Home Birth Pros and Cons
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Please note: I am not a doctor and I am not giving medical advice. Information on this website is not intended to diagnose or treat any form of any disease or medical condition. This article is for informational and entertainment purposes only.
Considering A Home Birth?
When I first found out I was pregnant, I had the idea of doing it at home. I knew a couple mamas who had done it and it sounded so peaceful. I liked the idea of avoiding the medical system (if possible). I kept reading blogs and birth stories of mamas who had their babies at home, trying to get myself hyped up. But, at the end of the day, the “what ifs” scared me too much and I decided to go the “traditional” hospital route. That is, until I was eight months pregnant and totally changed my mind - you can read about that here.
Looking over the pros and cons helped me make an educated decision on the subject. I hope I can help you do the same.
About Me
First off, I'm fairly crunchy, but also overall pragmatic. I believe hospitals and medicine are necessary, but also that they are wildly overused in our current society.
Second, I'm cautious, I don't tend to take big risks and I don't particularly consider myself to be brave (though it's something I'm often called when I tell people I had both of my boys at home).
Lastly, I'm a big believer in research and autonomy. I believe that in order to have control of your health you need to take responsibility for your health. In order to take responsibility for your health you have to be armed with the necessary knowledge on the subject. Only then can you make proper, informed choices, and get the outcomes you desire.
About You
While there are several factors involved in choosing where to have your baby, it ultimately comes down to you and your preferences. Some mamas have easy pregnancies with no complications but choose to have a hospital birth because it makes them feel safer and that’s totally okay. Other mamas are “high risk” (twins, breech babies, etc.) and go on to have perfect home births.
If you are considering a home birth, or you've already decided that you want one, your goal should be to get yourself into a state of mind where you feel confident about your ability to do so.
“Whether you think you can or you think you can't, you're right.” I know it's cliché, but I believe this is very true when it comes to home birth.
The Pros of Home Birth
Having had both of my boys at home, I will admit that I have somewhat of a bias. That said, I will make an effort to be as objective as I can here.
Now let's jump into all the reasons why I think birthing at home is awesome!
Comfortable environment
I strongly dislike hospitals. They serve a purpose, sure. But if I can avoid them, I generally do. The cold, impersonal and sterile environment stresses me out and that is NOT conducive to smooth labor.
At home, you can labor where you feel comfortable and safe. You can set up your space however you want, rest in your bed, labor on the couch, adjust lights, temperature and generally have complete control of the environment.
After you have your baby, you can snuggle up in your own bed and recover comfortably. In a hospital, you're typically expected to stay for 24-48 hours after delivery during which time there is a parade of nurses and hospital staff coming in, poking you and prodding you, and asking you questions every hour or two, all day and night.
Personalized care
Hire a midwife you love. You'll see her for all of your prenatal appointments, building a relationship like no other. Go over your birth plan, talk about your concerns, establish your preferences for how you wish to birth. When the day comes to have your baby, you will have full confidence that you'll get the exact care you need and want from a midwife you know well and fully trust. (Looking for a midwife? Click here for a list of questions you'll want to ask when interviewing potential midwives.)
In a hospital, you don't know who is going to be delivering your baby. You may have the most amazing midwife. You may have someone who's birthing philosophy totally clashes with your own. Personally, that's not something I'd want to leave up to chance. Not to mention, doctors and nurses typically have twelve hour shifts. Depending on the length of your labor and what time you're admitted, you may even have the whole birth team change while you're in the thick of labor.
Birth Team Freedom
At home, you have the freedom of having whomever you want on your birth team. In a hospital, there are usually limits on who can be there with you.
I had my first kid while covid restrictions were in full force. Yale hospital had all sorts of rules and limitations. There was even a chance that my husband wouldn't be allowed in with me, and that was not something I was willing to experience.
I ended up having my first son at home with my midwife and her assistant, my husband and my parents. It was perfect.
For my second baby, I had the same team, plus my firstborn. Some people probably don't want their toddlers around while they're laboring, but for me it was a great experience.
Medical Test Autonomy
During the course of one’s pregnancy (whether you're planning a hospital birth or seeing a homebirth midwife), a mama is directed to do all sorts of tests. Ultrasounds, gestational diabetes, blood work, drug tests, GBS (group B strep), etc.
My experience was this: the OB I was seeing told me these tests were required. If I wanted to have my baby at Yale, I had to do these tests. I wasn't educated as to their purpose, what the possible outcomes could be, what risks there were for me or for my baby if I declined. I was simply told, “you do these tests or we won't have you as our patient”. (Don't get me started on being called a “patient”. Pregnancy is not an illness. But that's a rant for another time.)
My home birth midwife, on the other hand, approached each test as an option. My option. We would discuss the purpose, the possible outcomes, any risk factors and any other questions I had. Then she would allow me to make an educated decision as to whether or not I wanted to move forward with the test in question.
This was simply my experience. Perhaps there are hospitals and OBs who allow for more autonomy on the part of the mother, but I think it's safe to say that you are likely to have much more freedom and control when you go the home-birth route.
No Medical Gadgets and Interventions
A hospital is a medical facility. It follows, then, that giving birth at a hospital is more likely to be regarded as a medical activity that can sometimes happen naturally. My belief is the exact inverse: birth is a natural activity that can sometimes require medical assistance.
There are so many things that are done during childbirth that many mamas think are required. The simple fact is, for most births, they are not. Heart rate monitors, hospital robes, cervical checks, an IV in your arm “just in case”, laboring and delivering on your back with your legs in stirrups, the list goes on.
