Janine O’brien ‘iBirth’ | Understanding the ‘model of care’ and professional standards behind Homebirth assessment, communication and professional standards.
In this Midwife At Your Door video interview, Janine provides a clear understanding of the clinical structure behind homebirth. The conversation demonstrating that decisions are guided by assessment, communication, and professional standards. This interview highlights how safety and physiological birth are supported together within the home setting.
Topics explored in this video
This interview explores how midwives clinically assess and monitor labour during a homebirth while supporting the natural physiology of birth. The conversation explains the observations midwives use to ensure labour is progressing normally, how they monitor both mother and baby without unnecessarily disrupting the birth environment, and the signs that may indicate when additional support or medical intervention is required.
The discussion also addresses how midwives make decisions about hospital transfer when needed, including how those conversations take place with families and how transfers are organised in real time. It highlights the importance of calm communication during unexpected situations and outlines the professional guidelines, training and clinical accountability that underpin midwives’ decision-making.
Viewers also gain insight into how midwives balance supporting physiological birth with maintaining safety, and how they collaborate with hospital teams if care needs to transition. The interview explores common misconceptions families may have about risk in homebirth and explains how preparation, trust and continuity of care help reduce fear and build confidence throughout labour. Ultimately, the discussion provides a clear understanding of what safe and successful homebirth care looks like from a midwife’s perspective.
Video Transcript
So we met that change-the-world women are always the women that no one knows what to do with. And I feel like that’s you. Thanks. I feel like that’s you.
So Janine, when a woman comes into your care, how does that look? Talk us through from the beginning. Once you’ve met, she’s gone through all the questions, you’ve decided that you’re going to work together, and we can go backwards afterwards and look at the questions that typically families ask you. When you begin that journey with a woman, talk us through what that looks like.
Well, it depends if it’s your first or third or fourth baby with me, because usually if it’s someone I’ve known before, they usually call me after they’ve had sex and they’ve peed on a stick. So I’m the first person that they usually call after they tell their husband or their partner, which is really nice. Some people even plan their lovemaking around my holidays and ask if I’m going to be available. So it’s actually preconception as well, which feels strangely odd, but it’s nice to know that they want me there.
Word of mouth is often how people reach out. Usually we meet for an initial meeting because I really believe that it’s such a personal journey that you need to feel really safe, and you can usually sense that in a first meeting with someone. If I’m going to be the right person to walk with you on such an incredible journey, bringing your little people into the world while you go through this really incredible rite of passage, that connection matters.
Usually we meet first, and then I say go away, have a feel about it, talk with each other, and then get back to me. I have clinics in Bilgola and Annandale, so a lot of the antenatal care happens there. Sometimes I also visit the woman’s home in the early days of pregnancy if it works out with other women in the area that I’m already visiting.
We do everything together. We talk about hormones, relationships, family life, and everything that surrounds pregnancy. It’s not just about the medical aspects. It’s about preparing for birth and for becoming a parent. Antenatal visits allow time for conversation, education and emotional support, as well as clinical care such as checking blood pressure, measuring the baby’s growth, listening to the baby’s heartbeat and reviewing any tests or scans.
Over time the relationship develops, and that continuity of care becomes really important. By the time labour begins, the woman and her family already know the midwife well, which helps them feel calm and supported. Labour and birth are then attended by the midwife, often with a second midwife present for safety and support.
After the baby is born, care continues at home with regular postnatal visits. These visits focus on the wellbeing of both mother and baby, including feeding support, recovery, newborn checks and emotional support for the family during those early weeks.
For many families this continuity of care is one of the most valuable parts of the private midwifery model. Instead of navigating pregnancy, birth and early parenting with multiple different caregivers, families are supported by someone who knows their story and walks with them throughout the whole journey.
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