Why Have a Home Birth?
A better question might be 'Why NOT home?'
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God is the masterful designer of how women's bodies work and how they birth their babies. For centuries, women have given birth at home. In many cultures of the world, this is still the case! Modern obstetric care in which a doctor provides care in a hospital setting didn't become popular until the 1900s. By the 1950s, most births in the United States were happening in the hospital. Birth became medicated and treated as pathological (a sickness, a problem). Pitocin augmentation, forceps, vacuum extractors, and Cesarean sections all became commonplace to 'get the job done' in the name of making birth safer for women and babies. Women were put on the clock, and told if they did not progress at a certain (arbitrary) rate that they clearly were not able to give birth 'naturally.' Yet many women have been led to believe that the only safe option is to give birth in the hospital.
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You may have heard someone say, or even thought to yourself, 'I would love to have a natural birth at home, BUT I want to deliver in the hospital just in case.' Consider this: being in a hospital does not actually lower your risk of complication. It increases your chances of having medical interventions. How could this be? Hospitals are run by protocols and policies. ObGyns are excellent surgeons, but they are usually not well trained in how to support a normal birth without the use of drugs and other interventions. There is a cascade of interventions that occurs in almost every hospital birth in the US.
How the interventions might start: You are having your first baby. You are nervous, but excited. Contractions begin in the afternoon, and you aren't sure when you should go to the hospital. You wait around home for a while, but contractions are strong and you really want to get to the hospital to feel settled. Once you arrive, you are seen by multiple people and a nurse checks you, saying you are 3cm dilated. Now you are settled, but contractions have spaced out and you are now just chatting with your husband, occasionally stopping to breathe through a contraction. A few hours pass, and another nurse comes into to check you again. You are 4cm now, but you aren't progressing according to their guidelines. You are tired, and you haven't eaten anything since you arrived. Your doctor orders Pitocin and you are hooked up to an IV line so the drugs can cause strong contractions.
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Contractions come closer together now, but they are long and strong. It is hard for you to cope, and you aren't able to move around the way you wanted because you have an IV and you are hooked up to a fetal monitoring machine. You had planned on having your baby naturally, but now your nurse is asking if you want to go ahead and get the Epidural. You tell her no, but after a couple more hours and finding out you are only 5cm, you relent. Once the epidural is in place, you are able to relax. But with the relief, your contractions slow down again. Your doctor orders more Pitocin. Another couple hours pass, and your nurse is reviewing the readout of your baby's heartbeat. She tells you to lie on your side, that your baby looks like he's stressed. Your doctor comes in, looks over the readout and tells you the news. Your baby is in distress; the heartbeat is slow and not improving. For the wellbeing of you and your baby, you need to have a C-section now. This isn't how you wanted it to happen, but you would do anything to protect your baby. You say yes, and off you go for an emergency C-section.
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This scenario is not the case for every mother who births in the hospital, yet it is a surprisingly common story. According to the World Health Organization (WHO), there is no evidence of improved outcomes for moms and babies when the national cesarean rate is higher than 10-15%. Yet in the United States, the national cesarean rate was 32.1% in 2021. This is 2-3x higher than the recommendation by the WHO. As a nation, do we really believe that 1/3 of ALL women in the US need to deliver via C-section?
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How birthing at home can be different: You have autonomy. You make the decisions for you and your baby. There is no pressure to 'progress quickly' and you never have to decide when the right time is to go to the hospital. Your midwife will come and go as she is needed or wanted. You are free to move around, and are actually encouraged to eat and drink freely. Your risk of infection and disease is significantly decreased because your body is familiar with the microorganisms in your own home. Vaginal exams are not mandatory, and there are no time limit for your labor as long as you and baby are doing well. Your midwife has spent time with you during your pregnancy and seeks to support you in the way you need. You receive respectful, one-on-one, individualized care. Your belief in your body's ability to birth naturally is encouraged and supported. In the comfort of your own home, you can involve your whole family and have a peaceful birth in a familiar place without unnecessary disruptions or distractions.
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Homebirth: What Are the Issues? - Midwifery Today
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There's No Place Like Home: Why Having a Home Birth is a Good Option
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But is it safe?
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The studies say YES. Around the world, the benefits and safety of giving birth at home with a trained birth attendant can be proven again and again, even in the United States. The World Health Organization statistics show that births attended by midwives have lower rates of infection, lower
C-section rates, fewer complications and healthier outcomes-- meaning lower overall medical expense-- than physician-attended hospital births. The WHO even goes as far as stating that ALL women should be offered midwife-led continuity of care for pregnancy and birth unless they have a serious medical complication. There are no differences in infant mortality rates between midwife-attended and physician-attended births for low-risk mothers. The countries which have the best birth outcomes in the world (the Netherlands, Sweden, New Zealand) use midwives as their main care providers for pregnancy and birth.
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"The perception is that in order to get the highest quality of care, they [women] must be cared for by a senior clinician and that is simply not the case. Midwives provide a sense of normality and by having a midwife they know during pregnancy it allows the mother to feel comfortable and at ease during labor which in turn is much better for the baby.”
-Professor Hora Soltani from Sheffield Hallam University, one of the authors of the WHO study
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See for yourself...
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Home Birth Safety Outcomes - Midwives Alliance of North America (MANA)
This study is the largest analysis of planned home birth in the U.S. ever published.
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Home Birth is Safer Than Hospital Birth: Nation-wide Study Netherlands -- Health Impact News
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Documentaries:
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Midwife: Wouldn't it be great to just give birth?
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Is Homebirth right for you?
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