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A word or two about homebirth

Sometimes I get the impression that people think homebirth is crazy.  I dunno, maybe comments left on blogs or eyebrows raised when I mention my babes weren’t born in the hospital.  So if I might take a moment to share my thoughts on why a person might choose homebirth.  (And let’s just get this part out of the way:  obviously, I’m am not saying everyone should birth at home.  You should birth wherever you choose.  And I am not saying that interventions such as inductions or cesareans are evil when they are necessary to save lives.)

1)  Homebirth is safe. 

Numerous studies have shown that planned homebirths with a midwife is as safe as a hospital birth.  Some studies even show that they are safer.  Certainly there are fewer interventions.  “The first intervention in birth, that a healthy woman takes, is when she walks out the front door of her home, in labor. From that first intervention, all others will follow”.  Dr. Michael Rosenthal – Obstetrician

In 20 other countries, fewer babies die at birth or in their first few months of life.  Those countries have one thing in common:  most of the births are attended by midwives.  Compare that to our rate of 8% of births attended by midwives; only 1% of which are homebirths. 

A woman is four times as likely to die from a cesarean than a vaginal birth.  The US cesarean rate is over 30%.  Homebirth midwives have a cesarean rate less than 10%. 

2)  Midwives are super (and smart). 

Midwives are trained in normal birth.  Keenly aware that a hospital is the best place to be for high-risk pregnancies, midwives will transfer the care of these women prior to their birthing times.  Likewise, during labor or birth, a midwife will transfer a woman to the hospital if a complication arises. 

Midwives are trained for emergencies.  Though their focus is on prevention, certainly they are trained to respond to less common emergencies such as hemorrhage, neonatal resuscitation, shoulder dystocia, etc.  While regulations may vary from state to state, all midwives carry emergency equipment and administer certain medications when indicated. 

Part of the reason for their excellent outcomes is that midwives spend so much time prenatally with their clients.  A prenatal with a midwife typically lasts an hour.  How often does an OB spend an hour with her patients?  A midwife can more easily address nutritional concerns or emotional issues because she knows her clients and has spent time building trust. 

Midwives are the norm for most births in the world.   

3)  It is convenient.

No bags to pack.  No worrying about “when to go.”  No contractions in the car. 

Everyone comes to your home.  And they are guests.  They were invited.  That changes the entire atmosphere. 

I didn’t have to worry about someone feeding the dog or arranging childcare.  If I decided (as I did) that I wanted a grape popsicle, my freezer was just a room away.  If I decided (as I did) to play pass the pigs, then it was readily available. 

4)  It is economically sensible.

Some of my doula clients have shown me their hospital bills.  My jaw dropped when I saw the cost of an epidural.  Or an IV.  My first thought was “I don’t charge nearly enough for my services if a cervidil tampon costs more than me!”  Then they showed me the separate bill for the baby care.  Good grief.  The consumer has little control over these charges. 

Midwives charge a flat fee.  It covers your prenatal care, your birth, and postpartum care.  The postpartum care takes place in the comfort of your own bedroom.  There are no hidden charges.  You are not charged extra if your midwife gives you a tylenol or if your labor lasts 30 hours.  Of course, the fee varies.  Here, I’ve seen it range from $2600–4000.  And in SC, Medicaid covers homebirth midwives.    

5)  Easier to relax during birth and rest afterwards.

Hospitals were not designed for birth.  Women in labor need privacy, quiet, and room to move.  It is essential that our bodies relax during our birthing time.  If too much adrenaline creeps in, labor can stall.  In a hospital room, you will be monitored, you will be interrupted, you will hear unfamiliar sounds, you will sign a dozen consent forms, and you will be informed of policies. 

During your postpartum period, you will be interrupted during the night so that you may be monitored.  The nurses aren’t evil but it is their job to check on you.  If you birth at home, you will be snuggled with your partner and your little one in your own comfortable bed.   

6)  You can give birth in whichever position or room you choose.

Midwives follow birthing women around.  If she stops to push in the corner, the midwife squats down with her.  If it is dark, the midwife might use a flashlight.  If she wanders out to the back deck, the midwife will bring a few pillows.  If she wants to push on the toilet, fine.  Tub?  Fine.  Under the apple tree?  Whatever.  A midwife is accommodating.    

7)  The baby is mine.

No, I don’t mean the baby might be switched at birth.  I mean that families who choose to have their babies at home usually call the shots when it comes to the handling of their newborn.  It is assumed that the baby will be skin-to-skin with the mother for a lengthy period after birth.  In the absence of emergency, of course, the mom decides when the cord is clamped, when the baby is weighed, and if any procedures like eye ointment, vitamin K shot are administered.  I feel like homebirth gives parents “permission” to parent right from the start.      

Really, this control over how my baby was handled was my number 1 choice for choosing homebirth. 

8)  It is cleaner.

Hospitals are gross and they are filled with sick people.  Scary germs live there.  Now with swine flu and antibiotic resistent bacteria running amok, it makes sense to keep a newborn protected at home.  When a baby is born, she receives antibodies through her mama’s colostrum.  It will include antibodies for the microorganisms living in her home and places her mama frequents.  Newborns have immature immune systems and rely on this colostrum for protection.  The newborn is unable to make antibodies for foreign germs like those found in hospitals.     

9)  And this might not be the most important reason, but no hospital gown, no hospital food, and no hep-lock!

I don’t think this one needs explanation!   

Now, before anyone gets huffy with me, let me acknowledge that there are wonderful doctors and nurses.  My beloved mother is a nurse.  I grew up in doctor’s offices and hospitals.  However, there are not so wonderful regulators who enact ridiculous rules for low-risk women birthing at hospitals.  And there are frivolous lawsuits that scare the bejeebies out of otherwise accommodating physicians.  And I concede that not all midwives are angelic guardians of birth–a few are crappy.

But hopefully this list will help someone see why a person might choose the seemingly strange choice to birth at home.  Does anyone else have reasons to add?

6 responses »

  1. I’m sorry that you feel like you have to address people who might disagree with a reasonable, researched post that you happen to know a lot about. In the world of birth and motherhood there are too many battlelines. No one stops to realize that there isn’t even a war.

    I don’t know how to reach people like me, but I was afraid of homebirth and felt like I didn’t start considering it soon enough by the time I met you. I remember distinctly reading all those birth stories from The Farm and doubting my decision to birth at the hospital, but also thinking it wouldn’t be so bad, women do it all the time, blah blah blah. My case is unique, of course, but I do think raising awareness of the safety and overall increased satisfaction of homebirth would have helped me consider it a real option.

  2. Thanks for this. I may put a link to this post on my blog and on facebook. Very well written.

  3. Pingback: Julie from inexplicable ways writes about homebirth « Confessions of a Misplaced Alaskan

  4. Julie– do you have any site recommendations for a check-list of sorts on what to have handy for an unassisted birth? I’m sure folks birthing with midwives get that straight from the midwife…but I’m feeling like I may not have my bases covered.

  5. I don’t have a specific site, Emily although Laura Shanley’s site: and the UC forum might give you a good start. I’ll certainly share my list with you. Your bases will be covered!

  6. I want some mama to wander under the apple tree to birth while I dutifully follow. I could hear myself in that part of the description of following around in labor… Here? Sure. There? Of course. Somewhere else? Okie dokie. I could have never guessed where in the house/room some babes would end up being born.


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