We’ll start by emphasizing that a general operating rule amongst midwives is that a woman will deliver her baby best where she feels best and by best we mean safe, supported, and relaxed. We advocate for that with every woman who comes into the practice, especially if they aren’t sure where they’d like to deliver. That being said, a new mother might not know where she feels best – it could be in the hospital, surrounded by doctors and nurses, and it may be in the privacy of her own home surrounded by the things most familiar and comforting to her in her daily life, or it could be in a birth center which is a balance between the hospital and home – no beeping machines, but not your living room couch either, although it’s typically a very comfortable, homey space.
It’s important to clarify that birthing your child is not the ONLY component that a family should consider when deciding between a home or hospital delivery. Considering where you’ll be receiving your prenatal care is just as important as considering where you’d like to deliver. The entire process of being shepherded through pregnancy is how the foundation for comfort is set for your labor. If you feel supported during your pregnancy, chances are you will feel supported during your labor.
Whether you’ve had previous hospital births or this is your first child, you may be wondering whether birthing at home is the right choice for you. While nobody but you can answer that question, here are a few facts about home and hospital births that may help you decide where it will be best for you and your family to bring your child into the world.
1) General Health
If you are in good health, are committed to maintaining that good health for the duration of your pregnancy, and have a low-risk pregnancy, home birth is a viable option for you.
2) Medical Procedures
Most women don’t begin their pregnancy by saying, “I want to have an episiotomy during my birth,” or “I’d like to plan my C-Section right now.” If you are someone who would like to avoid medical interventions unless they are absolutely necessary, you might be interested to know some of the statistics about hospital births and medical interventions during delivery. One notable trend over the last half-century in deliveries is the rise in C-Sections. A recent study showed that planned home births had low rates of intervention, physiologic (vaginal) birth, and no increase in adverse outcomes even if they were transferred to a hospital.
Today, roughly 32% of all US births in hospitals are cesarean, making c-sections the most common procedure performed in operating rooms nationwide. As midwives, we operate with the evidence-based knowledge that the majority of planned homebirths for women with low-risk pregnancies happen without medical intervention. Birth is a normal human process that, when given enough time, can be achieved without induction, medication, or surgical procedure. We allow for that time by working with mothers where they are comfortable and by giving them the time and support they need to have an enjoyable, relaxed labor.
For more information on evidence-based care and the state of maternity care in the United States, visit the Evidence Based Birth ® Blog (it’s one of our favorites!).
Besides the aforementioned attributes to birthing at home, an exceptionally excellent part of a home birth is the comfort a woman and her partner will have in a familiar place where they are surrounded by people who they trust and love. Midwives provide truly personal prenatal care throughout the duration of a woman’s pregnancy. We don’t rush appointments, and we try to become as integral a part of your budding family as we can be (within reason). When a woman goes into labor under the care of a midwife, the only medical facilitators at her delivery will be people she knows and with whom she has established rapport. The benefit of being in your home is that you know where everything is, you won’t be around strangers, and you may feel more relaxed.
In a hospital birth, you may encounter some unfamiliar (and sometimes, therefore, unwelcomed) faces – nurses you’ve never met, or even a doctor you’ve never seen during your pregnancy – while you’re in labor. This can be stressful especially if you have experienced difficulties, or have existing reservations or fears about birth.
4) Breastfeeding and immediate bonding with your baby
In a recent study in Ireland and the UK, researchers found that healthy breastfeeding practices were strongly associated with homebirths in low-risk pregnancies. While there are many factors that contribute to healthy breastfeeding habits, and healthy sustained breastfeeding habits, several reasons such as decreased stress, and a simplified post-partum care process have been attributed to helping mothers and newborns to start on a strong foot in breastfeeding.
Additionally, there are fewer procedures that need to be done right away in a home birth than in a hospital birth, thereby allowing the mother and child the opportunity for more skin-to-skin time – a practice which has been proven to improve the transition and healthy development of newborns. This skin-to-skin time allows for biological bonding and it provides ample and early opportunities to learn to breastfeed for both mother and newborn. The process is relaxed in a home birth, and having one coach (the midwife) can reduce stress simply because there are fewer opinions and tactics being tossed around the room.
To read more about bonding after birth, visit UNICEF UK’s Baby Friendly Initiative website.
The average cost of a home birth in the United States is roughly 20-30% of the cost of a hospital birth, and will most likely be less than the out of pocket costs of a hospital birth as well. Furthermore, some insurance companies DO cover home births. So, it is likely that if cost is a factor for your family, delivering at home will be the most economic route.
At the end of the day, the only way to know if a home birth is right for you is if it feels right. Welcoming a healthy, vibrant baby and having an easy, peaceful labor is what we want for all mothers whether they deliver in the comfort of their own homes or the comfort of a hospital bed. The best and only way to ensure that outcome is for families to choose where they feel safe and supported, and to identify what practices align most with their values and beliefs. There is no wrong answer. Follow your hearts!