Home Birth

Most women choose to have their babies in hospital under the care of an OB-GYN, and the American College of Obstetricians and Gynecologists (ACOG) advises that hospital is the safest place to give birth.

However, if your and your baby are healthy and there haven’t been any complications with your pregnancy, and your first baby’s birth went smoothly, there’s no reason why you can’t plan a home birth. The American College of Nurse-Midwives supports it among women who are good candidates and who have experienced caregivers on hand.

What are the advantages?
The main advantages of a home birth are that you’re in familiar surroundings, cared for by a nurse midwife – it means you’ll have more say over your birth experience and be able to stick more closely to your birth plan, with medical interventions less likely (assuming no complications occur). Home birth is also great for your partner and your older child, as they can stay with you as you wish. After your baby is born, providing everything runs smoothly, you’ll be left with your partner, new baby and her big brother or sister to bond, breastfeed, and recover in the comfort of your own home.

What are the disadvantages?
The main disadvantage with home birth is that although it’s very rare that problems occur, they can still happen. If the delivery is proving difficult, or your baby has breathing difficulties once born, you may have to go to hospital. Home births can also be pretty messy and loud and it’s possible your older child may get upset if he thinks you’re in pain. Your pain relief options are also limited.

Pain relief in a home birth
You can’t have an epidural at a home birth as this has to be administered by an anesthesiologist, and narcotic pain relief won’t be available either. Your nurse-midwife will likely coach you in natural pain relief methods through your pregnancy so you’re well versed in them once your labor starts. She’ll encourage you to use controlled breathing and to keep active, changing positions as often as you need to ease your contractions. She may also use essential oils for massage. Warm water is also an option – you may want to consider hiring a birthing pool and laboring in it (if you don’t want to have your baby in the pool you can get out just before he delivers).

You’ll be able to use a TENS machine if you wish, though not if you’re having a water birth. TENS stands for transcutaneous electrical nerve stimulation, and a TENS unit is basically a small box that emits a mild electrical current via pads that adhere to your back. It blocks the pain and stimulates release of endorphins, which are your body’s natural painkillers.
Your nurse-midwife may also bring canisters of nitrous oxide with her if you think you will need them.

Practicalities
You should hire a certified nurse-midwife who is experienced in home birth and in water birth if you want to labor in a birthing pool, and check that she’s licensed to practice in your state. Make sure that she routinely brings emergency equipment, such as IVs, resuscitation equipment, oxygen, and medication to treat post-partum hemorrhage to every birth she attends. She also needs to have a contingency plan if complications arise, with OB-GYN and hospital backup if necessary. The American College of Nurse Midwives (240-485-1800; www.midwife.org) can help you find a local nurse-midwife.

As far as cost is concerned, bear in mind that not all health insurance policies cover home birth.

For advice on how to deal with an emergency home birth, read our article.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

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