Updated: Feb 10
Midwives, Labor Tubs, and Low Lights, Oh My!
I'll get to the point here for you real quick- I can't give you the answer to the question posed in the title of this blog post. It depends? Maybe? While I'm an advocate for homebirth, that comes with stipulations. I'm an advocate for home births for low risk moms who...gasp...want to have a homebirth. Here are 6 questions for you to consider as you decide if home birth is right for you. This is not to sway you in one direction or another, but to encourage you to think critically about your options.
1. Do I want a homebirth?
Before you roll your eyes at the obvious nature of this question, hear me out. When you visualize the most ideal place to birth your baby, do you see your home as a safe, comfortable, relaxing place to be? Can you envision yourself laboring in the quiet spaces of your home, meeting your baby face to face in your dim-light bedroom, falling asleep together in your own bed with your new squishy baby on your chest? If that sounds dreamy, homebirth may be just the right thing for you.
2. Are you and your baby low risk?
Birthing at home is a wonderful thing, but only if you are something called "low risk." A low-risk pregnancy is when a mother has no pre-existing, or pregnancy induced medical conditions, when the baby is growing healthily and on track, and, according to CA law, you are birthing between 37-42 weeks and are having a singleton baby with its cute head down (vs breech). There are things that may preclude you from having a home birth, and in those cases we are so thankful for hospital care.
3. Are you cool with having an unmedicated birth?
In case you didn't know, you can't have an epidural at home. That comes as a surprise to some. Birth? Without drugs? Oh yes, it can absolutely be done, despite what you may have heard. So, if you are wanting a homebirth, you'll need to wrap your mind around the fact that the options for drugs to reduce any pain and discomfort simply aren't available while you are at home. Yes, we can transfer to the hospital for them should that be necessary, but we have other options at home to help take the edge off. Laboring in water, the freedom to get into different positions as you desire, and utilizing counter pressure are commonly used options.
4. Is a homebirth in your budget?
It's a huge bummer that this is a question, and that it is such a huge barrier for those desiring and deserving a home birth. Unfortunately, many insurance companies still don't cover home birth (Do they not know how much money you are saving them?!). Some companies and/or plans cover it, many don't. And even more unfortunately, many insurance providers don't have a clear stance on the subject so you'll get different answers on different days. Talk to the midwives in your area about their pricing, any insurance billing companies they work with, as well their stance on payment plans. Personally here at Beautiful One Midwifery we offer a couple options for payment plans to either save on our global fee, or stretch out your monthly payments to make it more attainable. Some of our clients have set up their baby registries to help collect funds from loved ones for their homebirth, picked up extra hours at work, or sold items that aren't "sparking joy" around the house any more to help raise money. We hope with continued efforts by you, the consumer, to demand homebirth coverage from your insurance company will begin to break down this barrier.
5. Have you considered all the benefits?
Homebirth has some benefits that other birthing locations do not have. Staying home and not having to travel, being fully comfortable in your own surroundings, creating the exact ambiance you desire, orchestrating the exact birth team you'd like surrounding you and your baby, and being in an environment in which your hormones are much more likely to flow optimally are all benefits that you won't find elsewhere. Adding in things like not having unnecessary interventions, not being exposed to hospital germs, eating familiar food, being in your own bed to sleep after the birth (and not being woken up for vitals!), the increased bonding time with baby and increased breastfeeding rates...all of these things, and more, definitely add up quickly as you decide what sounds like the best environment physically and emotionally.
6. Have you considered all the risks?
Just as it is with any birth in any location, there are risks for homebirth. To reiterate: yes, there are risks to homebirth, just as there are risks to hospital birth or anywhere else one can have a baby. As much as we can tout the extensive research of the safety of homebirth with a skilled provider, we don't want anyone to be naive to the potential risks as well. As midwives we mostly attend births where things are pretty straightforward, and since we are experts in normal birth and serve low risk moms and babies, this makes perfect sense. Honestly though, we actually aren't there for the "normal" births we most often see...those are oh-so-lovely and fill our hearts to overflowing and we love to celebrate them...but we are really there for the births where things start to go sideways and we are needed to utilize our skills to bring things back into equilibrium. Make sure to discuss with your midwifery team how they handle complications, medications and equipment they bring with them to births, and what to expect in case of a hospital transfer. Obviously at home we do not have access to an operating room, so any immediate emergent situations would require a transfer to your closest hospital. Remember, wherever you decide to birth your baby there are benefits and there are risks, so it is up to you to weigh those and see what makes the most sense for you and your family.
We hope this has been helpful as you continue to think about how you would like to feel, where you would like to be, and who you would like to be surrounded by on your baby's birth day!
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