Back in September when I published my birth story I promised to answer the most popular questions that I received about homebirth “in a few weeks.” A few weeks came and went and well, here we are in January.
While I didn’t make the goal on timing, I am happy to deliver this content for you today, which contains the most popular questions that I received over the last year about homebirth. I hope that this helps eliminate some of the myths and misconceptions out there for any of you!
As always, please let me know if you have any more questions or any follow ups!
Isn’t the hospital the safest place to have a baby?
Approximately 99% of pregnant women in the United States give birth in a hospital setting.
One out of every three of those women will have their baby via caesarean section.
What if I told you that the United States has the highest newborn death rate and maternal mortality rate in the industrialized world, and that rate is increasing?
That’s right- the United States has higher infant mortality (as in, WORSE) than Latvia, New Caledonia, Cuba, Liechtenstein, South Korea, and dozens others?
And what if I told you that the United States has more women die in childbirth, up to 50% of which the World Health Organization says are completely preventable, than Qatar, Kazakhstan, Bosnia, Lithuania, Estonia, Belarus, Kuwait, and nearly 40 other countries? That’s right, more women die in childbirth than countries whose names we barely know and definitely can’t spell.
For starters, it’s not homebirth that drives the statistics regarding infant and maternal mortality in the wrong direction. It’s hospital birth.
Is hospital birth inherently dangerous? No.
Is hospital birth inherently safe? Also no.
But is homebirth safe?
A study that took place from 2004-2009 analyzed nearly 17,000 planned homebirths and found that among the low risk population who plan for homebirth, there are fewer interventions and no increased risk for mother or baby.
Birth is not an illness. It’s not a disease or a condition or an ailment. It is a normal, natural thing that has literally been taking place since the beginning of time. Birth began at home, and only in the last 70 or so years has really transferred to a hospital setting, coinciding with the invention of obstetrics.
The argument that birth should occur in a hospital stems from the mistaken belief that birth is risky and dangerous. While there can be risks in certain births, risks are minimal when there is a healthy pregnancy. Our bodies inherently know how to birth- that’s why women in comas can give birth while staff just stand by shocked. it is like any other bodily function- breathing or waste elimination. Our bodies have been designed with very specific functions so that our species can survive. Sometimes when we’re having difficulties breathing, we need to see a specialist. But we do not need a specialist to breathe on a regular basis. Birth is the same way. Sometimes we need the intervention of the medical community to help us, but usually – that is simply not the case.
An Australian Study by the University of Technology Sydney’s Centre for Midwifery analyzed data from 1800+ planned homebirths over a five year period and found that, compared to hospital birth statistics, homebirth had a reduced risk of stillbirth and early neonatal death. It also identified an increased chance of having a normal vaginal birth, and a reduced risk of third degree tears.
Another study on maternal and perinatal outcomes comparing planned hospital births, planned birth center births, and planned homebirths in Australia found that the odds of normal labor and birth were twice as high in planned birth center birth (compared to hospital) and six times as high in planned homebirth (again, compared to hospital).
Finally, study after study shows that most hospital transfers that take place in homebirth aren’t emergencies, but more related to the exhaustion of the mother after a prolonged labor.
What if something goes wrong?
But what if everything goes right?
Obstetricians are trained surgeons. They are trained for emergency situations and truly perform God’s work when emergencies arise.
However, MOST births are not emergencies. Most births are normal, natural events that humans interfere with. How? Well- if you’ve been induced, had your membranes swept, had your waters broken, or any other number of early stage interventions, the natural process that your body was designed for was interfered with. When birth is interfered with, it is more likely that other interventions will be necessary, including “emergency” c sections, infant resuscitation and NICU stays.
Homebirth care providers are trained, many clinically, in normal, natural birth. They are also trained to spot things that are not normal, and know how to respond when those situations arise, whether that means transferring to a hospital, bringing in medicines or herbs, or providing air.
What do you do about pain?
If you are intending to birth at home, it is true that some methods of pain relief will likely not be available to you. Depending on what state you live in and what kind of provider you have attending your homebirth, you may have options ranging from gas to TENS units to other natural pain relief possibilities.
Choosing homebirth does not mean that you just suck it up. While an epidural won’t be a possibility, laboring and birthing in the water may be something that you find especially comforting. Homebirthers often refer to water as the Aquadural, a play on epidural, because of its natural relief from the intensity of labor pains.
Homebirthers are also more likely to be equipped with hypnobirthing techniques or other labor relief strategies from their midwives or doulas.
For me personally, my first hospital birth with an epidural was way more painful than either of my natural births. While birth is inherently intense, whether your brain perceives it as pain may vary from person to person. Most natural birthers that I know say that training the mind is the single most important thing to do to prepare for a natural birth!
What about the mess?
To this I say to you — what mess?
The sheets, the bathroom, the rug — doesn’t it all get ruined?
