Whether you’re newly pregnant or hoping to be pregnant soon, you’re here because you’re wondering, is a home birth right for me?

Home birth might sound like a dreamy and unattainable reality to some, but a look at the home birth pros and cons might just convince you that home birth could be your reality!

A home birth might be right for you if you fit the criteria of a low-risk pregnancy. You should have an interest in natural childbirth, understand the financial aspects of a home birth, and feel excited and empowered by the idea of birthing in your own home. Home birth can be a wonderful experience for many women with the right midwife and adequate preparation.

Let’s find out the answers to some of your burning questions surrounding the pros and cons of home birth, such as:

• What are the pros and cons of a home birth?
• Can anyone have a home birth?
• What are the risks of homebirth?
• Is home birth dangerous?
• How does home birth compare to a hospital birth?

With a discussion of these topics, you’ll know if a home birth is right for you. You’ll be prepared to evaluate if home birth is medically safe for you, but also if home birth is the right choice emotionally and physically.

What are the pros and cons of a home birth?

Pros of a Home Birth

1. Natural Birth!

For many women that are entertaining the idea of a home birth, one of the most significant pros is the higher likelihood of achieving a natural birth! If medical pain interventions aren’t a present option, and aren’t medically necessary, odds are you won’t use them, right?

In a study published in 2015 on planned out-of-hospital births, researchers found that out-of-hospital births were “strongly associated with unassisted vaginal delivery (93.8% vs. 71.9% with in-hospital births). This stat alone speaks to your likelihood of natural birth success in your own home vs. a hospital setting.

If a home birth winds up being your choice, I can’t urge you enough to take a childbirth class geared for a natural birth. Set yourself (and your partner) up with a toolkit for success in this endeavor, momma!

2. Greater sense of control over your birth experience

You get to call all the shots!

Want to eat and drink during labor? Want to go labor on your back deck and get fresh air for a while? Want to use your stairs to get in the perfect labor position? Go for it, momma!

During a home birth you will have so much more control over your birth experience. You’ll likely have less medical monitoring, more freedom to move, and you will be calling all the shots (within safe reason of course).

3. Have (or don’t have) whoever you want in your birth space

An added pro of home birth for many mommas is the freedom to have whoever they do (or don’t!) want present during their labor and delivery. Maybe you love being surrounding by empowering women. You can achieve that in your home; whereas, hospitals may have strict limits on who can be in the labor room.

Alternatively, if you can’t stand the idea of various nurses and hospital personnel coming in and out of your birthing space, then a home birth will be so much more comfortable.

Labor is a raw and primal state. Controlling exactly who is involved in this experience is a huge pro about home birth for many mommas.

4. 1-on-1 Attention from your Midwife

Midwifery care is the best. The entire model of midwifery care focuses on serving the whole woman and providing hands-on physical and emotional support during labor and birth.

But it just can’t be as awesome in a hospital…

While you will get some of this in a hospital setting, the fact of the matter is, you are just one of potentially MANY women laboring at the same time. Your midwife, no matter how amazing, will have to divide her time in a hospital setting.

A good friend of mine planned to deliver with a midwife in a hospital setting. Her baby ended up being delivered by an OB/GYN because the midwife had two mommas pushing at the same time. What’s more, the physician used coached pushing with her (something she was strongly against!). Luckily baby was fine, but she was so disappointed in her birth experience.

All of this is to say…

You won’t have this problem at your home birth! You get your midwife’s undivided attention and full support for the entire duration of your labor and birth. Midwives who attend home births typically have a very low case load. This means they will be full devoted and available to you during your big day.

Prenatal care leading up to a home birth rocks, too

Typically, when you choose your midwife for your home birth you pay a flat fee that includes all of your prenatal care and follow-up postpartum care visits. This is in addition to the actual labor and delivery. Often, your prenatal care visits will also be held in the comfort of your own home.

5. Birthing in a familiar and intimate environment

Choosing a home birth gives you complete control of your birth environment. You can prepare the ultimate birthing space, specific to your wants and desires. It will be a space that you know and love. A space that you can easily visualize birthing in throughout your pregnancy. This allows for productive and positive mental preparation prior to your actual birth.

Birthing in your own home removes any anxieties surrounding medical settings, medical personnel and machines. You also don’t have to worry about hearing the sounds of other women laboring (something that might totally freak you out!).

Home is often a place where we feel most comfortable with ourselves. Our guard is down and we are completely relaxed. I truly can’t imagine a better mindset and space to labor- a process all about opening and letting go- than your own home.

6. No limitations on the type of birth or delivery you desire

Hospital settings, and even some birth centers, put limitation on the kind of birth and delivery you can have. Many simply won’t perform water births, even if they offer a tub for laboring purposes. Some settings require pushing in a certain position, and mandate that a medical professional catch baby.

