered and ready. What many people don’t realize, though, is that most home birth midwives also offer postpartum visits in the home. This allows the midwife to check in on breastfeeding, to ensure that the new mother is recovering well, and to see that the baby is thriving. All of this can be done without the resting mother and her precious baby having to leave the comfy nest of their home. This in-home attention is convenient, reassuring, and in some cases critical for identifying postpartum complications in the days and weeks after birth, and referring them promptly for the appropriate level of care.


Ina May Gaskin, a pioneer of modern midwifery in the United States, has dedicated much time and energy to promoting gentle support and diligent care of the postpartum mother. She proposes that the tendency toward isolation and loneliness in the postpartum period is a major contributing factor to the prevalence of postpartum depression. According to Ina May, we do women a terrible disservice when we send them home alone a couple of days after birth, not to be seen for another six weeks. She even suggests that this is downright dangerous. [1] She proposes that the United States should learn from other countries’ care of postpartum women and recognize that women need to be visited in their own homes.[2]


The first tenet of the Midwives Model of Care as outlined by the Midwifery Task Force is “monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle.” The second tenet, “providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support,” reminds us that the postpartum period is an essential part of the whole childbearing cycle.[3] Some call this time the fourth trimester as a testament to the mother-baby dyad’s ongoing need for attentive care. It is not enough to provide thorough prenatal care, education, and informed consent. It is not enough to provide continuous support during labor and birth. It is crucial that women also receive focused support in the postpartum period, and home birth midwives are uniquely equipped to offer this level of in-home support and ongoing availability in the weeks immediately following birth.





[3] Copyright (c) 1996-2008, Midwifery Task Force, Inc., All Rights Reserved.