Insights from an Australian midwife on birth preparation and prenatal education.
Danae sits down with Australian midwife Lu McCarthy to show you what you will never see in antenatal classes. Going through a Homebirth midwife’s bag can help expectant parents feel more confident and informed about the safety of Homebirth.
Danae and Lu show the clinical equipment midwives bring to a Homebirth and how it differs from what you might see in a hospital birth room.
Topics explored in this video
Looking through a private practice midwife’s birth kit offers a fascinating insight into the tools used to support safe and physiological birth. In this midwife interview, Lu opens her kit and walks through the essential clinical equipment she carries when attending a home birth.
Much like the equipment found in a hospital birth suite, Lu’s kit contains the key clinical supplies needed to monitor and support a normal physiological birth.
While every midwife’s kit may vary slightly depending on their practice style and personal preferences, the core items are generally very similar.
This interview provides a thoughtful perspective on the homebirth model of care, showing that alongside clinical knowledge and preparation, birth is also shaped by relationship, trust, and the creation of a calm environment where physiological birth can unfold naturally.
Video Transcript
Let’s go get Lou.
Lou is my personal doula educator and mentor. She’s a home birth midwife, she’s unbelievable. And I can’t wait to blow up a birth pool with her today, and talk about everything that she does to support women in the model of care of home birth at home. She’s here.
Hello. Oh, this is gonna be fun. This is my beautiful name.
When you have a really good connection with your midwife like that, you are the most important person to them in their life.
Yeah. Yeah. I know.
And then when they run into you, like not expecting to, it’s this sort of surprise. It’s the same for us though, when we see them. It’s got little growing babies. I haven’t seen this little baby since she was six weeks old. She’s 14 months today.
And I think that just goes to show the relationship that you have with women. It’s lifelong.
It’s lifelong.
Because you go on such a massive journey with them. You’re not meeting them just for the first time, working out what their name is, and then processing them through your shift, and potentially leaving before they’ve even had their baby. You’re seeing them from the beginning to the end.
Yeah, and beyond.
Yeah, and the family.
Do you think now, looking back, starting your birth work like this as a doula, was that a good foundation for you for your midwifery practice?
I think every midwife should have to be a doula first. We are not bound by the policies and the recommendations and all of the other things we have to say. We can just be a wealth of information and say, here’s all the information, you make the decision.
And sometimes we’re sitting with women who would make really different decisions to us, and then you go, this is good. It teaches us things. And to go into midwifery, we’re already with that.
It changes the way that you can work as a midwife, because it’s those deep foundation layers that are really well set up. Women will make different choices to me, that’s okay. I can support women who decline things.
I found as well that having the ability just to, without having to focus on anything clinical, just sitting with women in labour is really where it’s at. To learn about them and to learn about birth, before then adding onto that with all this incredible clinical skillset that adds the next element of safety.
We are learning from the women. Always keep that at the base of everything. You’re not learning from an education system, you are learning from the women. It’s all these snippets from what we teach, these little nuggets of information that you can hold onto, and then you go into the space, and that’s where the learning begins.
Lou, hello. Nothing gives me more pleasure and pride to be here with you today. I feel like it’s such a long time coming that we are here together to do this.
Absolutely. And let’s go through what you bring to a home birth. So when you arrive, the woman’s in labour inside, what do we walk in here with?
So I usually bring everything in with me in one go, if I can. Some of the things that we don’t need until after the birth, I keep in the car. So I bring in my birth kit, my resuscitation equipment, and my antenatal bag, which has got the doppler and blood pressure, all of the things that I would use at every antenatal visit.
Yeah. So you’re happy for us to go through?
Absolutely.
It’s like Christmas.
Interestingly, because you’ve had so much experience working at a big tertiary hospital, what’s different about what you have here compared to what you’ll find in a birth unit room?
I guess the things that we have in here that are clinical are here for a reason. We actually have everything in here that we would need in a hospital setting, as far as supporting a woman to have a normal physiological birth.
Some of the things that we’ve got in here, I’ve got medication that we would use for sterile water injections. If a woman was feeling nauseous in labour and we were giving her antiemetics. The drugs that we use for postpartum haemorrhage, I give to the women when I give her her pool, and they stay in her fridge.
That way, on the off chance they need to stay refrigerated, and on the off chance that I’m somewhere not expecting to be called, then I know that the woman has got the medication there. Any medication that doesn’t require refrigeration can stay with me.
And so you drop that off, that medication goes in the fridge with the pool at like 37 weeks?
Around 36 to 37 weeks.