When planning for your home birth, you have the freedom to hire a midwife that will adhere to the type of birth you want. If you are interested in a water birth, you can find a midwife with experience and expertise in home water birth.

In almost all cases you can expect the freedom to push in whatever position feels most comfortable and natural for you. And if the dad-to-be is up for catching the baby, this can be your reality!

7. Careful planning for a hospital transfer should complications arise

When creating this list of pros about home birth, I wanted to directly address the most common con in many people’s minds. What if there’s a complication?

A pro of a planned home birth? You and your midwife will have a detailed and organized plan in place should a hospital transfer be necessary. When it comes to what to ask your midwife before you home birth, ask ALL the questions about this scenario.

Your professional and experienced midwife will absolutely create a rock solid plan with you to use if anything goes wrong. Your midwife likely has admittance rights at a local hospital and may even have an OB/GYN she is affiliated with.

8. Easier to opt out of unwanted medical procedures

In a low-risk pregnancy, a number of the medical standards of prenatal and newborn care today are simply not necessary. If you are a momma who plans to actively research, question, and opt-out of unnecessary routine care procedures, home birth will make this so much easier!

Partnering with a midwife and receiving her one-on-one attention throughout your prenatal care and birth means you can discuss any and all suggested care procedures at length. You will also be able to opt out without a sense of judgement or negligence.

9. No logistics! (you know like getting into a car during active labor…)

A home birth means fewer logistics. Everything will be so carefully planned and prepared ahead of time, that once labor starts, you can just stay put and find your groove.

You won’t have to:

• Call the hospital to see if you should come in
• Go to the hospital for a progress check and potentially be sent home
• Be in the car during active labor
• Be filling out paperwork to get admitted while in active labor
• Be left by your partner when he goes to park the car or grab the bag you forgot
• Worry about bringing EVERYTHING you need to stay comfortable into the hospital with you
• Arrange for child and pet care (if applicable)

I think you get the idea. For me, labor was a rhythm of waves. Getting in sync with this is crucial in your labor progress. The fewer disruption, transitions and unhelpful changes the better. Not having to change locations once labor begins will be a huge relief.

10. Spend your first minutes with baby in YOUR bed

Ah! Can you imagine anything dreamier than your first skin-to-skin and breastfeeding experience with your new babe in your own bed?! The first moment with your new baby is like no other. Experiencing this in your own home is a huge pro to home birth.

Furthermore, you will be able to recover from birth and settle into your new role in the comfort of your own home too. No medical professionals prodding you and checking in throughout the night.

Cons of a Home Birth

1. May not be covered by insurance

A big con for many women is that home birth might not be covered under insurance. This can make a home birth an expensive and an unrealistic option financially.

However, don’t just write this off to be the case for you! In some cases, even without insurance coverage, a home birth may be less expensive than a hospital birth. Yes, you read that correctly.

And in many other cases, home birth is covered (in total, or to some extent) by health insurance. This varies greatly from plan to plan, and even state to state (because different states have different laws surrounding home birth). Sometimes, you’ll need to give proof of being a “low risk” birth, and sometimes not.

The best first step? A direct call to your insurance company to find out what the case is for you.

2. Possibility of a hospital transfer in the event of an emergency

Above, I listed a detailed plan for a hospital transfer as a pro. But the reality is, if you, or baby, needs a hospital transfer, the elapsed time to get to a hospital is time without necessary medical attention.

While you midwife will always err on the side of caution and send you to hospital if she thinks it is best, sometimes in labor and delivery things escalate quickly and time in transit to the hospital is time lost.

3. Not an option for every momma

Unfortunately, not ever momma is a candidate for home birth. Some states even require a risk-assessment which, if deemed high-risk, would make planned home birth illegal for them. This is often to protect the mother, but can sometimes feel like a huge infringement on pregnant women’s rights.

Can anyone have a home birth?

In general, home birth may not be for you if:

• You are diabetic
• You have warning signs of preeclampsia
• You have experienced pre-term labor in past pregnancies or show risk for preterm labor in this pregnancy
• Your partner doesn’t support the decision of a home birth
• You are pregnant with multiples
• You have known irregularities with your cervix, uterus, or placenta
• You have other chronic conditions (preexisting or new to pregnancy)

Having a past C-section and attempting a VBAC does not necessarily mean you cannot have a home birth. You just need to find a midwife to attend your home birth that is comfortable with VBACs.

4. Home birth is not as accepted by mainstream culture

Looking for (even more) of an opinion on your pregnancy and birth? Tell them you’re planning a home birth. Okay, while I hope you are surrounded by uplifting and open-minded individuals, the fact is, home birth is not mainstream.

