Every newly pregnant momma immediately starts to envision her birth. For mommas that feel passionate about natural birth, or with an interest in home birth—this wonder can be even more intense.

How do home births work? How can I make sure I have a natural birth? These questions are at the forefront of your mind.

The thing about birth is that so much of it is unknown. It’s hard to envision birth and that can make it feel daunting. Choosing to go against ‘societal norms’ by having a home birth can feel even scarier. But it shouldn’t feel that way!

In this guide, we’ll unpack exactly how home births work. You’ll learn the process of a home birth including when, what, and how things go down right from the very beginning.

At a glance, the process of a home birth includes:

  1. Hiring a home birth midwife and receiving prenatal care
  2. Gathering supplies and preparing for birth
  3. Checking in with your midwife during early labor
  4. Use of pain management strategies throughout your birth
  5. Birthing at home with your midwife
  6. Taking care of paperwork after birth
  7. Home postpartum and pediatric care

But each of those steps includes a whole lot more that I’m sure you’d like to know about. Read on to erase all of the wonder and doubt of what to expect at a home birth!

The process of a home birth throughout your pregnancy

The decision to have a home birth typically happens early in your pregnancy. One of the unique aspects from the start is the hands-on role you will play in planning every step. Sure, in a more conventional birth setting you can still interview providers and check out different hospitals for delivery, but it’s just not as common.

In a planned home birth, there are things you will do in every trimester that become a part of the process of your home birth. From the very beginning, you will be making informed and well-researched decisions.

First Trimester: Deciding if home birth is right for you

The very first step of the process happens right away. Shortly after finding out you are pregnant you will need to choose a provider and begin prenatal care. You can always switch your plan or any aspect along the way, but starting on the right foot can help you avoid unnecessary stress later on.

If you are interested in a planned home birth, the first trimester is an ideal time to decide if a home birth is right for you. Some of this decision is out of your control—because it’s important that you are considered a medically safe candidate to birth at home. But you’ll also want to do some deep reflecting within to make sure a home birth is really right for you mentally and philosophically as well.

Here are some questions to help you with this decision:

First Trimester: Choosing a home birth midwife

Once you’ve decided that home birth is the route you want to go, the next big step in the process is choosing a home birth midwife. One big difference between a home birth and a more conventional birth is the bond you will form with your provider.

Birthing at home is a raw and intimate experience. It’s important to choose a midwife that will enhance this experience, put you at ease, and that you can trust to make important medical decisions should an emergency occur.

When choosing a home birth midwife, it’s best to conduct interviews with a few different candidates so that you can get a sense of different midwifery styles and vibes. Having a point of comparison between more than one candidate will also make your decision clearer.

Where to start? Many midwives who attend home births have their own websites where they advertise their services, or they are affiliated with a larger birth center or midwifery group. Google is a good place to start in making a shortlist of candidates who delivery in your area.

Another great place to get recommendations is on social media. Join some local “crunchy mom” or natural parenting groups and put out a post with your inquiry. Women who’ve had wonderful home birth experiences will be eager to share their connections.

10 weeks-40 weeks: Home birth prenatal care

After selecting your midwife, it is important to keep up with routine home birth prenatal care. Depending on your midwife, this may occur in your home, in her private office, or at a birth center that she is affiliated with.

Participating in prenatal care is especially important when planning a home birth so that your midwife can constantly assess your candidacy for a safe home birth.

Things can arise during pregnancy that might make a hospital birth safer, such as:

  • Preeclampsia
  • Prenatal Hypertension
  • Pre-term labor
  • Gestational Diabetes
  • Pregnancy with multiples
  • Breech or transverse presentation

In short, your home birth midwife will ensure that your pregnancy is low risk at your regular appointments to make sure your home birth will be as smooth as possible.

Third Trimester: Gathering home birth supplies

As your due date draws closer, you will be in charge of gathering many of the supplies for your home birth. This is another big difference in the process of home birth vs. hospital birth. Your midwife will likely give you a supply list of things you must have, but we also recommend consulting our home birth supply list, and water birth supply list to make sure you are extra prepared.

Third Trimester: Preparing for your home birth

We can’t complete the process of a home birth without talking about the personal and physical preparations you will do in addition to the more medical or ‘actionable’ ones.