It’s a little box. It’s got everything in there that we need.
My kit stays with me everywhere I go. It never leaves me.
It’s so organised, Lou.
It always has to be.
But the thing is, because I use a variety of second midwives, I don’t always have the same second midwife with me. The reason I got the clear packaging is so that you could see what was in each pack. It makes it really easy for the midwives to be able to find something if you’re saying, actually, can you go and get me something?
I feel like the second midwives that I work with, at every birth, even if they’ve done a birth with me recently, they just sort of scan through the kit themselves when we’ve got time, to go, okay, everything’s here that we need.
And when you work with the person that you work with the most, they know your bags so well they could almost pack it for you.
Absolutely. Your bag is their bag too.
Exactly.
So we’ve just got gloves and gauze, all of the equipment that we would need for suturing.
So by suturing you mean if a mum has any graze or tear after the birth, you can do all of that at home?
We can. The only time that we would transfer is if we thought it was a third or fourth degree tear. If I thought that was the case, we would think that maybe the woman would have to go to theatre to have them sutured properly.
But smaller tears, first and second degree tears, if required, would be sutured at home. More often than not, though, if the tear is sitting very well and not bleeding, then we know the research shows us that those tears actually heal better without suturing.
Just on that, because I think so many women go, oh, transfer, the whole thing’s failed, right?
Yeah. And that’s not the case at all. Because if you need to transfer for something like that, that doesn’t mean that you have gone outside, you’ve had your baby at home, and you’re within a model of care. You are still under the care of Lou. And that doesn’t mean that everything that you’ve done to be in that model of care is all wasted now because you’ve had to transfer for a tear at all.
Absolutely. And it’s also very rare. It’s not common. We know that the transfer rate is sitting at about 10 percent, which involves everything that you could transfer for, but it is actually about a model of care.
And any scenario where a woman was going to the hospital, I would be going with her, for whatever that procedure would be.
Awesome. Okay. What else you got, Lou?
We’ve got things for your cord ties. I also have cord clamps in there, plastic cord clamps, that we don’t use in a home birth setting unless we needed to immediately cut or clamp the cord.
So if this cord snapped, or something happened where we needed to make sure that we could cut that off properly, then we would do that. That’s why they’re in with the cord ties. I haven’t experienced that, but you’re prepared for all potential scenarios.
Exactly. If on the off chance something like that could happen, you’re saying get a cord clamp, you want to know one, and the second midwife knows where to get one.
What else have I got here? Oh, this is all just the potions. Clary sage, rescue remedy, some herbs to help with the placenta releasing, blood loss, things like that.
Which I have seen work.
Oh, amazingly.
And then this is just my tea bags.
You need your tea.
Lou needs a tea, so this is important.
I feel like all the women also know I need my tea. There’s often tea.
Then we’ve just got needles and syringes, lube, things like that.
And this part here, this is all the stuff that I use for a water birth. And this is all what’s stacked up on the shelves in the hospital.
Absolutely. Everything that’s here is what’s stacked. Those hospital rooms are minimally shelved with stuff too.
Exactly. You don’t need a lot of stuff for birth. But they are stocked with, you know, 10,000 pairs of gloves. One, because they need a lot more gloves than what we need. They’re bulk stacked, everything’s bulk stacked.
The other thing that I do have in here is episiotomy scissors, which is also very rare. But you want to have access to that equipment quickly if we need it.
Preparing for all scenarios.
Preparing for all scenarios.
And then this is my mirror. The golden mirror.
Love that mirror. We know when the mirror comes out that we are looking. It’s serious. We’re looking for heads.
It’s getting real.
I’ve got three torches in here, just in case one of them goes flat.
You midwives all got a thing about who’s got the best torch.
Yeah. I’ve seen that. Who’s got a waterproof torch?
Been through quite a few different types of torches.
Absolutely. This one’s good because it’s little. It’s easy to hold and it’s easy to pass on to another midwife if you need to.
Do you find most women do have their babies in the bath at home?
By far. Most.
I’ve got a woman at the moment who’s told me that she doesn’t want me to drop off a pool. It’s so weird when women say that. I’m like, you sure you don’t want it just in case?
She just doesn’t want a pool. She wants a land birth.
Ah, cool.
So no pool.
No pool.
Fair enough.
I’ve got a couple of thermometers in there, to be honest. I feel like we can tell by touch. If we are needing to warm up a pool, we usually just add more boiling water.
So you have the pool filled, and then you can top it up with pots of boiling water?
