The moment that you find out that you are expecting is both thrilling and terrifying. A million thoughts rush through the brain about how you will plan for and take of this precious child. But of course, the first step is to prepare for that spectacular moment when they enter into the world. For many, the first decision involves a choice between a hospital birth and a home birth.
Why Choose A Home Birth?
There are many reasons why expectant parents may make the decision to have their child at home. While home births are not for everyone, a mother who has experienced a normal pregnancy and has no medical risks may find that it is a better option for them.
Home births provide:
- A familiar and comfortable environment for the mother and father.
- Control over the birthing experience.
- The ability to invite as many loved ones as you would like to share in the experience.
- You can move around, change positions, eat, and drink during labor.
Who Will Assist During Labor?
In the majority of home births, the family elects to hire a midwife. According to the Midwives Alliance of North America, midwives are “trained professionals with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period.”
Midwives must successfully complete an education program and be licensed before they can offer their services. A midwife will provide:
- Oxygen if it is needed in an emergency.
- IV fluids for the mother if she needs to be rehydrated.
- Sterile gloves, cotton, waterproof covers for a bed, drop cloths, fetoscopes or an ultrasonic stethoscope, certain prescription medications, herbal remedies, massage supplies, and the necessary materials for suturing any tears
Questions You Should Ask When Hiring A Midwife
It is important that you feel safe, comfortable, and happy with your midwife. When interviewing potential candidates, the following questions may help you determine who will best fit your needs:
- How did you become a midwife? What kind of education or training have you received?
- How often do you attend workshops and conferences?
- How many births have you been the primary midwife for?
- What kind of services are provided with prenatal care?
- Do you have assistants?
- What happens if two clients are in labor at the same time?
- Are you on call 24/7?
- What kind of emergency equipment will you bring?
- What kind of herbs and medications do you use?
- Do you have an affiliation with a specific physician?
- What kind of postpartum care is provided?
It is best if you are completely clear with the midwife on what you both want and expect.
How Do I Know If My Home Is A Good Setting?
Most homes are more than appropriate for a home birth setting. After selecting a midwife they will come to your home for the prenatal care they can evaluate your home setting and suggest any changes that may need to be made.
What Happens If There Is An Emergency?
If there is an emergency such as fetal distress, a failure to for the labor to progress, high blood pressure, a rupture of the membranes, or if the mother simply wants to go to the hospital, they can be transferred via ambulance.
How Often Are Mothers Transferred?
Statistics have shown that around 40% of first-time mothers and 10% of mothers who have given birth more than once are transferred to the hospital before their child is born.
Does Insurance Cover A Home Birth?
Some insurance companies do cover a home birth or at least a portion of it. To find out more, contact your provider for more information.
What Is A Water Birth?
A water birth is when a woman chooses to give birth in a tub of warm water. Some women choose to do just labor in the water and get out during the final delivery and others stay in the water for the entire process. Many believe that giving birth in water is less stressful for the baby since they have been in a fluid-filled amniotic sac. There is also a theory that the water reduces the pains of being in labor for the mother.
It is important that the tub chosen for the birth is carefully monitored for temperature and cleanliness. The temperature of the tub should never get higher than 98 degrees and mothers should be provided with water or other fluids to avoid becoming dehydrated.
Are here Medical Conditions That Would Prevent Me From Having A Home Birth?
Yes. If you have any of the following conditions then a home birth may not be the best option for you:
- Diabetes
- Asthma
- Pre-eclampsia
- High or low platelet levels
- Anemia
- High or low blood pressure
Additionally, if the child is suspected to have a birth defect or other health issue then it is most likely a better option to give birth in the hospital.
What Are The Problems With Giving Birth At Home?
While it might sound lovely to be in the comfort of your own home as you give birth, there are certain disadvantages and risks associated with this decision. These include:
A Lack Of Electronic Fetal Monitoring
An EFM can provide crucial information about the baby’s heart rate such as late decelerations, decreased variability, and the absence of accelerations – information that a midwife’s heart rate monitoring tools cannot. This information can inform doctors if the baby is being deprived of oxygen.
No Access To A Blood Bank
If the mother begins to hemorrhage uncontrollably, a midwife will be unable to administer blood products that could save her life.
No Access To An Operating Room
If the baby is in fetal distress, often the only way to save the baby and in some cases the mother is to perform an emergency c-section. In many cases, the surgery needs to take place in a matter of minutes and time spent on getting the mother to the hospital only decreases the chlid’s chances of survival.
No Resuscitation Team
Hospitals have an entire team who is specially trained in advanced resuscitation skills and who have immediate access to equipment and drugs which may mean the difference between life or death. Midwives may have some training but they do not have access to the tools or help from a team member.
The Statistics
According to the American Journal of Obstetrics & Gynecology, research has shown that home births have nearly 4 times the term neonatal death rates of hospital births. They also reported that babies born at home have an increased risk for brain injuries. Another study performed by the CDC showed that the neonatal death rate for a planned home birth is around 3.5% higher than hospital births.
