Giving birth at home is a safe and satisfying choice for families who want the best possible start for themselves and their babies.
Families who choose homebirth have a much higher chance of enjoying a natural, physiologic birth, and a much lower chance of experiencing unnecessary medical procedures, with outcomes that are just as safe, compared to healthy mothers and babies birthing in hospital.
Other homebirth benefits include:
- Fathers can have a closer and more intimate involvement in labour and birth, which can be difficult in a hospital setting.
- Siblings or other family members can be present and involved. In contrast, hospitals may not offer the flexibility that families seek.
- Homebirth mothers may want to avoid hospitals because of a previous bad experience, or fear of a bad experience, which may even be brought on by a visit to a hospital or medical professional.
- In special circumstances, hospitals may be unable or unwilling to offer gentle or personalized choices, such a preference to avoid routine monitoring and drugs; accommodating the needs of older or younger mothers who want a natural birth (and tend to be subject to higher intervention rates); families seeking a natural birth after cesarean.
- Women who book for a homebirth have an exceptionally low chance of needing a cesarean.
- Many homebirth families may have an awareness of the baby’s experience of birth, and a desire to provide the most gentle start possible for the baby
- Families may be seeking the personal and intimate support provided though one-to-one care with their chosen midwife, Midwifery care usually begins early in pregnancy and lasts through to several weeks after birth
- Staying home is usually a much more attractive option in labour than a cramped car ride to hospital!
- According to a recent US survey, safety is the number one reason that couples give for choosing homebirth.
Who chooses homebirth?
Women who choose homebirth, according to Australian research, tend to be older and more educated than the general population. In some places, homebirth is a more affordable choice than hospital birth because of the low need for expensive medical procedures. Homebirth midwives also tend to charge a lower fee than obstetricians, despite the much bigger time commitment that they make to in prenatal visits (usually at least 30 minutes each visit) and in-labour through to postpartum care, where a midwife may be present for many hours.
Giving birth at home is a safe choice, according to the best international research. Homebirth babies have equally good perinatal mortality — risk of dying around the time of birth — compared to low-risk babies born in hospital.
In addition, homebirth mothers and babies have strikingly lower rates of medical procedures. For example, cesarean rates among women planning to give birth at home are typically under 5-10%, compared with 30% or more for hospital- birthing mothers.
Even more safe
There are other aspects of homebirth that contribute to excellent medium- and long-term outcomes for mothers and their homeborn children.
The lack of disturbance associated with giving birth at home allows the full expression of the labouring woman’s “ecstatic hormones”. These four critical hormone systems — oxytocin, beta-endorphins, epinephrine/norepinephrine and prolactin — act to enhance ease, pleasure and safety for mother and baby in labour and birth, and give mothers and newborns an optimal start to breastfeeding and bonding. Successful breastfeeding (which is more likely after homebirth) and mother-infant attachment give irreplaceable and life-long health advantages to both mother and baby.
Homebirths are usually attended by a midwife who has training and experience in caring for mothers and babies at home. Homebirth midwives are highly skilled and competent, and bring all the necessary medical equipment, including equipment to deal with emergencies for mother and baby. Midwives will often work in pairs for support and safety.
Homebirth midwifery is supported by the government, and free to families in some countries including New Zealand, the Netherlands, and England. In other places, including some US states, homebirth and midwifery practice may be illegal. However, you may find midwives prepared to care for you in neighbouring states or countries, or other skilled and experienced birth attendants may be available.
In some places guidelines and/or local laws will also regulate local midwifery and homebirth practice. These may prohibit midwives from caring for, for example, women planning a VBAC, or who go more than 7 to 14 days overdue.
It is therefore important to be clear about what a midwife can and cannot offer you, when you first interview her.
Is giving birth at home for you?
Choosing your place of birth is a big decision and, in my mind, one that only the expectant mother, along with her husband or partner, can make.
If you are considering homebirth I suggest that you not only seek information, but also check in with your instincts.
Where would your body like to put itself so that you can feel safe to fully surrender to labour and birth?
Who would you prefer to be with you?
What degree of protection do you need for your birthing space and baby, and will this need be best served in a hospital setting, with medical protection, or at home, where your emotional safety will also be prioritized?
You can also talk to others about their experiences (including online in places such as mothering.com); read stories; watch videos, (including Youtube) of home and hospital births; and ideally attend the meeting of a homebirth group.
For more of Dr Buckley’s science and wisdom on homebirth, see her