Home birth is an option available to you for your birth! It can be really different from a hospital birth environment, as you have the most control over WHO is in your birth space.
I have given birth at home for my last two births, so I am a huge advocate for giving birth at home. There are a lot of benefits of giving birth at home, such as:
- Personalized, and more in-depth prenatal and postpartum care, and typically see the same midwife your entire pregnancy to establish rapport and build a relationship.
- My prenatal appointments were over an hour and I had over 4 postpartum visits, three of which were in my home after birth
- Choosing who is at your birth, such as your family, other children, and your medical team
- Familiar environment: Being in a familiar environment can help you feel more relaxed and comfortable, which can positively impact the birthing process. Being in one’s own home can help reduce anxiety and allow you to focus on the experience.
- Greater sense of control: Giving birth at home provides greater control over the birthing process. This includes the ability to choose the birthing position, who is present during the birth, and the level of medical intervention. In a hospital setting, the staff may dictate some of these factors.
- Reduced risk of intervention: Research has shown that home births have a lower rate of medical intervention, such as induction or cesarean delivery, compared to hospital births.
But, just because I gave birth at home does not mean that you need to give birth at home too! We fully support you wherever you plan to give birth, whether it be at home, a freestanding birth center, or a hospital!
Let’s breakdown some things to consider if you are wanting a home birth!
5 Considerations When Choosing Home Birth:
I absolutely loved my two home birth experiences. My greatest wish is that everyone could experience that same feeling of empowerment and power that I did during my births in their chosen birth locations, whether it be at home or a hospital.
When giving birth at home, there are some things to consider, as there is a lot of preparation and planning that goes into giving birth at home.
Prepare for Childbirth with these Courses:
1) Choosing a Home Birth Provider
The most important decision is choosing your medical provider. The majority of providers that support home birth are midwives, but there are some OBGYNs that support birth at home.
When choosing your provider, they can help you better understand if home birth is a good option for you, or if giving birth in a hospital setting may be a better option.
The criteria may vary from provider to provider, but there may be certain prenatal complications that may not make you a good candidate for a home birth. This could include, multiples, pre-term labor, placenta previa, preeclampsia, previous cesarean section, and high-risk pregnancy. But, it is worth discussing with home birth providers whether or not you are a good candidate based on your medical history and current pregnancy.
In the United States, there are several different types of midwives, each with its own approach and level of training.
There are four types of midwives:
- Certified Nurse Midwife (CNM)
- Certified Professional Midwife (CPM)
- Certified Midwife (CM)
- Lay Midwife
Each state varies in which type of midwife can legally practice and support births, which could affect your ability to have your home birth reimbursed or covered by your medical insurance.
1. Certified Nurse Midwives (CNMs)
Certified Nurse Midwives (CNMs) are licensed, registered nurses who have completed a graduate-level midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME).
They are also certified by the American Midwifery Certification Board (AMCB) and licensed to practice in all 50 states. CNMs can provide a wide range of services, including prenatal care, labor and delivery support, and postpartum care.
They can also provide gynecological care, family planning, and menopausal care.
The midwife I had for my two home births was a Certified Nurse Midwife, which is currently the only type of midwife that can legally practice in North Carolina and that my insurance will reimburse medical expenses.
2. Certified Professional Midwives (CPMs)
Certified Professional Midwives (CPMs) are independent midwives who are certified by the North American Registry of Midwives (NARM). They provide care to women with low-risk pregnancies and attend births at home, birth centers, or in some cases, hospitals. CPMs are not licensed in every state and may not have access to the same privileges as CNMs and CMs.
Roxanne had CPMs that supported her birth at a freestanding birth center in California! In just over half of the states in the United States, CPMs can legally practice. But, verifying with your insurance that there are no specific requirements on the type of midwife they will cover is important. Roxanne had to pay out of pocket for her birth center birth due to our insurance not covering births attended by CPMs.
3. Certified Midwives (CMs)
Certified Midwives (CMs) are midwives who have completed a graduate-level midwifery education program accredited by ACME, but do not have a nursing background. CMs must pass a certification exam administered by the AMCB to practice midwifery. They are currently licensed to practice in only a few states, including New York and New Jersey.
4. Lay Midwives
Lay midwives are also known as direct-entry midwives or traditional midwives. They do not have formal certification or licensing, but they may have received training through apprenticeships or self-study. They provide care to women with low-risk pregnancies and attend births at home or in birth centers. In some states, they may be subject to regulations, but in others, they may practice without oversight.