Yeah. For families that are trying to get their head around what that looks like, you’ve got your water in your pool. If time lapses or mum gets in and out of the bath, she’s used it in one part of the labour, you fill up saucepans on the stove, and we are just pouring in boiling water, stirring it through to keep the temperature of the pool.
Exactly.
And it depends, like if women have got ongoing hot water supply, that makes things a lot easier. Sometimes the water’s run out, then that’s when we’ve got all the pots going.
And then there’s the sweet spot of timing it, and saying, okay, we need to get the pool ready again. Sometimes we’re bucketing out some of the water in that scenario to be able to fill it up and keep it warm.
I’ve never though, in all the births that I’ve done, like if people worry about their hot water system, I’ve never been at a birth where we haven’t made it work.
Oh no. Not at all. So easy. Even if you’ve got four saucepans going at once.
Absolutely. We’ve always made it work for women.
If you just unzip this side, this is the side that is not used as much.
So in here we’ve got all the equipment for fluids and cannulation, vaginal examinations, amni hooks. If we were ever in a situation where we thought it was best to break waters, also something that’s not done routinely.
So for women, just with the medical terms. Cannulation for fluids, that would be if they’re dehydrated, if they’d been vomiting, and they just need fluids to get them going. Or if the woman had had a bleed after the baby was born and we were doing some fluid replacement to make the woman feel well.
Yeah, awesome.
And then in terms of catheter, that’s to help women wee in labour that are having a hard time weeing in labour.
Yeah, absolutely, to help empty the bladder.
So all of that equipment is all in this part. Sharps container to put any of our needles and all of the vials that we use. We’ve got a stack of blueys, thermometer, cleaning equipment, vomit bags. Stuff that we’re not using all the time is usually on this side.
This is the stuff that we more typically access, more so rebozo, all the things that we need.
And then my antenatal bag. This trusty bag that comes with me everywhere. My doppler and blood pressure, all of that is in that bag. That’s to keep an eye on the baby’s heart rate and mum’s heart rate during the labour.
Yep.
And this is what I bring to every antenatal visit. This is how we check on baby in the antenatal period.
And again, that’s exactly the same as what they would do in hospital in any other model of care.
Absolutely.
As far as documentation goes, I use an iPad during antenatal and postnatal visits. But during a birth I handwrite notes, and the second midwife will handwrite notes too. There’s nothing worse than hearing someone on the keys.
No.
It changes the environment, it’s just not very nice. You want to be able to sit gently in a corner without anyone really knowing that you’re there. So the handwriting notes is always much nicer.
I’m so happy that you brought that up, because what I see with home birth midwives is the nuance of how particular they are about making sure there is the perfect environment for the woman.
That’s the sound, the temperature, the smells, the lights, how they disturb, how they ask questions. Any tiny little details, down to making those tiny little noises, they do make a difference.
Yeah.
I think that really can change a birth environment. The light from the computer, all of it. It just doesn’t seem right.
Something that I’ve really started noticing lately is not just women’s eyes being sensitive to light. I see their body sensitive to light. If you really sit with women and really watch women in labour, those are the things that we really pick up.
Absolutely. Makes a massive difference. Unfamiliar light. Bright lights, any lights.
And in a home birth setting, sometimes it might be that lights get turned on by someone for something. So often the women will ask, can the lights be turned off, or we’re turning off the lights very quickly. You might be turning on a hallway light to make the bathroom dark, but with some light. Just that constant changing.
Which is so nice because you know where all your lights are at home.
Exactly.
There’s nothing worse than when you’re in a hospital room and there’s five switches, flick, flick, flick, and you can’t, especially in the private hospitals, you’ve got no control.
Absolutely.
At home you can control everything, because it’s your environment. And you’re inviting people into the space.
Yeah, makes a massive difference.
Okay, cool. So the only other equipment that I bring in with me is resuscitation equipment.
We carry oxygen, which is for the baby. Also not used very often, but certainly an important thing to have. Then we have a bag and mask. So we can use that with the oxygen, or we can just give the baby air through the bag and mask.
What I learned from two very experienced midwives was, on arrival at the home birth, to have this set up straight away, whether the birth was imminent or not.
So part of my arrival setup is that I set up the kit. It’s all laid out. Then I set up the resuscitation equipment so that we can have easy access to that if we need it. Nothing worse than rifling around trying to find things.
Yes.
Absolutely. And it’s safe practice, right?
Absolutely.
And I would imagine that helps the women feel safe as well, to know that all of the parameters that keep them safe in the birth are all set up ready.
Absolutely. In the unlikely circumstance you’re going to need it, you’re ready.
Amazing. Thank you, Lou.
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