Google+

Home Births: Another Option for birth. But are Home Births Safe?

3 comments

Sleep Like A Baby

Giving birth by yourself, in the woods, behind your house, naked, leaning against a tree with wild flowers in your hair & weaving a hemp necklace in-between contractions.

That’s a home birth…right?

#Notsomuch. Home births are usually a “very comfortable, offer more flexibility & have skilled providers there to catch baby” birth experience (as reported by many moms who’ve had hospital births & home births). The providers are able to handle complications & plan for a transfer to a hospital, if needed. The skilled providers, usually midwives (some Ob/Gyns also attend home births), come equipped with lots of things like Dopplers (for checking baby’s heart rate), some medications, oxygen, blood pressure cuffs, essential oils and more (read this on Midwives for a thorough list).

*When we talk about home births, we’re talking about “planned home births”. That means you are planning on birthing at home with a skilled provider attending your birth.*

Are home births safe?

Great question. After all, that’s the elephant in the room, isn’t it?

The uncomplicated answer is YES. Infant mortality rates of planned home births are on par with low risk hospital births. The American Public Health Association says  “Planned home birth carried a rate of 1.7 infant deaths per 1,000 births, a rate consistent with most North American studies of intended births out of hospital and low-risk hospital births.” Another study of 5,418 women comparing low-risk hospital births to low-risk homebirths (with certified professional midwives) concluded homebirths are safe. Evidence here.  

According to a growing body of research, for low-risk women, planned home births are safe.

How is that possible? The reality is births can happen {and do happen} just about anywhere (car, plane, fields, beds, showers, etc.). Obviously those places may not be optimal. The point is that it’s not a requirement to be in a hospital to successfully labor & birth a healthy baby. 

Most home birth parents hire very skilled providers. For example, a couple might hire a midwife who’s helped moms deliver over 4,000 babies (in & out of hospitals) & who’s in tune with enabling & supporting a woman’s body to do what it was designed to do- only intervening when medically required. We’ve also talked with Ob/Gyns who attend home births, but they are fewer in number, so we’ve focused on midwives. (here’s an interview with an Ob/Gyn who attends homebirths)

You may be asking- “but what if…” the cord is wrapped around the neck, the baby is breech, the labor goes on for a really long time, the mama doesn’t stop bleeding after birth, etc?  These are very legit questions & concerns. And if you’re considering a home birth- they are fabulous questions to ask your prospective midwife (each midwife practices & handles things differently).

Midwives (in general) are trained to approach birth & overcome birth challenges in non-medical ways. Understand that does not mean midwives are not skilled, capable & able to provide medical care, because many midwives are able to provide medical care & they do if there’s a medical requirement (depending on what kind of midwife you hire). It means their lens from which they view birth begins & stays a normal natural non-medical event, until a medical need arises necessitating medical intervention.

It’s astounding how effective & successful home birth midwives are when dealing with the exact same scenario as a traditional hospital birth, without all the fancy shiny high-tech equipment. They often successfully accomplish naturally (meaning no medical procedure), what a hospital would routinely medically intervene for. 

Most normal birth scenarios do not require high-tech equipment. High-tech equipment does not guarantee or automatically equate to “better care”. It’s a different method from which to administer care. How the care is given (the when, why & what) is just as important as the super high-tech highly trained care itself, in determining the quality of care.

Here’s a saweet analogy- you might go to the best salon in the world, but if they’re too aggressive with their Gucci hair gear & product…you can most def still end up looking like Carrot Top. Or you could be riding with your friend who drives ‘the safest car’ in the world (like a crazy big shiny hummer), but are you really ‘safer’ if she’s taking unnecessary risks in that big ole’ thing? 

This in no way diminishes a hospital’s life-saving capabilities, but in fact shows the incredible skill of many midwives.

For example, home birth midwives often get babies to turn head down into the optimal birthing position (from the other non-optimal positions) by skillfully massaging the belly, when hospital protocol would require a C-Section. They can unwrap the cord around baby’s neck, where a hospital might suggest an emergency C-Section. (FYI- it’s common for babies to have cords wrapped around their neck…listen to this interview with Dr. Greenfield, an Ob/Gyn & mom, talk about it.)

They let a mama’s labor take its natural course (99% of women will go into spontaneous labor on their own), for as long as she wants (assuming mama & baby aren’t in any danger), while a hospital would most likely “help” things get going by inducing with Pitocin. Or midwives might suggest sleep breathing as a way for mama to rest when she’s fatigued during labor, instead of giving heavy duty meds.

Midwives expertly use the freedom that comes with the home environment as a very effective tool, to keep mamas relaxed & laboring towards their baby’s birth, without the quick reliance on technology.

That might be compared to a hospital birth where a doctor follows hospital protocol & does set things at set times, regardless of what the mom wants (even when baby & mom are not in any danger). 

Of course there are times when a transfer to the hospital is needed. And having a skilled midwife who knows her limitations & proactively recognizes when it’s in your & your baby’s best interest to go is essential. 

Why Couples Consider Home Births

Couples decide to birth at home because they have a low risk pregnancy, want to keep things as normal & natural as possible & feel safe at home. Women who labor at home usually have shorter and less painful labors, because they’re in their nest, surrounded by the comfort & familiarity of home, they have control over the ambiance & who’s right there with them, what they’re wearing (or not wearing), where & how they want to labor, etc.

