Giving birth can be a dividing discussion. Some women grow up dreaming of the day they’ll become mothers. Others know, emphatically, that they don’t want kids. Of the group that plans on becoming mothers, some will get pregnant easily. Others will struggle through rounds of fertility treatments, their plan of having two girls and a boy, raised in a sprawling home just outside of the city, growing seemingly dimmer with every hormone injection.
When the pregnancy happens—whether it happened with no effort or it was worked and prayed (and even paid) for—another topic will split the consensus: the birth plan. Most women in developed countries have an endless number of options for giving birth. You can choose to give birth at a hospital or in your bedroom. You can utilize modern medicine to its fullest (hello, epidural!) or you can choose to go a more natural route.
If you’re thinking about having a home birth, read on for an in-depth, practical look at the different factors to consider when you’re evaluating birth at home and how they can impact your emotions, finances, and physical being—so you can make an educated decision that is best for you.
What is a Home Birth?
Since the beginning of time, women have been delivering babies at home. Before there were hospitals, that was the only option. Now, with the resurgence of natural-living advocates, home births are popular again. Basically, a home birth is exactly what it sounds like: giving birth at home.
With a team of people—midwives, a doula, an obstetrician, and a pediatrician—you’ll prepare your home to be an optimal and safe environment for labor. Some women choose to give birth in bed, while others set up birthing tubs.
Who Can Have a Home Birth? Who Can’t?
Since modern medicine has become more advanced, experts have become more deeply divided on whether a home birth is safe. What this boils down to is your personal health, the health of your baby, and whether you have a low- or high-risk pregnancy. The American Pregnancy Association gives the following guidelines for who should (and should not) have a home birth.
Home birth is an option for you if:
- You have a low-risk, healthy pregnancy
- You’ll have a physician or certified nurse-midwife at your home during the birth
- You live within 30 miles of a hospital
- You want to share the experience with your friends and family
- You want to avoid medical intervention unless absolutely necessary
- You want to be free to move around and change positions while you give birth
Home birth is not a good idea for you if:
- You have diabetes
- You have preeclampsia
- You have experienced or are at risk for preterm labor
- Your partner doesn’t fully support a home birth
While some doctors may vehemently advise against a home birth, others may be OK with it under certain circumstances. It’s important to find a doctor who both supports your birth plan and provides you with a contingency plan, should you need to go to the hospital at any point during labor. You should have this conversation well before your due date, so everyone is on the same page.
What Does it Mean to Have a Natural Birth?
A natural birth is a vaginal labor with little to no medical intervention. This includes avoiding epidurals, IVs, inducing labor, continuous fetal monitoring, delivery with forceps, or a C-section. Most home births are natural—considering that epidurals are only available in the hospital. Of course, if medically necessary, these avoidances may be altered to ensure the safety of mom and baby. If you’re having a home birth, you’ll want to have a backup plan that includes transfer to a nearby hospital, in case any complications arise.
There are many reasons women choose to have natural births, including:
- They don’t want to expose themselves or their baby to any complications that medication could cause
- The belief that labor is a “natural process, not a medical event”
- They are unable to have pain medications
- They want to try out a new birth experience or stick with what they know works for them
How do you Manage Labor Pain During a Home Birth?
In an article published in The Journal of Perinatal Education, Dr. Judith A. Lothian said:
The pain of labor is what most women worry about. It is important to understand that the pain of the contractions in labor is valuable. It is an important way in which nature actually helps women find their own ways of facilitating birth. In a very real sense, the pain of each contraction becomes a guide for the laboring woman. The positions and activities she chooses in response to what she feels actually help labor progress by increasing the strength and efficiency of the contractions and encouraging the baby to settle in and move down the birth canal. When the pain is entirely removed, the feedback system is disrupted and labor is likely to slow down and become less efficient. As labor progresses and pain increases, endorphins (much more potent than morphine) are released in increasing amounts. The result is a decrease in pain perception, quite naturally. Nature’s narcotic!
Still, women who want to have a home birth may want options if the pain is just too much. Epidurals aren’t possible unless you’re at a hospital (because they have to be administered by an anesthesiologist). However, there are plenty of techniques you can use to manage the pain naturally:
- Massage (One study found that massage during labor found that “women experienced significantly less pain, and their labors were, on average, three hours shorter with less need for medication.”)
- Giving birth in a tub or taking a shower during birth
- Changing positions
- Heat packs
Your doctor, midwife, and doula can all offer suggestions on what has worked for other women who have given birth at home. It’s likely that you’ll need to utilize more than one technique to manage the pain while giving birth at home.
What are the Risks and Benefits of a Home Birth?
As with anything, there are both risks and benefits of having a home birth. You’ll want to decide, with the help of your doctor, midwife, and doula, whether the pros outweigh the cons for your personal situation.
The benefits of a home birth include:
- Being in the comfort of your own home, surrounded by supportive friends and family
- Lower potential for maternal infection than at a hospital
- Fewer unnecessary medical interventions
- Allows for immediate breastfeeding, which can help you form a stronger bond with your baby and lower your risk of postpartum depression
- It can be more affordable
The potential risks of having a home birth are:
- You can’t get pain meds, even if you decide you want them
- You may end up needing to transfer to a hospital
- Some studies have found a strong correlation between home births and neonatal death
How Much Does it Cost to Have a Home Birth?
From diapers to college tuition, the total cost of raising a kid can cost upward of $245 thousand. But what about the cost of giving birth? In 2014, the University of California, San Francisco, published a study that found the costs of giving birth at a hospital for an uncomplicated vaginal delivery could be anywhere from $3,296 to $37,227. A C-section could cost between $8,312 to $71,000. These costs depend on the hospital you deliver at, how much your insurance covers, and whether any additional complications arise.
Home births, however, are often far cheaper—between $3,000 and $4,000, depending on whether your midwife is covered by your insurance. This does not include the costs you could incur if you need to go to the hospital. Some midwives do accept insurance, so be sure to ask. Alternatively, a midwife may offer a discount or charge on a sliding scale if you’re paying out-of-pocket.
Advocating for Your Birthing Experience
Whether you want a natural birth or plan on taking full advantage of the drugs you’re offered, decide to deliver at a hospital or choose to have your baby at home, or if you have a vaginal birth or a c-section, one thing is certain: your birth plan is up to you.
That said, plans change and your doctor and medical team will have your and your baby’s best interest in mind. If they’re recommending that you change your birth plan, don’t hesitate to ask for more information. Unless it’s medically necessary to deviate from your plan, your team is there to help support you in giving you the birth experience you want. Remember: plans change and all that really matters is that you and your baby are healthy.