Pros and Cons of Home Birth
There’s no shortage of strong opinions when it comes to home birth. For this reason, it can be difficult to find accurate, unbiased information when you’re trying to make an informed decision for yourself. There are benefits and drawbacks to giving birth at home, just as there are with hospital births. Every person is unique, and your specific circumstances and preferences should help guide your decision. Here are some of the potential pros and cons of home birth to take into consideration:
Pros:
Lack of pressure to accept unwanted medical monitoring, intervention, and/or medication
Familiar, comfortable setting with only people and providers you choose
More control over the birthing process
Cultural or religious considerations
Lower cost
No need for transportation or concerns about when to go to the hospital
Birthing parent reports better experience of giving birth at home than in the hospital
More personalized care and more time spent with home birth care providers
Cons:
There may be a delay in receiving medical intervention in the case of an emergency
Insurance may not cover some home-birth costs
If intervention becomes necessary, you may need to be transported during labor
Home Birth vs Hospital Birth
While most births in the U.S. still take place in a hospital, home births are becoming more common. Labor management is generally different during a home birth vs a hospital birth. In a traditional hospital or birth-center setting, your temperature, blood pressure, pulse, and your baby’s heart rate are monitored continuously throughout your labor by your provider. During a home birth, this is typically done intermittently with a doppler monitor.
Most expectant parents who choose to plan a home birth go through labor and delivery with no complications. However, if you’re pregnant with multiples, have previously had a cesarean, or your baby hasn’t settled into a headfirst-delivery position, you may be at an increased risk. People who choose to give birth at home can help mediate potential risks by having an emergency plan prepared and seeking the assistance of a nurse, midwife, doula, or other professional provider.
VBAC Home Birth
If you’re planning a VBAC (vaginal birth after cesarean) in your home, you may be concerned about the increased potential of needing to be transferred to a hospital during labor. While HBAC (home birth after cesarean) is associated with a higher rate of hospital transfer than home births with no previous cesarean, research indicates that the majority of people who’ve had a cesarean in the past are able to deliver at home without complications or the need to be transferred.
An emergency plan and the involvement of at least one trained professional are generally more important in cases of VBAC home births compared to those with no prior cesarean.
Support Options for an At-Home Birth
While preparing to give birth can be an incredible time in your pregnancy journey, for many expectant parents, it can lead to anxiety. This is true whether you’re planning to give birth at home or in a clinical setting.
Giving birth at home doesn’t mean giving birth alone or without assistance. There are many professional support options for an at-home birth. In fact, one of the primary reasons many people choose home birth in the first place is the ability to choose the type of support that’s right for them based on their preferences and unique circumstances.
Here are just some of the options available to those planning a home birth:
Midwife Home Birth Support
Many people choose to give birth at home with the help of a midwife. Midwives are health professionals trained to provide assistance and support during labor, delivery, and after childbirth. They don’t only work in home-birth settings, but often also provide childbirth support in birth centers and hospitals, working alongside doctors, nurses, and other healthcare providers.
Midwives may have varying types of training, so you can choose the type of midwife home-birth support services you want and/or need. Certified nurse-midwives (CNMs) are registered nurses who often work in clinical settings and can provide more comprehensive medical care, and if needed, during a home birth. Certified midwives (CMs) and certified professional midwives (CPMs) are non-nurse midwives with advanced education and clinical training. Some midwives may not have formal or institutional education, but are trained in informal settings or as apprentices.
Home Birth Doula Support
Doulas are trained to provide comprehensive physical, emotional, and informational support to pregnant and birthing people as well as new families. Although midwife support is generally focused on the clinical aspects of giving birth, a doula is comprehensively trained to provide guidance throughout the pregnancy, labor, and delivery processes as well as postpartum. It’s common for people to work with both a midwife and a doula as part of their home-birth assistance team.
Home-birth doula support may include helping to prepare a birth plan, offering evidence-based education and information during pregnancy, providing physical and emotional support to you and your family during labor and delivery, and offering postpartum and newborn-care support. Many doulas also teach childbirth classes to help prepare your mind and body for the process and experience of giving birth.
Unassisted Home Birth
An unassisted home birth, often also referred to as a “freebirth,” is one that takes place at home without the presence of a doctor, midwife, or any other trained health provider. While some are the result of surprise or emergency situations, about two-thirds of all unassisted home births are planned. Some birthing people still choose to work with a doula during a planned freebirth.
People who choose this route report doing so for a variety of reasons, including negative past experiences with hospitals or healthcare providers, a desire to limit medical monitoring and intervention during labor and delivery, and concerns about costs. Some also choose unassisted home birth because they want to reclaim childbirth as a private and natural experience.
