Insights from an Australian midwife on homebirth care and antenatal education.
In this Midwife At Your Door video interview, Danae explores the practical structure of care provided through The Nesting Hub group practice model, asking questions that help families understand how continuity of Homebirth midwifery care works across pregnancy, birth, and the post-partum period.
Topics explored in this video
When a woman first contacts the Nesting Hub, the conversation begins with understanding her needs, preferences and pregnancy journey. From there, families receive personalised care throughout pregnancy, rather than following a rigid or standardised system. Midwives provide clinical antenatal care, support birth planning and prepare families for labour while building a strong relationship over time.
Care may include support across different birth settings if needed, and continuity of care remains central throughout the experience. Midwives stay with the family during labour and birth, with a second midwife joining to provide additional clinical support and ensure safe, collaborative care.
If plans change or a hospital transfer becomes necessary, midwives coordinate care and manage the process while maintaining clear communication with hospital teams. Emergencies are carefully planned for, and appropriate equipment, protocols and documentation are always in place.
Families are supported not only clinically but emotionally. Preparation during pregnancy helps partners and families feel confident about labour, pain management and the birth process. The familiar home environment often supports physiological birth by promoting emotional safety and relaxation.
Support continues after the baby is born, with midwives providing ongoing postnatal care, guidance and reassurance as families transition into life with their newborn.
This sequence of questions gives viewers a clear snapshot of the full discussion, highlighting how the Nesting Hub approach provides continuous, relationship-based maternity care while maintaining professional structure, safety planning, and clinical accountability.
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Video Transcript
What if I transfer?
What if there’s an emergency?
These are all the questions that people ask when considering home birth, and they’re totally missing the point.
It’s the most misunderstood model of care for birthing women and families out there.
I’ve got Nesting Hub inside. We are going to answer all of those questions and more. Let’s get to know these incredible women and let’s get to know the homebirth model of care with Midwives At Your Door.
So I’m here with Gail, Emma, and Kate, and you are The Nesting Hub, which is a beautiful collaborative group that work as a model of care in homebirth. So could you talk us through what that model of care looks like?
So what does it look like when a woman comes to you? What do they get through your services as Nesting Hub?
Well thank you Danae. First way you’re inviting us to be part of this. This is a really beautiful opportunity, so thank you. We’re really grateful to you for that pleasure and for showcasing homebirth and continuity of care, which is what we’re all about as private midwives.
So private midwives all work very differently. But at The Nesting Hub we provide an individualized model of private midwifery and continuity, which means that it is guided by what the individual client wants from us and what her needs and requirements are. And that really is what structures it.
So there’s no hard and fast “this is what we do”. Typically we would do four to six weekly visits up until 28 weeks. Then maybe a visit around 31 weeks, and then 34 weeks, then 36 weeks. Some people do from 36 to 38 weeks. Then we do weekly after that.
Some people once we get to 36 weeks want weekly visits and that’s absolutely fine. We are happy to customise it to meet their needs and requirements.
And then labour and birth for as long as it takes. And also we are 24/7 on call for these beautiful women and couples and families from 37 weeks onward.
What can you do at home?
You know, can you put cannulas in for giving women fluids if they get dehydrated or if they’re vomiting a lot?
Yeah. Can you empty their bladder if they need support with doing a wee if they’ve got a full bladder and can’t wee like they can do in the hospital?
Yeah.
What if mum has a tear?
Yeah we can all suture. And we have local anaesthetic to make that as comfortable as possible as well.
I think one of the biggest things that people ask me about is around pain management. We know there is so much more to birth than just pain, but a lot of people’s focus is around whether they can manage their pain or not.
So if you are in an environment where all those things are available to you and you’ve got someone knocking on the door going “sounds like it’s epidural time”, then you’re more likely to have that pain relief.
Whereas at home, what are the measures that you use to help women really work with their labour?
I think we prepare them for it, don’t we. We speak about it. And I think what’s really important is getting it through that this is a normal thing and it’s physiological pain. That’s a very different thing to experiencing, I always say to my women, something like stubbing your toe.
That’s a very different sensation. This is meant to happen and it’s a good sensation. It is meant to be intense, but you can do it.
Being at home facilitates that. It’s so much easier to be in a space where you feel comfortable and you can do what you want than in a room where you feel exposed and vulnerable.
When you’re safe and comfortable it’s easier to cope with.
And the best thing about home is you’re not stuck there. If it all becomes way too much, we have options. It’s not the be all and end all. You don’t have to stay in that point.
But it can really help.
We have a lot of second time mums who were in the hospital the first time and maybe had epidurals and have come to us this time to have a homebirth. Afterwards they all usually say that it was a lot easier to cope at home.
You’re more relaxed in your own home environment. You’re not confined to one room like you are at hospital. This is your house. You’ve got all your home comforts. There’s no restriction on movement.
You can go in all the different rooms, be in the bath, in the shower, on the toilet, walk around the garden, whatever you want to do.
