Why Homebirth?

This article by Christy Santoro, CPM was published in the first edition (2007) of the Philadelphia Guide to a Healthy Birth.

Welcome to the world Sadie!

Welcome to the world Sadie!

Having a baby? Consider a homebirth

Did you know that on the day you give birth, over 350,000 mothers worldwide will join you in birthing their child[1] and over 80% of those babies will be born at home? For many in contemporary American culture, the thought of anything outside of a conventional birth in the hospital is not even considered an option. Frequently mothers planning homebirth are met with reactions such as “Women still do that?” “Is it safe? Legal?” or “What’s a midwife?”

Today’s homebirth midwives know how to balance the art and science of pregnancy and birth. Drawing from formalized education and training as well as apprenticeship-based and experiential learning they use intuition and experience as well as evidence-based practice and research. Therefore, women who choose midwife assisted homebirth can benefit from having access to the best of both worlds—skilled, compassionate, individualized care from a trained midwife and the ability to go to the hospital to access the technology and expertise of obstetrics when needed for the health of mother or baby.

Some reasons you may want to consider homebirth:

AVOID UNNECESSARY INTERVENTIONS AND SUPPORT FOR NATURAL BIRTH
 Caesarean sections, epidurals, pitocin inductions and augmentations and other tools of the obstetrician and hospital all have their appropriate uses. However, given the 30% and rising C-section rate in this country, these tools are being over-applied and unnecessarily utilized in almost every hospital in the US. The fear of lawsuits often drives decision-making for doctors resulting in “defensive medicine” rather than evidenced-based medicine. This influence, combined with the alarming decrease in maternity units and beds across the Philadelphia region, have resulted in aggressive approaches to get babies out in an efficient and controlled manner and these aims often work against the needs, desires and best interest of mothers and babies, especially those seeking a natural, normal childbirth.

When a woman labors at home with a midwife, she is given time to let her labor begin and progress on her own timeline. A midwife assisting at a birth allows the natural process of birth to unfold and guides the mother safely through the event. The midwife keeps vigilant watch over the health and safety of mother and baby but does not interfere with the process unless truly necessary.

HEALTHIER AND SAFER FOR YOU AND YOUR BABY
 Pregnancy is not a disease and birth is not a medical event. There is a growing body of research showing excellent outcomes for planned homebirths[2] which indicates that home is as healthy and safe a place to give birth as a hospital or birth center for most women and babies. An added benefit is that you and your baby have less chance of infection or catching any sickness from foreign germs commonly found in hospitals by birthing at home, an environment your immune system is already equipped to deal with. But it is important to remember that homebirth should not be the goal—the true aim is to have a safe, empowering birth while minimizing unnecessary interventions or complications. If health conditions or risk factors arise during pregnancy or in labor and suddenly home is no longer the safest place to be, then transfer to a hospital is indicated and the tools and techniques of obstetrics are welcomed and utilized.

COMFORT, CONVENIENCE AND PRIVACY
 Homebirth is not a medicated hospital birth minus the medicine. In fact, a homebirth labor is very different – the mother can eat and drink what she wants, be in the tub, be in any room or position she chooses, and have her family and friends around her. Birth is not a clinical, sterile event and it is helpful to be in your home environment where you can make noise without feeling self-conscious, listen to music, get massage, cry, laugh, sleep, walk, dance or do whatever else is needed to help the baby be born. After the birth, mother and baby don’t need to go anywhere—they are already home! Not having to drive anywhere while in labor can also be a big plus- especially for those often fast to arrive second babies! We’ve all heard about babies being born on 76 or the Bridge or in a taxi on the way to the hospital—with a planned homebirth, that’s not an issue.

INDIVIDUALIZED CARE AND INFORMED CHOICES
 During a homebirth, you as the birthing mother are the central character in the amazing event of your child’s birth, not the policies and protocols of an institution. Your midwife comes as guest into your home to work with you in your individual circumstances to help facilitate a healthy birth, and to offer guidance, support and reassurance. When working with a homebirth midwife, decisions are made with you, not for you (except, of course, in a true emergency situation). Your birth, your informed choices and your needs lead the way.

FAMILY INVOLVEMENT
 A homebirth is truly a family affair – siblings, family and friends, anyone and everyone you want can be involved in the birth of your child —I once attended a birth with five generations of the family present! Many families choose to have children present and part of the birth experience—sometimes cutting the cord, or announcing the sex of the baby. Others may not want anyone other than one’s partner present for a homebirth. Birthing mothers often catch their own babies, and dads receive their children into open welcoming hands with the midwife alongside offering guidance and support.

INCREASED BONDING AND NO SEPARATION FROM YOUR BABY
 Unless the baby needs extra attention, at a homebirth you can keep your baby by your side throughout the postpartum period, newborn exam and for any other procedures you choose. In fact, keeping your baby skin-to-skin helps facilitate bonding, breastfeeding and helps your body recover from the birth more quickly. At home there is no need for armbands to keep track of who and where your baby is—your baby is the only newborn on the premises!

No one should make you feel like you have to choose between having a healthy baby and having a meaningful birth experience – both are possible. Most women of childbearing age in the U.S. today possess many layers of fear and doubt about their ability to birth their baby. If we can get beyond the messages telling us that we can’t and don’t know how to give birth, we can connect with our bodies’ innate wisdom and knowledge and discover that our bodies are designed to give birth!

Are there risks to choosing a midwife-attended homebirth? Yes. As with anything in life there are always risks. But there are risks involved with a hospital birth, a birth center birth, an unassisted homebirth, or a planned C-section too. Women give birth best where they feel safe. It is up to each mother and family to decide what setting with its related risks and benefits is the right for their pregnancy and birth.

Is a planned homebirth for everyone? Of course not, but in reality neither is a planned hospital birth. Even if you are sure that homebirth is not for you, I encourage you to support others that make that choice and recognize that the choice should be available to women who desire it![3]

[1] Facts and Figures from the World Health Report 2005; WHO. http://www.who.int/whr/2005/media_centre/facts_en.pdf

[2] The largest and most comprehensive study to date was published in the British Medical Journal in June 2005. It can be accessed at…

[3] In April 2007, the British Government implemented a policy guaranteeing all women access to homebirth with a midwife by 2009 covered by their National Health Service. For more information access the report “Maternity Matters” at: