HOME BIRTH -101

Updated: Dec 2, 2019



Whenever you hear that there is a more natural alternative to do anything, do you get excited? Home birth is one of those subjects we love. Home birth is the planned delivery of a baby inside its parent's own house with the help of a trained expert, most commonly a midwife. This alternative was the norm centuries ago, and it was a part of the family dynamic.

While modernization has brought many improvements with medicalized birth, every day more women find in going back to home birth a more suitable alternative for them.


How can you do it?


The first step is to choose the person who will help you with the delivery. You should seek a trained specialist who has done many home births. It’s the moment to be fully aware of the process and what to expect, as well as the risk and the benefits. It's crucial at this point to establish whether this alternative is safe for you.


Once you choose your right fit, it's time to make a birth plan: where will you deliver? What do you need? Who will be with you? What can you do to ease the pain? Try to cover every detail you can think of. Think about preparing your space, decorating, and getting everything you may need ready, for you and your baby, not only for the delivery date but also the upcoming days. This part can be a beautiful and personal experience too.


And the last part of being ready is to have a transfer plan. Even with low-risk births, complications may arise and transfer to a nearby medical facility could be necessary. It can make a big difference the time that a transfer takes, so make sure to have a backup plan ready to reduce risks, discuss this plan with your health care provider and make sure that all the arrangements for an emergency transfer are made.


Is home birth safe?


Planned Home birth has been proven to be a safe alternative when compared to hospital birth. Home birth, as demonstrated by medical practitioners in some countries like the U.K and Netherlands, shows comparable outcomes for newborns and reduction of maternal procedures. However, some conditions must be met to allow this secure development, and unfortunately, some of them are not in our hands. Delivery is safer when performed by a trained expert: Studies show better outcomes when experts like trained and certified midwives assist birth.


Home birth should be integrated with the health system. This assures accurate assessment and action when complications are identified. In some cases, midwives work along with obstetricians and have a well-established relationship with hospitals. This puts them in better care of complications that might arise.


Urgent Obstetric care and transfer must be available: 9% of planned home birth will be referred to a hospital, this rate could go up to 45% in first pregnancies. It's safer to have a hospital facility within 3 miles and to have a plan in case of complications.


Home birth is safer in case of low-risk pregnancies: some conditions like first pregnancy, multiple pregnancies, previous C-section or breech presentation puts you at high risk of complications. While it's not impossible to have a home assisted birth in this condition, it is not the safest alternative, and risk assessment should be carefully made.


In the US, the experience is different. Homebirth in most cases is not integrated with the health system. That’s why homebirth is indeed not as safe as in other countries with studies showing adverse outcomes for newborns. Because of this, it's not recommended by health specialists as the most reliable alternative, and it could take a long time until an infrastructure that supports home birth can be available in America.


Pros and cons of home birth


Benefits:


Lower medical intervention rate with a smaller number of episiotomies, facilitation of birth with the use of oxytocin or amniotomy, also a more moderate use of pain medication (for you to judge as a pro or a con)

Lower maternal hemorrhage

Fewer problems of birth progression (likely related to the absence of pain medication)

A higher maternal sensation of comfort and control

Integration of the family if desired


Cons:


A higher number of vaginal and perineal lacerations

Safety concerns for high-risk pregnancies: like in first pregnancies, multiple pregnancies, previous C-section.  

Higher levels of stress in case of transfer need, and other repercussions due to delayed medical treatment.

No possibility to use pain medication


Is home birth for you?


Home birth is for you if:


You feel more comfortable in familiar spaces

You trust your body's processes

You want to feel more in control of your delivery

You want the birth of your child to be a family experience


Home birth is not for you:


If you feel anxious and hospital environments reassure you

You want the fastest attention in the event of complications

Have a high-risk pregnancy

Would like to use pain medication


The bottom line is that giving birth to your child should be a beautiful experience, and home birth can be an excellent option for some women if done right. We encourage you to explore other options like water birth or how to have a more natural birth in a hospital facility and then discuss with your healthcare provider which one is best for you. Childbirth is one of the most beautiful experiences in life, and it should be lived without fear and full of love. Let your comments below, we'll love to know your opinion!