Because you are birthing in your home, you will need to prepare the physical birthing space. But it can also be even more important to prepare yourself mentally and physically for this big day.

More detailed ways to prepare for your home birth before the big day?

How do home births work once labor begins?

So far, we’ve focused on the process of home birth before you’re even in labor. As you can see, there are a fair amount of logistics that you will be responsible for. The appeal of this for many mommas is how perfectly executed and catered these aspects of birth are to you and your unique experience. Now let’s talk about what goes down once labor actually starts.

Keep in mind that every birth is unique, but in general, your experience will probably follow the steps outlined below.

Check-in with your midwife and doula during early labor

In the weeks leading up to your due date, you and your midwife will discuss a plan outlining exactly when you should call her. Likely, she will ask you to call and give her a heads up that things are starting when early labor begins. Remember, early labor, especially for first-time mommas can be very long.

Early labor is a time when contractions have begun, but they are not yet intense or close together. Generally, this is considered the time before your contractions reach the magic 4-1-1. This is when contractions come every 4 minutes, lasting a full minute, for at least an hour.

Usually, your midwife will want to check in with you during this time to hear how you’re doing, and so that she can prepare for birth to happen very soon!

In addition to calling when things first start, there are other reasons you should definitely call your midwife right away during early labor, or at any time before she arrives:

  • If your water breaks
  • If your water breaks and it is green or brown in color (this can warrant an early hospital transfer due to baby’s meconium in utero)
  • A decrease in baby’s movement
  • Excessive bleeding or any bright red blood
  • If you’ve tested positive for Group B Strep (your midwife may come over much sooner to begin antibiotic treatment if that is the plan)

Some home birth midwives routinely stop by during early labor to get a blood pressure read and have a listen to baby as things are beginning. This varies based on your midwife’s distance from you and general style. You can ask your midwife what to expect as you complete your birth plan and discuss aspects of the big day.

Use early labor pain management strategies

During early labor, you should use distraction techniques to help with the discomfort. These are things like watching TV or a movie, sleeping (if you can), light cleaning and cooking (hey, some mommas swear by it!), or going for a walk.

You might want to take a bath or a shower, eat a light but nourishing meal and be mindful of staying as hydrated as possible. Light yoga stretches and time spent on your birthing ball can also be helpful to continue your progress during early labor.

Be sure to save your main pain coping strategies for active labor and pushing. You don’t want to start in on intense breathing exercises or hypnobirthing too early and exhaust them as options before you’re really uncomfortable later on.

Call your midwife and doula when labor is progressing

You will know your labor is progressing when your contractions are getting longer, stronger, and closer together. Typically, your midwife and/or doula will want to be alerted when you’re experiencing the 4-1-1 I mentioned above. At this point, your birth team will start to gather in your home and support you through the active labor, transition, and stage two.

What will your midwife do upon arrival to your home during labor?

When she arrives she will check your blood pressure and monitor baby’s heartbeat. She will check in with you verbally to hear how things are going and check other vitals as she sees fit. If you are opting for internal checks, and have discussed this prior to birth, she will check to see your progress and let you know how far along you are.

Once she sees that you and baby are safe, she will bring in her supplies and start preparing what she may need for the birth. Remember that your midwife may be accompanied by an assistant or apprentice midwife.

Start using active labor pain management strategies

At this point, you will be feeling the pains of labor and it is time to start utilizing your pain management strategies and techniques. Your partner should be ready to provide you with support as needed. If you’ve chosen to hire a doula she will be suggesting techniques and strategies to try as you labor.

Some effective and popular pain management strategies include:

What will my home birth midwife be doing during my labor?

During your active labor, your midwife will be monitoring baby’s heartbeat and your vitals. She will be on alert for any reasons that a hospital transfer might be necessary before an emergency occurs. At intervals, she may check you for progress, and she will let you know when you should be in position for pushing.

In addition to these roles, your midwife will provide you with encouragement and support during labor. She may suggest positional changes or techniques. She will encourage you to drink water and maybe even eat (I use the term loosely), if you are up for it. Your midwife will offer birth affirmations and mantras and help you focus on your goal of birthing naturally at home.

Above all, your midwife will follow your lead and your energy. In many cases, home birth midwives are pretty hands-off and let you labor naturally as you see fit. She will let your birth be as private and intimate as you desire. She will respect your labor intuition as best as possible.