There is also the fact that when medical interventions are available, they are more likely to be utilized, even when not completely necessary. Things like pitocin, episiotomies, epidurals, forceps and c-sections have their place in the world of childbirth. I firmly believe, however, that they are used way in excess of their actual necessity.
At home, you can be free to just labor naturally with no unnecessary medical gadgets or interventions.
Newborn Care on Your Terms
Your birth plan should include what happens after the baby is delivered.
In a hospital, the cord is usually cut almost immediately after delivery, after which there is a standard newborn protocol. It starts with observation of things like heart rate, color and muscle tone. Then come the vitamin K shot, eye ointment, vaccines, bathing the baby, newborn screening tests like a heel prick to test their blood, hearing tests, etc.
At home, you can have all of the above, or none. Again, you are able to make an educated choice and be fully in control.
For me, I wanted to have an uninterrupted hour of bonding with my babies immediately after birth. And I really mean uninterrupted. With both of my boys, as soon as I delivered my placenta, I moved to the couch, got comfy and snuggled my baby with nobody touching us or talking to us for an hour. It was incredible.
My husband cut the cord after our golden hour ended after which my midwife checked the baby’s measurements (weight, length, etc.), reflexes and overall health.
I didn't have to fight with anyone about my choice to skip the vitamin K shot and eye ointment. I didn't have to argue about not getting any vaccines. Our boys did not get their first real bath until they were weeks old (other than a damp washcloth to get some birth residue off of them). My husband and I had researched these things and made our decisions and everything was done on our terms.
The Cons of Home Birth
Limited Medical Resources
For some, the idea of giving birth without any medical resources available is not desirable. At home there is no option of pitocin to induce, no epidural to fall back on if the pain gets to be too much, no operating room for an emergency c-section.
The hospital has all sorts of medical gizmos and gadgets that some may prefer to have. If there is any risk or complication associated with your pregnancy, you will have medical specialists available at the hospital and a Newborn Intensive Care Unit (NICU) to care for any issues your newborn baby may have.
At home, these things are not readily available. Any mom birthing at home usually will have a back-up plan arranged with their midwife of what to do in case of emergency. Though transferring to a hospital mid-labor isn't ideal, it can be done if it becomes necessary.
High Risk Concerns
Some pregnancies are considered to be “high-risk”. This means that there's a higher-than-normal chance of complication during labor and delivery. This can be due to a number of things such as underlying medical conditions in the mother, known deformities or conditions in the baby (picked up by ultrasounds or other tests), prior history of birth difficulties, etc.
Since there is such a broad range of issues that fall under this category, each one has to be assessed by the mother and whatever healthcare provider she trusts in order to come up with a plan that will have the best possible outcome.
While being high-risk doesn't necessarily preclude you from having a home birth, you may want to be extra thorough in selecting a midwife who had experience with the kind of scenario you're dealing with. If you are pregnant with multiples, for example, you can still have them at home, but I would recommend finding a midwife who has delivered multiples successfully before (ideally more than once).
If your risk factors are such that you feel more comfortable birthing in a hospital, that is completely okay.
Insurance May Not Cover
It may not be the most fun aspect of childbirth to think about, but financial details may impact your decision when it comes to choosing your provider and place to have your baby.
If you have insurance, you're pretty much guaranteed to have coverage if you birth at a hospital. Birth centers and home birth midwives are covered by some, but not all, insurances.
Without insurance, most home birth midwives charge somewhere in the range of $5000 for their services. You'll also need to get some supplies, which can be a few hundred dollars. (For a list of items you'll need, click here.)
In a hospital, however, a vaginal birth can cost $10,000 to $20,000 without insurance.
Hospitals and midwives, alike, often offer payment plans if needed. Some midwives are even willing to barter services, which you almost definitely won't be able to do with a hospital.
Those are some things to consider when looking at the financial side of labor and delivery. I hope it helps!
Haters Gonna Hate
I am fortunate in that my family and friends were all supportive of my idea to birth at home. The worst I got was people asking me if it was safe, and a few, “but what if there's an emergency?”
I've heard stories, however, of mamas having to deal with really nasty naysayers on the subject of home birth, from acquaintances and friends, and even parents and husbands.
Of course, the decision is ultimately yours to make. You don't owe anyone an explanation. I do, however, recommend that you have your husband completely on board.
If anyone else is going to be present for your birth, they, too, should have no qualms about you having your baby at home. The reason for this is that when you're in labor, you need to have the most calm environment possible. Having someone worrying or stressing you out with their doubts or concerns could make your labor longer and more difficult.
Aside from that, friends and family may have their worries, but if you're calm and confident and have done your research, you can handle that without a problem. Their concern usually comes from a place of love.
If You Lack Confidence…
If you are not confident in your ability to give birth at home, if the idea of it stresses you out, you are going to have a harder time of it. That's not just opinion, there are actual, biological reasons for that. If you want to learn more about how stress affects childbirth, click here.
If you are just not comfortable with the idea of birthing at home and you want to go to a hospital, that is totally okay.
If you want to have a home birth but it makes you nervous, do not despair. Spend time getting yourself educated on all aspects of pregnancy and childbirth. The more you equip yourself with information, the more control you'll have of the outcome.
At the end of the day, you call the shots. It's your birth and you know yourself and your circumstances better than anyone else.
I hope this article helps you feel more confident in your choice of where to birth, no matter what you ultimately decide.