So what’s the complicated answer to the question… “Are home births safe?”

The complicated answer is actually a question- “Is it safe for you?” Each of our own values plays a huge role in birth. That’s why there’ll never be “one right way” or “one right place” to birth. What’s safe for some may not be safe for others. What do you value, what is risky to you?

For example- complications can arise during a home birth. But there are also risks with routine interventions done in the hospital, that often cause complications, which the evidence shows happens much more frequently than births with skilled providers during an ‘out of the hospital’ birth.

Just as we need to ask the question “are home births safe?”….we also need to ask “are hospital births safe?”.

A hospital birth by an Ob/Gyn does not mean there are necessarily less risks, there are different risks. Some hospitals are amazing places to birth, others are not. Each hospital is very different from the next. Each provider is very different from the next.  

You will need to decide what risks you’re willing to take on & which risks you’re not. Of course this is where a solid, trusting, relationship with your provider is CLUTCH, as well as being educated about the various risks & benefits. {Hear one mama share her mistakes & teach you what she wishes she knew about ‘finding THE best provider‘…so you can avoid making her same  mistakes and be better prepared}

It’s like asking someone if flying is safe. The evidence says it’s the safest way to travel, but for some people, the thought of flying will never be comfortable. For others, it’s the only way to travel. It’s the same with home births. But don’t take our word for it, look at the research & evidence. 

The evidence supports home birth as a safe option for low-risk women. But more importantly is that YOU are 100% comfortable & confident & you have a skilled provider helping you.

For women who’ve planned and prepared themselves, home birth gives them options a traditional hospital environment does not. Some of the options include:

  • Freedom to move around in whatever labor & birth position works for them
  • Water births 
  • Comfortable environment 
  • Ability to eat/drink freely during labor
  • Not staying in a hospital (staying in a hospital can be fear inducing for some) 
  • Being in your own safe haven during birth. 

These options have been shown to help mamas have easier labor & births overall, increase the speed of labor, decrease pain, decrease need for interventions (C-Sections, etc.) & increase birth satisfaction.

It’s understandable to feel that anything outside of a traditional hospital birth is unsafe. Because that’s all we’ve been taught & it’s all we’ve known. Our culture reinforces that “hospital birth” is “the only way to birth”.

If you want to learn more on the “is it safe” question, you might find interesting how the American Public Health Association “supports efforts to increase out-of-hospital maternity care services.” Evidence here.

At the end of the day, it’s your birth & wherever you decide to be, you’ll feel way more confident having learned more about your care.

If you want to deliver at Home, then you might want to think about…

  • If you are a good candidate for a homebirth (low-risk pregnancy). 
  • What provider can best support your goals for a home birth? 
  • How you want to handle a transfer to a hospital should it be required? 
  • Does your Midwife have good relationships with specific OB’s in the event of a transfer? 
  • Which hospital you’d want to be transferred to and how far away it is.

Summary

If you feel safe at home & trust your provider and your body to birth your baby, then a planned home birth is an ideal place for you to give birth.

It’s totally cool that not all women feel this way about birthing at home, that’s why it’s a personal decision.

For example, a friend expressed that she really wanted to have a home birth. She planned on having one until she realized that she felt stressed out about it. She knew during her labor, she would be distracted by her 3 kiddos and where they would be and what they would be doing and realized that for her, she wanted to go somewhere AWAY from home so she could relax and focus on birthing her baby.

Home Births aren’t for everyone.

The same questions asked about ‘are home births safe’ should also be asked about any other place you might birth. How care is given is just as important as where it’s given. 

Learn the pluses & minuses of each, and tune in to how YOU feel about your choices. Then make an informed decision (based on the evidence) & hire a provider who will support YOU wholeheartedly- wherever you want to give birth to that baby.

“You must know for which harbor you are headed if you are to catch the right wind to take you there.” Seneca click to tweet

 

An Army of Mentors helping you Be Ready for Baby- Easier | Faster | Smarter

 

 

Leave your email above & share what you think below. : )

  • jwilridge

    this is a nice article…but your missing a section on unassisted home births, witch are generally even safer and more pleasant then an assisted one.

  • Sabrina Fletcher

    The article states that, “This is no way diminishes a hospital’s life-saving capabilities, but in fact shows the incredible skill of many midwives”.

    I would also like to point out that so many successful, safe home births also show the “incredible skill of *women’s bodies* “: the innate knowledge of the birthing mother’s body, when left to birth naturally.

    Even Ina May Gaskin, one of the most renowned U.S. midwives and natural birth advocates states: “I make the point about (myself and my fellow midwives) having done many things right from the beginning because it illustrates an important truth about birth: Birth is a normal physiological process. In no field other than midwifery could my partners and I have entered as amateurs, arranged for our own education, and still have managed to safely produce results that far out-stripped those of meducal professionals in hospitals with the most up-to-date technology. We could not have become dentists or surgeons this way” (p. 131, Ina May’s Guide to Childbirth).

    The body knows what to do… and does it even better when not tethered to an IV, denied food, liquid, rest or movement.

    It’s one of the best kept secrets – that women are strong. Our bodies are meant to give birth.

    • yourbabybooty

      We completely agree with you:) Our bodies are simply incredible. Thank you for that quote & your thoughts, Ina May’s book is definitely one of our favorites around here.