Home birth involves giving birth in a home or residence rather than in a hospital or a birth center. A question often asked is why someone would choose to go this route in the first place. Many people prefer home births for various reasons. Home births offer options and benefits that are otherwise impossible while birthing in a hospital. Home births can be planned or unplanned, assisted or unassisted.
Home births have benefits and drawbacks, and like all birthing options, they’re not for everybody. This article will give you many things to consider when exploring all birthing options and specifically what’s involved in home birth.
Who is a good candidate for a home birth?
Home births are not a viable option for every person. So what makes a good candidate for home births?
Home births are for:
- Those with healthy, low-risk pregnancies. A low-risk pregnancy can look like: Single pregnancy, the baby isn’t breech, no diabetes, or no high blood pressure.
- Those who understand the risks and benefits.
- Those who are confident and trust in their body’s ability to give birth.
- Those who want to get involved in making decisions around their labor.
- Those who prefer fewer medical interventions during labor and delivery.
Remember to consult your doctor, midwife, or birth provider to see if you’re a good candidate for this type of birth. Issues like a breech baby do not disqualify you automatically from home birth guidelines. Things like spinning babies are a thing, and some medical professionals are experts in delivering breech babies. As always, consult your medical team, be safe, know when to take risks and when to play it safe, and always have a plan in place.
Assisted or unassisted home birth?
An assisted home birth is when you have medical professionals present to assist in your home birth. An unassisted home birth is when you’re giving birth at home by yourself, or your family is catching the baby and there are no medical professionals present. An unassisted home birth is also termed a free birth.
Is it legal to give birth at home alone? Currently, no specific laws are outlawing unassisted or assisted birth per se. There are regulations for deliveries in different states. For example, some states have rules on who can assist in home births, while other states have laws about taking the baby to a doctor or midwife for medical care after birth in order to receive a birth certificate. The hard part about these laws, especially with unassisted birth, is determining whose unassisted birth was unplanned and who planned out their home birth.
That being said, the best thing for you to do is to research the laws and regulations in your state for home births, both assisted and unassisted. That way, you’re working within your allowed options or at least aware of the consequences if you choose to exercise certain options.
Benefits of a home birth
Home birth benefits differ for each person because often, people have their own reasons for choosing to give birth at home in the first place. Benefits of a planned home birth include:
- No medical intervention.
- The freedom to labor and birth freely.
- A home birth setup allows for birthing in a familiar setting.
- Respect and freedom for cultural and religious aspects.
- A home birth cost is much lower. On average, it’s about 60% less in a home than in a hospital.
- It provides access to immediate bonding and breastfeeding, which stops bleeding, clears the mucus in the newborn’s nose and mouth, and transfers antibodies that fight diseases from mother to baby via the milk.
- You are in the safety of your own home, so the number of support people will be in your control
- Including more family members in the birthing process helps and relieves you and your partner of some tasks.
- It lowers rates of intervention and maternal morbidity.
Home births have their benefits. With the pandemic changing the way birth happens in hospitals and even birthing centers, these benefits begin to draw more people. Ensuring these benefits fit your needs and outweigh the risks for your baby and body is an integral part of choosing a birthing method.
Risks of home birth
Birth itself, even in a hospital, can be a very risky business. With all the benefits, there are some risks. When you choose to give birth at home, you must consider the negatives too.
There is a chance that a home birth transfer to the hospital is necessary. A transfer from home to hospital during and after planned home births mainly occurs during labor.
The reasons a transfer is needed is if:
- Labor isn’t progressing.
- The baby is showing signs of distress.
- Pain relief is required.
- The mother is bleeding or develops high blood pressure.
Although a home birth helps combat the maternal mortality rate, it comes with twice the risk of perinatal death and thrice the risk of neonatal seizures. Beware that many of these home birth statistics come from observational studies, which leave a lot to be desired. That said, the common drawbacks and risks associated with home birth are perinatal death, neonatal seizures, and hospital transfers.
Birth plan for home birth
So you’ve looked closely at the home birth pros and cons and you wish to go ahead with this option. The next thing to do is knowing how to prepare for home birth. This is where a birth plan comes into play. It is a valuable tool in prenatal care regardless of what type of birth you decide to have. It helps you, your partner, and your birth team be aware of your desires and plan for how your journey should go during labor, birth, and afterward.
It’s important to be realistic that birth in and of itself is unpredictable and that your birth plan is not a script. A birth plan for home birth has similar things like regular hospital births with some extras. The list of things you would see on a home birth plan that isn’t standard to other birth plans include:
- What are you going to eat/drink during labor?
- What are the roles of your family members who will be present?
- Do you want your children (if you have other children) to be present? If so, who’s going to be watching them, or what are their roles?
- What home birth supplies do you have and what are you going to use them for?
- What is being done with your placenta?
These are a few of the questions you can ask so as to add much needed information to your home birth plan.
