Home births have become more and more common in the last decade – and not just in cosmopolitan, wellness obsessed cities like Los Angels and New York. If we could point to two main factors that drive women to consider home birth that would otherwise never be the type to do so (besides the obvious – lower cost and no desire for medical intervention), they would be: the documentary film “The Business of Being Born” (see here also) and more recently the coronavirus pandemic and all the hospital restrictions that came with it. Whatever a woman’s reason for considering a home birth, there are some key elements to planning.
The first step is to assess whether you’re even a candidate for a home birth.
According to the American Pregnancy Association (APA), to be a candidate you need to meet the below criteria:
- You are having a healthy, low-risk pregnancy
- You want to avoid an episiotomy, cesarean section, epidural and other similar interventions
- You want to share the experience with family and friends
- You want to be free to move around, change positions, take a shower and eat or drink freely during labor
- You want to enjoy the comforts of your home and familiar surroundings
Home birth will not be an option if any of the below apply to you:
- You are diabetic
- You have chronic high blood pressure, or toxemia (also known as preeclampsia)
- You have experienced preterm labor in the past, or are at risk for preterm labor now
- Your partner does not fully support your decision to give birth at home
Once you’ve established that you are a candidate for a home birth you’ll want to interview certified professional midwives in order to find one you bond with. It’s very important that you get specific with your questions and dig in to make sure the midwife you are considering not only has a lot of experience with home birth, but experience handling emergencies. According to The American College of Obstetricians and Gynecologists although planned home birth is associated with fewer maternal interventions than planned hospital birth, it’s also is associated with a more than twofold increased risk of perinatal death (1–2 in 1,000) and a threefold increased risk of neonatal seizures or serious neurologic dysfunction (0.4–0.6 in 1,000).
About 20-40% of first time moms are also transferred to hospitals at some point during the home birthing process, so you’ll want to be sure you’re close to a fully equipped hospital. In that same vein, you’ll want to discuss doing all your prenatal labs and checks through a doctor affiliated with a hospital, so that should you need to be transferred, they will already have a medical file for you.
The APA notes that midwives should bring the following on the day of delivery:
- Oxygen for the baby if needed
- IV’s for mom if she becomes dehydrated or needs additional nutrients
- Sterile gloves, gauze pads, a cotton hat for the baby, drop cloths, waterproof covers for the bed, a thermometer, a pan for sitz baths after birth
- Fetoscopes or ultrasonic stethoscopes
- Medications to slow or stop a hemorrhage
- Special herbal preparations, homeopathic remedies, massage supplies/techniques and perhaps even acupuncture needles
- Items for suturing tears
Once you have your midwife and hospital backup in place, you’ll want to think who else you want around you for support on the day of your birth. You’ll also want to go in depth with your midwife when it comes to exactly how the birth will transpire and what coping mechanism you’ll be using so that you can properly prepare your environment. This may include a bathtub, various essential oils, TENS machine, music, a birth ball, candles, ice cubes, snacks, etc.
Remember to also have a hospital bag packed and ready to go should you need it. When it comes to birth, there’s nothing more important than to be prepared for the unexpected.