First stage of labour at home

Although labour and birth represent only one moment in the continuum from conception and pregnancy to parenthood, it is perhaps considered the gateway between the two states and is the subject of much anticipation. The homebirth midwife therefore has an important role to play in helping the woman or birthing person, their partners and support network to navigate this transformational process. Intrapartum care in hospitals places an emphasis on the mechanistic process of labour whereas choosing to labour and birth at home is often in recognition of the equal importance of psychological safety (Olza et al., 2020). It is by foregrounding this understanding that the homebirth midwife is able to practice most effectively and in synergy with the needs and wants of those who have made an informed decision to have a home birth. Whilst acknowledging the phenomenon of the ‘ever narrowing window of normality’ (Scamell & Alaszewski, 2012), this chapter focuses on intrapartum care for term singleton pregnancies without additional complexities that may require input from obstetricians. Nevertheless, many of the core principles of intrapartum care at home are readily transferable to support the needs of a diversity of midwifery caseloads.