What supplies do you need for a home birth?
One of the home birth plan questions is about supplies. Since you’re not in a hospital, you have to provide your own home birth supply kit. Even when birthing at home, you will need items to help with the labor and delivery process.
Below is a supply list of standard materials you may need for your home birth:
- A pair of sheets. You don’t have to ruin your typical sheets so buying new ones for the bed just for birth is helpful.
- Towels. For any clean-ups needed.
- Wash cloths. For wiping yourself and your baby or cleaning up.
- Pillows. For comfort and different position changes while birthing.
- Food. This isn’t for everybody; do your research and see if you are comfortable eating. Some moms who give birth at home do eat while in labor to keep their strength up.
- Ice chips. An excellent snack to have during labor if you aren’t comfortable eating food.
- Ice pack or heating pads. This is another pain relief tool that you may use while in labor or afterward in postpartum care.
- Overnight maternity pads. Use these for after birth in your choice of mesh or regular panties.
- Your choice of mild pain killers. For home birth pain relief.
- Water birth supplies. For those having a home birth.
- Camera. To capture all those amazing moments!
- Music. It is a fun tool to use for labor, birth, and after for pain help, relaxation, and entertainment.
- Essential oils. A great labor and birth tool. The different scents bring about different feelings for each person to help guide them through and relax them.
Alternatively, you can find a home birth pack put together with almost everything you’ll need for labor, birth, and postpartum.
It’s essential to have all your supplies in order because there’s no such thing as being too prepared. Ensure you have a hospital bag packed with additional items such as outfits for mom and baby, insurance cards, and toiletries—on the off chance that a hospital transfer might be necessary.
Regular home birth or home water birth?
Some home births involve part of labor, delivery, or both happening while you’re in a birth pool filled with warm water. Some people labor in the pool but deliver elsewhere. Some people labor elsewhere but deliver in the pool and some do it all in the pool.
Why water birth? According to the American College of Obstetricians and Gynecologists (ACOG), the benefits of home birth water are especially seen during the first stage of labor. Immersion in water in the first stage of labor may help shorten your labor’s duration and laboring in water may also decrease your need for epidurals. However, ACOG doesn’t recommend laboring beyond the first stage of labor or giving birth in water.
What do I need for a home water birth?
Here are some home birth supplies often used in a home water birth:
- Birthing pool. Birth pools are available for purchase and are to be filled and placed wherever convenient and comfortable for you during labor and delivery.
- Pool liner. This item is to go inside the birthing pool for easy clean up.
- Strainer. This helps clean the water as needed of debris.
- Towels. Needed for clean ups.
- Plastic liner for the floor. It’s important to protect your floor from all the water, so there is no damage.
- Hose. This item helps get the water in and out of the pool.
- Floating thermometer. Making sure the water isn’t too hot (or too cold) for you and the baby is important.
There are other home birth accessories needed, but this is what you specifically need for water births. You can purchase them separately or find a complete water birth kit put together for you. If you and your midwife are considering a water birth, The Waterbirth book: Everything you need to know from the world’s renowned natural childbirth pioneer provides more insight.
Not every home birth has to be a water birth. Whatever your preference, make sure all your supplies are in order and that you have everything you need to be comfortable and enjoy your journey.
What happens after a home birth?
Postpartum looks a little different for home births seeing as you are already home. Placental delivery occurs, but it’s often unaided instead of the typical “exert downward pressure on the top of the uterus” active management done in a hospital. At that point, you have options on what to do with your placenta. You may have a lotus birth where you keep the placenta attached until the cord turns white; you must sprinkle the placenta with certain herbs to keep it viable. There is also placenta encapsulation, where the placenta is dried and put into capsules for postpartum consumption.
For most home births, if you’re breastfeeding, get your baby latched right away. Eating and family bonding happens during the postpartum period and there are no worries of anyone taking your baby. Your birth team gets to conduct the first baby check-up and can do a follow-up a few days later, but you should still take your baby to the pediatrician for future check-ups.
All in all, the postpartum period after home birth is relatively easygoing and catered to your preference and flow.
The emergence of a global health crisis and strict hospital policies have impacted birth plans and how people view giving birth, especially in hospitals. Those who had previously not considered home birthing have had to reassess their options because of concern about attending hospitals in a pandemic and exclusion of birth partners in some hospitals. More pregnant moms have been researching and opting for planned home birth and unplanned home birth due to wanting to labor at home.
Home birth services are key to improving birth outcomes, especially in this unprecedented COVID era, as you may be hesitant to have a hospital birth. There are questions about whether the popularity of home birthing and free birthing will dwindle as restrictions get lifted. Or will mothers find that the pros outweigh the cons and continue to grow the home birthing community? Everyone has different birth needs; hence decisions will always be different. For each option, look at your history, consult your birth team, and weigh the pros and cons to help build the roadmap for your birth journey.