You will likely be met with your fair share of judgement, stories of scary labors and births, and general disapproval by many. What do I say to this? Who cares!

If your midwife believes you are a good candidate for home birth, and you feel mentally prepared and passionate about delivering at home, go for it!

5. Necessary to monitor you and baby’s vitals on your own

After a home birth, your days postpartum (might) be largely unattended by medically professionals. While this is a pro in a lot of ways, it does mean you and your partner are responsible for monitoring you and baby’s vitals.

However, hiring a postpartum doula can help with this task. You will also likely have postpartum follow-up visits by your midwife. Lastly, you will need to find a pediatrician that can come to your home within 24 hours of birth.

What are the risks of a home birth?

The greatest risk during a home birth is the need for a hospital transfer, and the lost time associated with getting to the hospital. Because home birth accounts for less than 1% of all U.S births out of a hospital, it’s difficult to find data on hospital transfers.

In one European study, 39% of first births attempted at home transferred to a hospital.

Additionally, because home birth is not the norm in our country, there isn’t always a sense of reliable, supportive collaborative care when women need to be transferred to a hospital.

Why might you transfer to a hospital during a home birth?

• No progress in labor
• Fetal distress
• Need for pain medication
• Hemorrhaging
• Cord prolapse
• High blood pressure
• Exhaustion or prolonged labor

What other risks are associated with planned home birth?

• Higher rate of perinatal death in births that intended to deliver at home (3.9 deaths per 1000 deliveries vs. 1.8 per 1000 deliveries in hospital birth)
• Higher odds of neonatal seizure (3-fold increase compared to hospital deliveries, but still very low in both settings)

Is home birth dangerous?

The stats above, do show slightly more risk in a planned home birth. But, below, you’ll see more specific statistics pointing to the huge benefits associated with a home birth.

In short, a home birth is dangerous if it is not well planned for! If you are having a healthy low-risk pregnancy, have an experienced and credentialed midwife and team of birth supporters, a home birth is probably not significantly more dangerous.

Remember: you should always get the advice of a birthing professional to determine if a planned home birth is safe for your unique pregnancy

See sources for further reading on the topic

Comparison: Hospital Birth vs. Home Birth

There is a rising trend for planned home births (and birth center births) in the U.S. This is leading to more and more research and evidence driven data about how hospital and home births compare.

This is wonderful because it allows for mommas to make more informed choice when it comes to where they want to give birth.

Where do women in the U.S. give birth?

• 1.2% of births happen out of hospital, and of these births, the overwhelming majority is at home vs. in a birth center.
• 35,000 births occur at home each year in the U.S. This accounts for roughly .9% of all births.
• As many as 25% of recorded home births are not planned home births.
• There are roughly 26,000 planned home births in the U.S.
• 98.8% of births in the U.S. happen in a hospital setting.

Labor and Delivery Events in Planned Home Births vs. Hospital Births

• Significantly lower rates of labor induction in home birth
• Significantly lower rates of labor augmentation in home birth
• Significantly lower rates of C-section in home birth
• Slightly higher rates of blood transfusion/hemorrhage in home birth (6 vs. 4 in 1000 births)
• Slightly lower rate of severe perineal lacerations in home birth (9 vs. 13 in 1000 births)
• Less experience of low birth weight in home birth
• Less experience of preterm birth in home birth
• Less experience of infection in home birth
• Less use of epidurals, episiotomy, electronic fetal heart rate monitoring in home birth
• Slightly higher rates of perinatal deaths (but still overall extremely low in both settings)
• Slightly higher odds of neonatal seizure (but still overall extremely low in both settings)
• Lower rate of infants admitted into the NICU in home birth vs. hospital birth

See sources for more information

Is a home birth right for you, momma?

Because home birth goes against the norm here in the United States, many women are under the impression that a home birth is far riskier and more dangerous than a hospital birth.

While there are always emergency situations, if you are deemed to be a good fit for a home birth, the risks associated with the decision aren’t significantly higher.

What’s most important is finding a midwife that is professional, experienced, and will KNOW when it’s time to go to the hospital if something goes wrong. There are so many pros to a home birth vs. a hospital birth, and many statistics that point in favor of a home birth.

As you continue to research home birth and decide if it’s right for you, remember to honor what YOU and your partner want. Surround yourself with people who will support you in whatever kind of birth you ultimately decide on.

Let us know in the comments what your thoughts are on home birth and make sure to share or pin this post to help other mommas be informed.

Sources

• https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth?IsMobileSet=false
• https://www.nejm.org/doi/full/10.1056/NEJMsa1501738?query=featured_home
• http://nationalacademies.org/hmd/activities/women/birthsettings/birth-settings-graphic.aspx
• http://www.childbirthconnection.org/healthy-pregnancy/choosing-a-place-of-birth/collecting-information/