“Can you *do* that?” you ask.
Well, sure! Women for centuries have been having their babies at home. There’s no reason to stop now, and there are many reasons to keep the practice up.
True, some 98 percent of U.S. women today have their babies in a hospital, which became *the* place to birth in the early 20th century as physicians, not midwives, became the normative providers for maternity care and pain-relieving drugs became more available.
But the Centers for Disease Control and Prevention (CDC) reported in January 2012 that from 2004 to 2009, the number of women having home births increased by 29 percent from 0.56 percent of all U.S. births to 0.72 percent of all U.S. births. (CDC Report January 2012)
Why? Well, it’s hard to know *exactly why* for sure, but here are the reasons families tell us they want home births (in random order):
- They understand that for a healthy mom and a healthy baby, birth usually need not be a “medical” event, so they don’t want a “medical” birth. Home births include significantly fewer interventions and allow for more freedom for the birthing mother, the baby and her family to birth more organically. They want a licensed, clinically competent provider, sure, but they don’t believe they need a specialized surgeon and many medical interventions for normal, natural delivery.
- Along those ^ lines, one main reason families choose home birth is because they want to do things on their own terms and not be roped into “routine” procedures. For example, they want to give birth wherever and however seems best – the bathtub, the recliner, the closet sometimes, standing, squatting, kneeling, side-lying, in the water, on the back porch or over the toilet. They want to eat and drink in labor, to play music or light candles. They want to wear their own clothes, soak in their own bathtubs or welcome the new baby with their other children around them. They want to be free to choose, after receiving informed consent, which procedures they want for mother or baby without hassle.
- It’s usually less expensive than other options. Even if home-birth midwifery care for the childbearing year costs a family several thousand dollars, as it is likely to do, a home birth is still a lot less pricey than a hospital birth. Depending on the community, patients are likely to pay upwards of $10,000 for a spontaneous vaginal delivery in a hospital – triple that for surgery. It’s often just plain economical to stay home. Some insurance companies – including Indiana Medicaid – cover home birth, though clients often have to do a lot of legwork and be proactive to get it covered.
- They had a poor experience or outcome in the hospital and want the next time to be different. This is such a common reason and one way clients are self-converts to home birth, often becoming passionate advocates for it. Perhaps it was an induction, labor augmentation, epidural anesthesia or assisted delivery that bothered them. Perhaps they had surgery. Home-birth CNMs in Indiana attend VBACs, for example, and will sometimes care for women who would otherwise face certain questionable interventions (ie, a scheduled surgical birth) were they in the hospital.
- Some clients just don’t want to go anywhere! Ever traveled in a compact car at 6 cm dilated? Yeah, it’s not very pleasant. For some women, the thought of leaving home, traveling, checking in and laboring in a strange place is just too much. It seems to make more sense for many to just ease into labor at home – with the attendants coming to them – and to have the baby (often) in the same place where it was conceived.
- People love their midwives and want that attendant specifically. Some choose home birth simply because they want the assurance they’ll get the provider they want at the birth. Because midwifery includes viewing a woman holistically, many women forge intimate relationships with their midwives and do not want the less-personalized care of other types of providers. They also like the one-on-one, continuous care they get from their trusted midwives versus more common come-in-at-the-end care in the hospital. Many times clients can choose the midwife’s assistant, also, and they often hire doulas. Women themselves, then, are the ones who have chosen their birth team and do not have to worry about breaks in the continuity of care brought about by shift changes or whatever else.
Not every reason is a good reason to have a home birth, and some people are just naturally risked out along the way. For example, home birth isn’t for the woman who feels pressured into it – by family or society or whomever – but who, herself, would be more comfortable elsewhere.
Other reasons NOT to have a home birth include:
- Solely to save money. Often the person who’s viewing home birth strictly from a financial perspective but who doesn’t hold well with the philosophical underpinnings of home birth will not do well.
- To try to prove something. One’s birth experience is not the forum for making a political statement. Again, unless the fundamental understanding about the benefits and risks of home birth is there, people like this usually get risked out one way or another.
- If there is a significant health issue either with mom or baby. CNMs are constantly – throughout 9 months of maternal care and during labor – watching for signs that a woman’s body or her baby need more than she can offer at home. Because the midwife is bound to what she knows, she doesn’t hesitate to transfer a woman who needs something else.
(Oh, and if you paid attention, you might wonder where the other 1.28 percent of women are birthing. Birth centers, most likely, or miscellaneous, random places like the car on the way to the hospital.)