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 you and you babyare healthy and there haven’t been any complications with your pregnancy, there’s no reason why you can’t plan a home birth – and the American College of Nurse-Midwives supports it for 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. 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 any other children you have, 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 and new baby to bond, breastfeed, and recover in the comfort of your own home.
What are the disadvantages?
The main disadvantage with home births 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 any other children you have may get upset if they think you’re in pain. Your pain relief options are also limited.
Pain relief during a home birth
You can’t have an epidural during 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 delivery).
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 can 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 to every birth she attends, such as IVs, resuscitation equipment, oxygen, and medication to treat post-partum hemorrhage. 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; http://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 births.
More advice on how to deal with an emergency home birth.
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.