We’re the guests in that house, so we’re not there to be saying what you can and can’t do. You’re free to eat and drink too. That’s a big one.
When you think about the neuroscience behind the way the body modulates pain, a huge part of that is social factors. Who is around you, the environment you’re in.
If you’re in an unfamiliar environment or you’ve got to get in the car and go somewhere and there are other people you’re going to run into and all the smells are different, you actually experience pain differently.
We are experts in getting people through that transition. It’s so normal for us to see it. We see it all the time.
Because we don’t have the same pain relief options available, we can’t just call an anaesthetist. We know how to get women through that.
And I always say to my women who have had epidurals before, that situation of having to sit there when you’re in transition, curved over with all the lights on while someone organises an epidural, that is so much harder than us being there with you.
We have the luxury of sitting with them and getting through every single contraction.
We have lots of little tricks up our sleeves.
Comfort.
And that’s certainly what I see in the difference between women that birth at home with private midwifery care compared to women in hospital.
I’m not saying there aren’t incredible hospital midwives out there. There absolutely are. But you specialise in getting women through that moment because this is what you do.
You touched on the key differences between the behaviours of couples at home compared to hospital. I’m really interested in hearing about how that plays out for dads.
You used the words the guest of the birth versus the host.
In hospital the birthing parents are the guests. In the home, the parents are the hosts and the care providers are the guests.
In hospital you see dads not knowing where to put their stuff, not knowing if they can turn the light on, not knowing where to go. Often you see them retreat into their phones.
But in the home they are calmer because they are in their own environment.
We talk about birth hormones like oxytocin and adrenaline, but they affect everyone. When a baby is born at home everyone experiences that oxytocin. Dads get that too.
If they’re scared in a hospital and don’t know the people, their adrenaline goes up. At home they know us. We try to have dads at as many appointments as possible so we build a relationship with them too.
And if we see dads struggling a little bit we can give them support as well, give them jobs to do, but mainly we want them to be with the woman helping keep her relaxed.
Lots of kisses and cuddling. Getting in the shower together. You can’t really do that in hospital.
We even put couples to bed together and say go to bed, have a sleep, maybe have some sexy time and wake up and have a baby.
Because the environment for birth should be the same environment that you feel comfortable having sex in.
Who goes to hospital and has sex in a hospital bed?
For partners as well, they don’t feel like they have to advocate constantly for the woman like they sometimes feel in hospital. They can relax and be the support the woman needs.
Partners can sleep in their own bed, cook food in their own kitchen, take the dog for a walk and know the woman is being well cared for.
What about other family members like kids?
We love kids in homebirth. Dogs, cats, animals and children.
It depends on the woman and what she wants for her birth. It’s not up to us.
It’s beautiful for families birthing for the second time who don’t have childcare support. Children can be part of the experience.
Animals and children are massive oxytocin boosters.
They’re involved in the antenatal care as well. Siblings get to listen to the baby’s heartbeat and start bonding before the baby is even born.
We encourage parents to read homebirth books to toddlers and preschoolers so they understand what’s happening.
If parents don’t want children there, that’s absolutely fine too.
Everything is centred around what the woman and family want.
Is there anything a hospital or obstetrician can do that you can’t do?
They often scan women at antenatal visits. We do measurements and abdominal palpation. As midwives our skill is our hands.
We can identify the baby’s position without using a scanner.
We can’t do inductions. We can’t do instrumental births. We can’t do caesareans at home.
We can’t do fetal blood sampling.
But we listen to the baby’s heart rate at every appointment and throughout labour. If something changes we can refer to hospital.
We can also organise scans if women want them.
What is it that you can do that hospitals can’t?
Physiology.
Waterbirth. Physiological third stage. Trusting the normal process.
It’s not that we physically do a lot. The woman births her baby and placenta.
We just have the confidence to support it and recognise when things move outside normal.
We are experts in normal physiological birth.
We’re also passionate about supporting students and the future of midwifery.
This year we supported a University of Sydney medical student on a continuity journey with a homebirth, which was amazing.
This helps medical students understand normal physiology.
For the women out there, homebirth has become a financial choice.
Could you outline the financial structure?
The Nesting Hub has evolved a lot over the years. The first question people ask is usually about finances.
We listened to feedback and reduced our fee to $6,000.
As endorsed midwives we have Medicare provider numbers. We can give Medicare rebates, ultrasound referrals, pathology requests and prescribe medications.
So we charge $6,000 and use the Medicare rebate as part of the fee to make it more affordable upfront.
When you think about the clinical care women receive through pregnancy, being on call, attending the birth and providing up to eight weeks postpartum care at home, it’s extraordinary value.
Thank you for everything you do. It’s unbelievable.
Thank you for showcasing homebirth and supporting our clients. We love working with you in the birth space.
This has been an incredibly insightful conversation about this model of care.
I hope this helps families, care providers and anyone curious about homebirth understand what this model of care really looks like.
Thank you so much for sharing your time and expertise today.
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