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Should I have a Home Birth?

Whether it’s your first time pregnant or you’re already a mother, the thought of giving birth at home may sound intriguing. While you’ve heard of home births before, you’re still wondering if it’s a good option. Is home birth just for hippies? What are the pros and cons of home birth? How does home birth work? Is home birth even safe?

This post will help demystify home birth and give you the information you need to make your decision.

What Is Home Birth?

Home birth means exactly that: Giving birth at home instead of a hospital.

Home births are often attended by a trained professional. In the U.S., 62% of 2009 at home births had a midwife present. Most midwives were certified, professional midwives or direct-entry midwives. Another 19% were certified nurse midwives.

The expectant mother chooses an area in her home where she wishes to have the baby. Prior to the big day, the midwife will visit the home to decide where the equipment will be set up. The midwife will also instruct the parents on supplies they’ll need for easy clean up. For example, placing plastic sheets over your mattress will prevent costly messes.

A woman may also choose to have a physician present. However, that was only the case in 5% of home births, many of which were unplanned or emergency situations.

Surprisingly, 33% of babies born at home were delivered by “other” attendants, which may include a family member.

Is Home Birth Common?

While home birth may seem like a dangerous practice to people in North America, it’s actually quite common in the United Kingdom and the Netherlands. In the Netherlands, 30% of babies are born at home.

According to the Centers for Disease Control and Prevention (CDC), women over the age of 35 who have had several children before are more likely to give birth at home. Home births are less common among minorities and unmarried women.

While some people may think home birth is a new trend, it was actually the norm at one point in history. In the 1900’s most births occurred at home and away from a hospital. As time progressed, more and more mothers started giving birth in hospitals. By 1940, only 44% of mothers continued to give birth outside of a hospital. That number fell to only 1% by 1980.

While home birth is still uncommon in the U.S., it has been increasing in popularity since 2004. In fact, from 2004 to 2009, home births in the U.S. increased by 29%, according to the CDC. That survey concluded that home birth was most popular in Montana, Oregon and Vermont. Home birth was least common in Texas, North Carolina and Connecticut.

In Canada, less than 2% of expecting mothers give birth outside of a hospital.

Are Home Births Safe?

According to the CDC, home births actually have a lower risk profile than hospital births:

• Preterm: 6% at home births, 12% hospital births
• Low birth weight: 4% at home births, 8% hospital births
• Multiple deliveries: 1% at home births, 3.5% hospital births

These statistics suggest that women who chose home birth are already low-risk. Women that know they are at a higher risk for complications may be more likely to give birth in a hospital.

A 2009 Ontario report found that planned home births where certified midwives attended were safe and resulted in fewer interventions than hospital births. However, what makes it safe is that there are hospitals within a reasonable distance should a complication arise.

A 2015 Ontario study also concluded that giving birth at home was as safe as giving birth in a hospital if the pregnancy is low-risk.

On the other hand, a 2013 study published in the American Journal of Obstetrics and Gynecology found that babies born at home were ten times more likely to be stillborn. They are also four times more likely to have neonatal seizures, according to the study.

Whether home birth is safe or safer than hospital birth continues to be debated.

Home Birth Pros and Cons

Pros of Home Birth

• Comfortable in own home— Women can use their own bed and bathroom, which may make them feel more relaxed. They are also free to move around as they like and can move into comfortable positions.
• More intimate/private— In a hospital, you will come into contact with strangers such as doctors, nurses and other patients. When you give birth at home, you can choose who is in the room with you.
• Belief home birth offers personalized care— Women who choose home birth can meet and get to know their midwife before they give birth. For this reason, some women feel like they will receive better, more compassionate and trusting care. Some also believe that home birth is safer than hospital birth.
• Access to their own belongings— Women have access to their own food, drinks and clothing at home.
• Easier preparation— If you have birth at home, you do not have to arrange someone to watch your kids or take care of your pets. You don’t have to pack a hospital bag beforehand, either.
• Lower cost (depending)— If your health insurance plan does not cover birth and you have to pay out of pocket, home birth is the cheapest option compared to hospital birth.
• Pain relief options— While pregnant women in a hospital can receive an epidural for pain, women who give birth at home can use a warm bath, massage, yoga, aromatherapy and other options for comfort.
• Birthing options— Women who give birth at home have more options surrounding the actual birth of their baby. For example, women can choose water birth.
• Belief that home birth is natural— Some women believe that birth is a natural process that will be kept more natural in a home setting as opposed to a hospital.

Cons of Home Birth

• No epidurals— Although there is a wider range of pain relief options available for home births, that does not include epidurals. Since epidurals need to be administered by an anesthetist, the drug is only available if you give birth in a hospital.
• Insurance may not cover— While your insurance may cover a hospital birth, it may not cover a home birth and the fees associated with hiring a midwife.
• Fees associated with preparation— Your midwife will tell you the supplies you need to purchase for your home birth to make clean up easy.
• Complications— Although midwives will generally only take on low-risk pregnancies, complications could still occur. If a complication does occur, you will have to be transported to a hospital.
• Unexperienced midwives— If your midwife does not have proper training and is inexperienced, you may lose confidence and complications could occur. It’s important to research your midwife to ensure they are licensed and have experience.

How Do Home Births Work?

If you are hiring a midwife, be sure to select someone who is certified and has experience. Asking questions and doing research about your midwife is key to having a healthy home birth. It’s important to note that midwifery is only regulated in some provinces and states.

Once you select a midwife, she will discuss the options of having your baby at home or in a hospital. She will also develop a birth plan, which will outline the details and your decisions during and after labour. During the time leading up to the birth, your midwife will provide prenatal care.

Before the birth, the midwife will visit your home several times to see where you will have the baby. When you’re in labour, the midwife will bring her equipment and medications. She will assist you in the labour.

After you give birth, your midwife will examine the health of your baby and give you information on newborn care. Your midwife will also make follow-up visits to ensure the health of your baby.

Should I Choose Home Birth?

If home sounds like a good option for you, talk to your physician. Whether you’re a good candidate for home birth depends on several health factors. A woman may be cautioned against home birth if she:

• Has a chronic condition or other medical conditions
• The baby is not in the birthing position
• You are expecting more than one baby
• Had a C-Section in previous births
• Is NOT between 37 and 41 weeks pregnant
• Lives in a rural area, away from hospitals
• Is okay with a natural birth. Epidurals are not available during home births.

Home births should only be considered an option if your pregnancy is low-risk. In general, you have a low-risk pregnancy if:

• You are pregnant with only one baby
• Your baby is in the birthing position
• You are free from serious medical conditions
• You’ve never had a C-section
• You are between 37 and 41 weeks pregnant
• You live close to a hospital (should any complications arise)

If your doctor has determined that you are a candidate for home birth, talk this decision through with your partner. If you have any questions, direct them to a midwife in your area. If you’re wondering about the home birthing experience, you may find it helpful to talk to a couple who has given birth at home.

Whether you give birth at home or in a hospital, it’s a personal decision. Before you decide, research, gather information and direct your questions to your healthcare provider.

Are you giving birth at home or in a hospital? Comment your decision below. If this post helped you make your decision, be sure to share it with other expecting mothers!

Resources:

http://www.cdc.gov/nchs/data/databriefs/db84.htm

http://www.theglobeandmail.com/life/parenting/home-birth-a-labour-of-love-few-canadian-parents-are-taking/article16050641/

https://www.thestar.com/news/canada/2015/12/21/home-birth-with-midwife-just-as-safe-as-hospital-mcmaster-study-finds.html

http://www.ontariomidwives.ca/care/birth/home

http://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/home-birth/art-20046878?pg=2