Independent midwives and homebirth in Belgium
Independent midwives can care for you during your pregnancy, birth and after your baby is born. For most ex-pat women in Belgium a home birth is not considered as a possible option. But, with the support and care of an Independent Midwife it is possible and here's how...
Home birth in Belgium is supported by Independent Midwives and if you feel a home birth is right for you then you need to seek an independent midwife who can support home birth. Birthing your baby at home is not just restricted to second and subsequent pregnancies. But, to be able to give birth at home, you need to meet certain criteria:
your pregnancy has progressed normally and you and your baby are healthy
you have reached term (37 – 42 weeks)
your baby is in the ‘head down’ position
You live within a 30-minute drive from a hospital. This is in case you need to be transferred to hospital during labour should your midwife feel it is safer for you or your baby.
With an independent midwife you can give birth either in one of the Brussels hospitals that currently allow independent midwives to deliver babies (currently CHU St-Pierre Brussels centre, Erasme Anderleccht, Ste-Elisabeth Uccle, CHU Brugmann, Ixelles-Etterbeek, Clinique Sainte-Anne Saint Remi Andelecht). If you live outside Brussels then you would need to check with your midwife or your local hospital to see if they offer this service. When you choose this option your own midwife cares for you during your labour at home and then in hospital and delivers your baby. She will take care of you and your baby during your postpartum period in the comfort of your own home and help you establish breastfeeding on a one-to-one basis. NOTE: not all independent midwives can support births in these hospitals, as it depends on individual agreements.
Hopital Erasme is the only hospital in Belgium to have a midwifery-led maternity unit, Le Cocon. The unit actively promotes natural childbirth and midwife care for you throughout your pregnancy and childbirth.
How much does care with an independent midwife cost?
Unlike hospital births, home births and midwife appointments are fully reimbursed by the mutuelle/ziekenfonds (social security organisation). Your midwife’s additional expenses (such as petrol etc.) are at your cost. You may have to pay a contribution towards blood tests and scans, unless you have top-up insurance. It is a good idea to investigate what health insurance you have anyway, just to make sure you are covered for all eventualities.
Home Birth Care With An Independent Midwife
Before your baby is born
Each midwife, whether she works independently or within a team, normally has a partner midwife to help with deliveries. She is also connected to a hospital and a gynaecologist. Most (if not all) of your routine prenatal checkups will be with the midwife, although you will be able to visit the hospital for scans and the standard prenatal blood tests. It is a good idea to visit the maternity facilities of the hospital and meet the gynaecologist anyway, just in case things don’t go according to plan at home.
During your labour
Your midwife will provide you with a list of equipment (e.g. waterproof sheets, sanitary towels etc.) you will need to get for the birth. She will bring her own equipment such as oxygen (in case it is required) a Doppler to monitor your baby’s heartbeat etc.
Your midwife may visit you on and off at home during the early stages of labour. Once you have reached established labour she will remain with you until your baby is born. If the midwife detects even the smallest hint that your pregnancy or labour is not progressing as it should, then you will be referred to a hospital and a gynaecologist. A home birth is attended by two midwives. The midwives will remain at your home for several hours after the birth to ensure there are no unexpected developments. She will also make sure everything is tidied up afterwards and you and your baby are washed and tucked into bed before leaving you and your family to gently get to know each other.
Pain relief at home
There is no artificial form of pain management (such as gas and air) available here for home births. Physiotherapy sessions or taking a prenatal or hypnobirthing course prior to the birth can help you develop breathing and relaxation techniques, and during your labour your midwife can give massages to help you cope with contractions.
You may want to consider using a TENS machine. You can rent these from the Brussels Childbirth Trust (but you would need to be a member), online, or from your pharmacy.
After your baby is born
A midwife will drop by for a visit every day for up to two weeks after the birth in order to assist and offer advice, and a visit to the GP is also required within the first week after delivery.
Finding a Midwife
Flemish Professional Organisation of Midwives (Dutch)
Union Professionnelle des Sages-Femmes Belges (French)
Both organisations provide information on how a midwife cares for you in pregnancy, birth and after your baby is born. Plus a search function on how to find a midwife near you.
The power of women, and their families, is strengthened by the power of the midwife.
Further Reading
● Homebirth, a practical guide. Wesson, N. (2006) London, Pinter & Martin
● New Active Birth. A concise guide to natural childbirth (chapter 10: Active Birth in home or in hospital). Janet Balaskas
● Water Birth – a concise guide to using water during pregnancy, birth and infancy. Janet Balaskas and Yehudi Gordon
● The Father's Homebirth Handbook Hazard, L. (2010) London, Pinter & Martin
● Homebirth: The Politics of Difficult Choices. Nolan, M. (2011) Abingdon, Routledge
Online Resources
● www.nct.org.uk/birth/faqs-home-birth
● www.nct.org.uk/birth/what-do-i-need-home-birth
● Homebirth Reference Site Horn, A. Available at: www.homebirth.org.uk
