In 2014, the UK’s National Institute for Health and Care Excellence (NICE) issued new guidelines for the care of healthy women and their babies during childbirth. After reviewing the evidence, NICE recommended that low risk pregnant women—the vast majority of the over 700,000 women who give birth in the UK—give birth at home or with a midwife-led unit, rather than a hospital.
As these guidelines suggest, low-risk women are better off staying at home than going to the hospital. This is because there is a greater risk of over-intervention at the hospital than there is a risk for under-intervention at home.
Homebirth is also on the increase in the US. According to the CDC, the percentage of out-of- hospital births increased from 1.26% of U.S. births in 2011 to 1.36% in 2012, continuing an increase that began in 2004. Most homebirths are attended by midwives.
Reasons to consider homebirth
- It is the birthing environment you will have the most control over. In your own home you have the best shot at deciding what visual elements, sounds, smells and faces will surround you when your baby is born. You can lower the lights, play Reggae music, or invite anyone you want to have around you to attend, if you like. Women who give birth at home do report a greater sense of control over the experience and this sense of control generally contributes to greater overall satisfaction with the birthing experience.
- At home you can avoid unnecessary medical interventions unsupported by scientific evidence, such as: episiotomy, shaving, enemas, IV, withholding nourishment, early rupture of membranes, and electronic fetal monitoring.
- There are fewer cesareans associated with homebirths than with hospital births. The CDC puts the US cesarean rate at 31.9%. A cesarean rate of 5% to 10% is optimal and a 2014 study showed a cesarean rate of 5.2% among women who plan a homebirth and transfer to the hospital.
- Many experts believe that you, and your baby, will have a reduced chance of getting an infection if you are not in a hospital. Hospitals are known for spreading staph, and other infections, around to patients. You are already accustomed to the bacteria present in your home and have probably developed some immunity to them.
- You will have unrestricted access to the birth companions of your choice, ones who are sensitive to your specific beliefs, values, and customs.
- You will have the services of a midwife, who provides continuity of care, follow-up well-baby care, and breastfeeding support.
- You can have freedom of movement and will be encouraged to get off your back and try upright postures for birth.
- You will be offered suggestions for non-drug pain relief.
Find a homebirth midwife
Here are some resources for finding a homebirth midwife.
- Midwives Alliance of North America
- American College of Nurse Midwives
- National Association to Advance Black Birth
- Citizens for Midwifery
- Midwifery Today
Questions to ask a homebirth midwife
Here are some questions to ask your prospective birth attendant. Add your own.
- What is your midwifery education and experience? What certifications or licenses do you hold?
- How long have you been practicing? How many births have you attended?
- Who is your midwifery back-up? Who is your medical back-up?
- How often will I see you during my pregnancy? How long will prenatal visits last?
- How will my partner (and children) be involved in prenatal visits, during labor and at the birth?
- Will you provide me with nutritional guidelines?
- What is your philosophy about prenatal testing?
- Do you offer childbirth education classes?
- Will you suggest non-drug soothers, and different positions during labor?
- How long after birth is the umbilical cord cut?
- How long will you stay at my home after the birth? How often do you visit afterwards?
- What emergency equipment do you carry?
- What back-up hospital do you use?
- Under what circumstances do you transport to a hospital and what is your rate of transport?
- What happens when there is a hospital transport?
Surround yourself with the positive
Birth is normal. Trust yourself. Trust the process. Trust the outcome. In addition to asking the right questions, surround yourself with positive images of and stories about birth. Look at cross-cultural art that depicts classic images of mother and child. Read homebirth stories. You can find these stories in Ina May Gaskin’s books, Spiritual Midwifery, Birth Matters and Ina May’s Guide to Childbirth.
Listen to Ina May
Watch The Business of Being Born.
Come to terms with Pain in Labor.
Learn labor coping from Penny Simkin.
About Peggy O’Mara. I am an independent journalist who edits and publishes peggyomara.com. I was the editor and publisher of Mothering magazine for over 30 years. My books include Having a Baby Naturally, Natural Family Living, The Way Back Home and A Quiet Place. I have conducted workshops at Omega Institute, Esalen, La Leche League, Hollyhock and Bioneers. I am the mother of four and grandmother of three. Please sign up for my free newsletter with the latest posts on parenting, activism, and healthy living.