Why Choose Homebirth?
Giving birth naturally can be an experience of transformation and empowerment for everyone involved, and yet the intensity of the process can be challenging for many women. The key to a birth that is both healthy and minimally painful is the ability to relax, as it allows the spontaneous rhythms of labor to progress without interference. The greatest obstacle is fear, for it generates tension and resistance and makes coping with contractions more difficult. In general, the more relaxed the mother, the easier the birth.
Mothers birth best where they feel the most comfortable. For many healthy, low-risk mothers, home provides a supportive and safe environment in which to give birth. Moreover, when a newborn baby is perceived to be a conscious, cognizant being, the manner in which he/she is born can have far reaching effects both psychologically and spiritually. In the privacy and sanctity of home, a mother can surround herself with those she loves and trusts. Assisted by capable, experienced practitioners, the family has more freedom to create the experience they desire and welcome their new child with love and dignity.
|*Statistics have demonstrated that, for the majority of women, home birth with the presence of a skilled attendant is a reasonable and safe option. Home birth has a positive effect on the reduction of unnecessary medical intervention and the application of technology. Birth at home allows for unique conditions that ensure individualized care, facilitate the birth process, support the health of women and babies, contribute to family life, and optimize birth outcomes. *Excerpted from Midwives Alliance of North America Position Statements
Advantages for Mother
- Childbirth has the potential to be a profound, life-transforming experience for the woman, one which may facilitate emotional healing, strengthen and deepen her relationships to all aspects of herself--with far reaching effects to her children, her mate and family members.
- She is not subjected to routine procedures such as continuous electronic fetal monitoring, IVs, and episiotomy.
- She can eat, drink, walk, and rest freely, working with her own natural body rhythms.
She has continuous care with the same attendant throughout the prenatal, labor, delivery and postpartum periods, facilitating trust and competent decision-making based on process as an individual.
- She is more likely to deliver without drugs, vacuum extractors or cesarean section when supported by caregivers who feel that birth is a normal physiological function.
- The woman and baby have less risk of infection in her own home.
- She is free to explore a variety of creative birthing options such as waterbirth, birthing stools, delivery positions like squatting or hands and knees, and may utilize comfort measures like candles, incense, inspiring music, and aromatherapy.
- She is less likely to experience postpartum depression when she has not been separated from her baby. In addition, when childbirth takes place at home, it becomes an integral part of family life, with father and/or siblings able to participate in as complete and appropriate a manner as possible. This assists postpartum adjustment for all family members.
Advantages for Baby
- The baby's experience at birth can be made as gentle and loving as possible, and routine procedures such as deep suctioning, bright lights and artificial warming can be avoided unless medically necessary.
- The healthy baby remains with the mother, preserving the mother-infant bonding so crucial to the development of attachment parenting.
- The baby is more likely to be born vaginally without breathing difficulties so often associated with anesthetics and cesarean birth.
- Breastfeeding is easier to establish when the baby can nurse on demand, and the mother is given immediate encouragement and instruction in proper technique.
- Baby is less likely to develop an infection at home.
- Requires a higher level of effort and responsibility on the part of the parents, and may not be supported by medical doctors/society. While midwives are trained in emergency measures, access to some equipment may be delayed, and transport to a hospital may be required. In urban areas, access to emergency medical services are expeditiously obtainable, and most midwives work in consultation and collaboration with an obstetrician who is willing to assume care of their patients if necessary.
Safety of Homebirth
There have been a number of clinical studies on the safety of homebirth for normal, low-risk women receiving good prenatal care. Practically all of them show that homebirth is either as safe, or safer, than hospital birth - for low risk, healthy pregnant women with normal pregnancies. The main study describing homebirth as more dangerous is a study that was done by the American College of Obstetricians and Gynecologists in 1978 called "Health Department Data Shows Danger of Homebirths." This study included all out-of-hospital births, including unattended births in the home, births en route to the hospital, mothers who may have been high risk, had received no prenatal care, and babies who were pre-term. This factor, which skewed the results, was not widely acknowledged. In fact, this report also included miscarriages in its data showing the risks of homebirth. Clearly, this report is not representative of the kind of homebirth that midwives are offering. And interestingly enough, it seems to be the ONLY study that showed homebirth to be less safe than hospital birth, although many studies have tried.
To read more about the safely of homebirth with skilled midwives,
read The Five Standards for Safe Childbearing , by David Stewart, Ph.D. It cites study after study which detail the statistics that prove the safety of midwife-attended homebirth.
The Philosophical Assumptions of Home Birth Parents and Attendants*
- Because pregnancy and birth are natural physiological events, normal birth does not belong in hospitals.
- The natural course of labor is already perfect, and should be interfered with as little as possible. Pain is part of an essential and healthy feedback mechanism in labor, which women can learn to cope with, with proper encouragement and support.
- Medical management of pregnancy and birth should be limited to those that are medically complicated.
- Unnecessary medical interventions complicate normal labor, creating additional risk and the need for more intervention.
*excerpt taken from Birthing from Within by Pam England, CNM , MA , and Rob Horowitz, Ph.D.
Homebirth Risk Factors
There are certain health factors that may make home delivery unwise. We screen for these possibilities by first asking questions about the client's health, reviewing their health history and blood work results, and then watching carefully for any problems throughout the prenatal period. Below are guidelines for our practice; these may be adapted to particular situations according to our judgment and experience.
Definite contraindications to homebirth
- Placenta previa
- Breech presentation
- Multiple gestation
- Blood disorders
- Drug dependency
- Delivery before 36 weeks gestation
- Previous classical (vertical) uterine incision
- Other serious health problems, such as epilepsy, tuberculosis, renal disease, cardiovascular disease, AIDS
Possible contraindications to homebirth
- Sexually-transmitted diseases
- Abnormal fetal growth
- Poor nutritional status
- Psychological problems
- Active herpes eruptions at time of labor
Should your pregnancy fall outside the parameters for a safe homebirth, we will refer you back into medical care. Should you so desire, we will be happy to continue to support you in the role of a doula (childbirth assistant) as you plan your hospital birth.
Complications which MAY require transport to hospital during labor, birth or postpartum
- Irregular, depressed or accelerated fetal heart rate
- Thick meconium staining
- Prolonged lack of progress in labor
- Elevated maternal temperature
- Poor infant response after birth
- Infant abnormalities
- Retained placenta
- Extensive perineal or cervical lacerations
- Maternal hemorrhage