How does the second stage of labor work at my home birth?

The second stage of labor is also known as the pushing and birth stage. At this point, you will want to be in position for the type of birth you want, or whatever winds up feeling the most natural and appealing in the moment.

For some women that will mean getting into their birth tub, for others it will be going to their carefully prepared bed. Others still may find themselves on the couch with a plastic liner or on the floor on all fours. You can plan to birth one way, but in the moment you can never truly know where your intuition, instincts, and general comfort will take you!

While you are in this stage, your midwife will be right with you. She will talk you through your pushes and may be applying pressure with warm cloth to your perineum to prevent tearing if you are birthing on land. If you are birthing in the water and your second stage lasts a while, your birth team will be actively working to keep your birth tub’s temperature at the right place by adding hot water.

Once baby is crowning, your midwife will honor your wishes about who is catching the baby and will help facilitate delayed cord clamping, or even cord blood banking if it is your plan. When baby arrives, your midwife will quickly check them for good coloring and sounds. As long as everything seems normal you will be able to engage in immediate skin to skin bonding.

What happens immediately after my home birth?

While you are bonding with baby, your midwife will put off all newborn care procedures for 1-2 hours, as long as baby seems healthy. She will stand by while you birth the placenta and then she will assess you for tearing and perform any necessary sutures.

Mommas who have given birth on land will likely deliver their placenta right in place. If you’ve had a water birth, you may stay in the water to deliver the placenta or you may relocate to a birthing stool or other position.

While you’re bonding with baby and enjoying the golden hour after birth, your midwife will already be tidying and helping get your home back to normal. Most midwives aim to leave your home as it was when they arrived. In many cases, your midwife will draw you a recovery sitz bath and serve you a nourishing meal (which you will have on hand). Her goal will be to leave you and baby clean, comfortable and happy.

After the golden hour, your midwife will perform newborn care procedures. She will be trained and able to check baby’s weight and height. But also to administer Vitamin K, eye ointment, check reflexes, and perform other transitional care procedures as outlined by the AAP.

Prior to birth, you should have chosen a pediatrician that is aware of your plan to birth at home. This pediatrician will likely make a home visit between 24-36 hours after birth.

During the few hours after birth, you will be bonding with baby and focusing on breastfeeding. Typically, your midwife will stay until things are cleaned up and breastfeeding is going well.

How does the paperwork happen at my home birth?

You are probably wondering about some logistical things like getting a birth certificate and social security number for your new baby. Again, this is something to discuss with your midwife in the third trimester, but most likely she will provide the necessary paperwork. Usually, you will fill this out and she will take it for submission before she leaves.

In some states, you and your partner will have to take your new bundle of joy, along with your ID’s and the paperwork completed by the midwife to the local county clerk’s office to obtain a birth certificate and SSN. Make sure you are clear on the required timing and information needed prior to giving birth.

Make sure you also add the little one as a dependent on any insurance plans within 31 days of being born. Most insurances will require the birth certificate and the SSN to be submitted to cover any care related to the birth and ongoing well-child visits.

What is the follow-up care after a home birth?

Within a few hours of giving birth, your home will be cleaned up and you will be left to bond as a new family. For most home birth mommas these are the sweet moments they’ve been waiting for! Because you are on your own, your midwife will make sure you are aware of any red flags that warrant a call to her for either you or baby.

Usually, your midwife will come back for postpartum check-ups at 24 hours, 3 days after birth, 7 days after birth, and again at 2-3 weeks after birth depending on how you are doing. She will monitor your vitals, check your stitches, and maybe even give advice about breastfeeding.

Independent of this care, you will need to arrange for pediatric care for your newborn. As I mentioned above, you will likely have chosen a pediatrician during your pregnancy that is aware of your planned home birth.

This person will ideally be willing and able to perform a pediatric home visit sometime between 24-36 hours after birth. After this point, you will either continue to have baby seen in the office, or perhaps a few more times in-home depending on their protocol.

Feeling more informed about how home births work?

With this detailed guide, you should be well on your way to a better understanding of exactly how a home birth works. You now know about the planning aspects prior to the actual birth, and how the actual labor and birth will unfold.

No matter where you’re at in your home birth planning process, this article is packed with a ton of great info! Don’t forget to PIN IT so that you can easily access it again later.

Have a question about the home birth process? Please let us know below!

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