You don’t have to be a granola-loving, tree-hugging, Birkenstock-wearing mom-to-be to consider a home birth. (Although with the sole-comforting sandals back in style, many of us might be a step closer to supporting the stereotype.) The truth is, you just need to be a woman with a low-risk pregnancy who is interested in playing a more active role in her birth experience.
Everybody’s doing it—well, some people are
In 2012, there were 35,184 babies in the U.S. born at home—which sounds like a lot until you realize that number makes up a little less than 0.9 percent of total births that year. Hospital births are still very much the norm, but data from the Centers for Disease Control and Prevention shows that out-of-hospital births have been trending upward since 2004, due in part to rising interest in home delivery.
“Women want to feel heard and understood in their healthcare relationships,” says Jodilyn Owen, LM, CPM, founder and owner of Essential Birth & Family Center in Seattle, co-founder of Rainier Valley Community Clinic and co-author of The Essential Homebirth Guide. “A lot of families want assurance that they will have a role to play in decision-making, and many want control over whom they work with.” A home birth can offer that by providing a hands-on approach to prenatal care, a flexible labor and delivery experience, and an intimate birth environment.
“I loved being in my own bed and being free to move and do whatever I needed to during my labor,” says Sarah Malarney, DC, a chiropractor at West Michigan Chiropractic and mom of one in Portage, Michigan, who delivered her son at home. “I was able to truly relax in between every single contraction, with no distractions or anyone interrupting me. George’s birth was more amazing and peaceful and beautiful than I ever could have imagined.”
To be sure, though, it’s not for everyone. “The location of the birth has to fit with the mother’s cultural and social belief system,” says Owen. If the thought of pushing out a baby in your bathroom without access to an epidural sounds certifiably insane to you, don’t hesitate to stick with the tried-and-true hospital route. But if your ears perk up at the notion of welcoming your wee one into the world in a quiet setting with just your partner and midwife by your side, home birth may be an option worth discussing.
Whatever you choose, you want to be sure you feel secure in your decision. “In my experience, mothers have better outcomes if they birth where they feel safe,” says Owen, who has attended more than 1,200 births, approximately 20-30 percent of which took place at home.
A recent study published in the Journal of Midwifery & Women’s Health found that among low-risk women, planned home births came with no increase in adverse outcomes for mothers or babies. However, “all the data in the world doesn’t matter if a woman does not feel safe in an environment,” says Owen. “I never want a woman to take a leap—I like steps. I love it when women haven’t decided where they want to birth yet and just want to learn together.” So do some research, talk it over with your partner, and go with what keeps you in your comfort zone.
In addition to personal preference, your health will come into play as well. The best candidates for home birth have normal, low-risk pregnancies and deliver between 37 and 41 weeks’ gestation. They also live within 20 minutes of a hospital in case a transfer needs to take place at any point during the labor and delivery process. Women with high-risk pregnancies—for example, those with gestational diabetes, preeclampsia or predisposal to preterm labor—should plan to deliver at a hospital where they will have immediate access to medical amenities.
“The biggest risks associated with home birth are usually equated with medical emergencies,” says Owen. “We don’t have an operating room 30 seconds down the hall, and catastrophic emergencies do happen.” For this reason, your midwife will be on the lookout for any signs of complications and can usually recommend a hospital transfer before the situation becomes emergent.
If you think you might be interested in a home birth, talk to your care provider. Direct-entry midwives (DEM), certified professional midwives (CPM), licensed midwives (LM), certified nurse-midwives (CNM) and even physicians can attend home births, but not all do. If you need to make a switch in providers, do so early on for the sake of continuity in your care. Interview several candidates until you find someone whose abilities you’re confident in and whose disposition puts you at ease.
Inquire about fees, licensure in your state and affiliation with professional mid-wifery associations. Ask about education, training and experience. Find out how emergency situations during labor will be handled and under what circumstances you’ll be transferred to a hospital.
“My midwife had more than 30 years of experience, and I knew from the moment I met her that I would be safe in her hands,” says Malarney. “She has relationships with various doctors, and we had a complete plan B should we have needed it.”
Throughout your pregnancy, you’ll meet with your care provider either at her office or in your own home, and there will be plenty of time for conversation at each appointment. “A midwife is an educator—a guide—and will share in decision-making along the way for every screen, test, procedure, goal and dream,” says Owen. She’ll invite you to chime in often, so if there’s something on your mind, speak up.
On the home front
So can a kiddy pool in your living room really beat the well-oiled machine of the maternity ward? For some moms, yes.
“Although my hospital birth was fine, my home birth experience was truly amazing,” says Rachel Marynowski, ND, a licensed naturopathic physician at Intonu Wellness and mom of two, who delivered her second child at her Atlanta residence.
For starters, there’s the convenience of being in your own abode. There’s no need to pack a hospital bag or worry about forgetting your lucky socks. You get to control the room temperature and the ambiance (candles, essential oils, punk rock—anything goes), and you’re free to move about as you please.
“I was in my own bed shortly after my daughter was born, had my kitchen stocked with healthy foods of my choice, and there were no interruptions from health care providers needing to check vitals throughout the day and night,” says Marynowski. “That was the best part.”
Home births can happen in just about any size or type of home. “We need very little beyond a mother and baby to have a home birth,” says Owen. “Clean water, a light source, proximity to a hospital and the equipment a midwife carries are the baseline.” An added bonus, she says, is a clean and tidy space.
“To be honest, not only was the process much better than I had expected, but the mess was nearly nonexistent,” says Malarney. “People always seem to be worried about that, but if you’re prepared, it’s really not a big deal at all.”
Choosing a location for your delivery is a deeply personal choice, and many women feel most confident in a hospital setting. However, home birth can be a safe and meaningful alternative. “To hear my husband or me tell our daughter’s birth story sounds like we are fabricating some dream-like experience,” says Marynowski. “And it was. To deliver a new baby in the comfort of your own home as smoothly and seamlessly as a hospital birth? There really is no comparison.”