Let’s talk a few facts.
Birth is messy. It’s part of the beauty of it. However, the way we see it in movies isn’t exactly reality (is it ever?). You probably see fluids being thrown around like Oprah hands out cars in most modern day depictions of hospital birth- that’s not really how it happens.
Actually, there is almost no mess with homebirth, and to the extent that there is, your team of midwives takes care of cleanup and returning your birth setting back to normal prior to leaving your house.
You’d be amazed at how much of a system homebirth midwives have down. In the weeks leading up to birth, they advised me to double make my bed with throw away sheets on top, a plastic tablecloth or sheet under that, and regular sheets underneath (so you can just pull the top sheets, toss in the laundry or throw away, then lay in bed and sleep!). They told me to put a tarp under the birth pool so no water got on the floor and have some towels handy for any water cleanup. At my homebirth, and every other one I’m familiar with, the midwives take care of returning the room back to the way it was prior to the birth. That included draining and deflating the birth pool, getting sheets and towels into the laundry, putting away their equipment and herbs, and took the trash out.
Arguably, my house was cleaner when they left than it was when they arrived.
Can you have a homebirth if you have [CONDITION]?
I’m a lawyer, and I’m going to answer this question like a lawyer. It depends.
States that regulate homebirth have varying rules about who can have a homebirth. And providers that attend homebirths often have their own set of guidelines that “risk out” some moms.
Some of the more common reasons that people believe they might not be able to have a homebirth are high blood pressure, previous cesarean section, breech baby, or twin birth. It is still possible for women in these scenarios to give birth at home, and many of them do. It’s simply a matter of finding a provider that is skilled in your particular medical situation.
Aren’t hospitals cleaner?
Hospitals are for sick people, and therefore are filled with all kinds of infections germs and diseases.
Unless you give birth by c-section, which you wouldn’t be doing at home anyways, you do not need a sterile environment to have your baby. Even with strict cleaning and disinfection protocols, it is very difficult for hospitals to control infection risk because of the large number of sick people in them every day.
Isn’t homebirth more expensive?
Again I say — It depends.
My first birth, which included a two night hospital stay with an epidural, cost my insurance company $55,000 ($36 out of pocket for me- yes, I had amazing insurance).
My second birth, which included a 15 hour stay at a different hospital (unmedicated), cost my insurance company $4,600 ($18 out of pocket for me).
My homebirth, which included 14 prenatal and 5 postpartum in-home visits, along with my birth and the birth pool, cost me $2,500. Because the Commonwealth of Pennsylania fails to license midwives for homebirth, it wasn’t able to be covered by my insurance, so that amount was out of pocket.
My hospital births were expensive for the hospital and my insurance company, but very inexpensive to me because of my amazing military insurance. My homebirth was less expensive for all parties involved but more expensive to me because of licensing failures of the Commonwealth. Go figure.
There’s no easy answer to this question because it depends on where you live. If you have a licensed midwife attend your homebirth, chances are your insurance will cover it. If not, I’d say a few thousand bucks for arguably the most magical experience of your life is welllll worth it. At least it was for me.
Do you have to take your baby to the hospital right after?
No. Your baby will be examined by your homebirth midwife team after birth (when you and baby are ready). They will conduct the same evaluation, APGAR, that is done in the hospital right after birth. If anyone has concerns about your baby, you of course can take the baby to a hospital or arrange for a pediatrician visit right away. You could also call 911 in the event of an emergency.
However, there is nothing or no one that will make you take your baby anywhere. It is your choice if you think something is wrong, just like it is every other moment of parenthood and you have to evaluate whether to make a trip to the hospital or doctor’s office.
Isn’t homebirth illegal?
No. It is not illegal to give birth anywhere. You can choose to birth in a hospital, at home, at a gas station, in a car, in your favorite aisle at Target, at a Celine Dion concert, or just about anywhere you can fathom.
Again, it is not illegal to give birth anywhere.
Depending on what state you live in, though, what may be regulated is who may attend your birth if it is intentionally outside the hospital setting.
What supplies do I need to birth at home?
Depending on your providers, you may not need much at all. That certainly was the case wtih my homebirth. My midwives provided everything that I needed for birth, including the birth pool, and for 24 hours postpartum. However, that will obviously vary by your provider.
It was also important for me to have a beautiful atmosphere for my homebirth, so I spent a lot of time creating that space. I chose to have dozens of candles, fairy lights, birth affirmations, a vision board, and a few letter boards with motivational phrases on them. Whatever your space looks like will be up to you!
I hope that I was able to answer some of your questions through this post; as always I appreciate your thoughtful questions and concerns and discussion points! Happy homebirthing, everyone!
And, in case you missed my social media posts, my episode on the Happy Homebirth Podcast aired yesterday, January 6, 2020. You can find the episode on any of your normal podcast apps or by following the link below!