2) Establishing Back-Up Care
The provider that you choose to support your home birth will be your primary care, but depending on their facilities you may need backup care established, as well.
For me, my midwife did not do labs or ultrasounds at her office, so I established backup care with an OB clinic that was supportive of home birth. I went to the OB clinic once a trimester to check in, and then did all my labs and ultrasounds with their office.
If I risked out-of-home birth, such as going into labor outside 37 weeks to 42 weeks, or developed a complication that required induction, then I would go to the hospital where my back-up care supported births. Having this backup plan was important as I navigated my pregnancy in case I needed a higher level of medical care.
3) Emergency Response Capability at Home
A home birth midwife is trained to handle emergency situations during childbirth and typically carries a variety of emergency equipment and supplies to manage any unexpected complications that may arise. Here are some of the emergency response equipment and supplies that a home birth midwife may have at a birth:
- Oxygen Tank: An oxygen tank is an essential piece of equipment for a home birth midwife. It can be used to provide oxygen to the mother and baby in the event of respiratory distress or other emergency situations.
- Resuscitation Equipment: A home birth midwife may carry resuscitation equipment, such as a bag-valve-mask (BVM) device and suction equipment, to help support the baby’s breathing if necessary.
- IV Supplies: In the event of excessive bleeding, a home birth midwife may need to administer medications or fluids intravenously. IV supplies, such as catheters and fluids, may be carried by the midwife.
- Medications: A home birth midwife may carry medications to manage emergency situations, such as medications to stop bleeding or manage hypertension.
- Emergency Transportation Plan: While most home births proceed without complications, a home birth midwife should have a plan in place for emergency transportation to a hospital in case of an emergency. This may involve contacting emergency medical services or arranging for a private ambulance.
In addition to these supplies and equipment, a home birth midwife is trained to recognize signs of potential complications and take appropriate action. Midwives also have a network of collaborative relationships with obstetricians and hospitals in case of any emergency situations that may require a transfer of care.
It is important for anyone considering a home birth to discuss the midwife’s emergency response plan and available equipment and supplies. Home birth is a safe and reasonable option for many women with low-risk pregnancies, but it is important to be informed about the potential risks and the available emergency response plan.
Understanding how a home birth midwife and their team would respond to different types of emergencies, and possible emergencies, can be helpful in building your confidence when giving birth at home.
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4) Setting Up Your Birth Space
The next thing to consider is preparing for your home birth! This could include:
- Birth supplies. Most midwives will have a birth kit that you order ahead of time that includes necessary medical and sanitary supplies.
- Your midwife may also have a list of items that they need set aside, such as trash bags, towels and linens, a heating pad, a cooking sheet or tray, and a bowl.
- Birthing pool, liner, hose and adapters, sump pump, and pool cover
- Make sure that your pool blows up and has no holes in it, and that your hose reaches the faucet that you want to use to fill the pool!
- Setting up your bed for a possible birth or labor, by putting on a clean set of sheets, waterproof cover, and another set of sheets on top.
- Deciding where in your home you will be laboring and birthing your baby
- Consider what food and drinks you want available on the day of your labor
- I made a list of snacks that I wanted the day of my labor, and we stocked the nonperishables in our pantry. On the day of our labor, my husband grabbed all the perishable foods I wanted for my labor, such as fruits and vegetables.
5) Birth Day Party: Who's Invited?
The best part about home birth for me was that I got to decide who was going to be at our birth. I got to choose my provider and her birth assistant. I had my husband and other children with me during my labor. I also was able to have other family members, such as my sister and mother at the birth.
When deciding who will be at your birth, assigning tasks to each person will be helpful and help with idle hands.
If you have other children, assigning one person to be in charge of caring for the other children is really important! This person should be someone other than your birth partner.
We also had someone that came to grab our dogs from our home and took care of them for a few days while we recovered after birth.
Bonus: Transfer Plan and Hospital Bags
In the rare event that complications arise, it is crucial to have a plan in place to transfer the birthing person to a hospital quickly. This may require having transportation readily available.
While the majority of people will give birth at home, it is still beneficial to understand your transfer plan and to have a small hospital bag packed.
Transfering, or leaving your home to head to the hospital, can be a stressful event, but not having a bag ready to just grab can make it even more stressful and overwhelming.
Choosing a Home Birth
In conclusion, giving birth at home can offer many benefits, including personalized care, a familiar environment, greater control, and a reduced risk of intervention. However, it is crucial to consider the above factors carefully and make an informed decision that is right for you and your baby. Working closely with an experienced midwife can help ensure a safe and empowering home birth experience.