How Much Does a Home Birth Cost?
A major concern of many pregnant people and their families is the cost of childbirth, and it’s understandable why. Including both vaginal births and cesareans, the average cost to have a baby in the U.S. is $10,808. In almost every case, home birth is less expensive than hospital birth, but by how much? How much does a home birth cost anyway? The answer depends greatly on your insurance status and plan.
The cost of giving birth varies substantially depending on your circumstances and the level of medical care you require or prefer. Here are some very general estimates:
On average, a home birth costs somewhere between $1,500 and $5,000.
With no insurance, a hospital birth can often cost between $15,000 and $20,000.
With insurance, the average out-of-pocket cost of a hospital birth is about $4,500, although this can vary widely depending on your specific plan.
Does Medicaid cover home birth?
Medicaid is a major funder of childbirth in the United States. In fact, medicaid covers almost half of all births nationwide, and over 60% in certain states. But does Medicaid cover home birth? Generally, while states are required to cover inpatient hospital births for low-income birthing people, it’s up to the states to determine coverage for out-of-hospital births.
Based on self-reported national survey data, about half of all states cover home births through Medicaid, including Oregon and Washington. However, even in states that provide coverage, not all aspects of home birth are covered by Medicaid, and generally there are some out-of-pocket expenses associated with giving birth, whether in a hospital, a birth center, or at home.
Does insurance cover home birth?
Childbirth is expensive, even for people in higher income brackets. While many states cover in-hospital and home births for low-income people through their Medicaid programs, it isn’t only low-income people who are concerned about cost. It’s worth asking: does insurance cover home birth?
Many people choose home birth because it’s less expensive. Unfortunately, private insurance doesn’t always cover the costs associated with giving birth at home or in a birth center. If you have private insurance individually or through your employer, it’s important to look carefully into exactly what’s covered and what isn’t.
Home Birth Photography
Home birth photography is a wonderful way to capture the difficult, beautiful experience of labor and delivery and the incredible first few moments of your child’s new life. The desire to be in a comfortable, calming environment surrounded only by trusted family and support-team members is a major contributor to many people’s decision to give birth at home. Related to this desire is the hope that childbirth will be an intimate, natural experience that you’ll look back on and remember for many years to come. A home environment offers the ideal backdrop for birth photography and/or birth videography.
Home Birth Videos
Videos tell stories in a different way than photos do. Home birth videos capture the process of childbirth completely and in motion. The experience of labor and delivery is emotional, intimate, and powerful. You will never forget that moment when your child enters the world, draws their first breath of air, and opens their eyes to look into yours for the very first time. Home birth videography is designed to capture these moments and preserve them forever for you, your child, and your family.
Home Birth Photos
Home birth photos can immortalize the struggle of labor, the revelation of delivery, and the beauty and intimacy of the moment when you hold your new child for the first time. Many people choose to capture their home childbirth journey through videos, while others choose to opt only for birth photos, and others decide they’d like to have both.
It’s important to find a home birth photographer (and/or videographer) you trust, who will take the time to work with you prior to your planned home birth and make sure they know what you want and don’t want, as well as what you’re hoping for during the process of giving birth and from your home birth photos.
Home Birth Kit: Preparing for a Home Birth
As you plan your home birth, your midwife, doula or other support professional will generally ask you to make sure you have a home birth kit that includes all the supplies and items you’ll need for the process of childbirth. If you’ve decided to plan an unassisted home birth, it’s still important to make sure you’re well prepared with all the supplies you’ll need.
As a general rule, it’s recommended that you gather all the necessities for your home birth kit by the time you’re 36 weeks pregnant. In some cases, you may be able to buy everything you need in one official kit, while other times you may need to purchase items individually.
Home Birth Supplies List
As you prepare for your home birth and gather all the items you need, it can be helpful to make a home birth supplies list and check the items off as you gather them. It’s a good idea to keep them all in one place, so you can easily access them when you need them.
Home birth kits usually contain a combination of medical and sanitary supplies and items to keep you comfortable. Common items to ensure you have in your home birth supplies list include:
Learn how to check dilation
Several sets of clean sheets
Plenty of clean bath towels, hand towels, and washcloths
Clean blankets
Plastic drop cloths
Large plastic trash bags
Large metal or plastic mixing bowl
Large metal cookie sheet
Cotton balls
A bottle of isopropyl rubbing alcohol (70%)
Sterile gloves
Disposable underwear
A thermometer
Lubricating jelly
Bags of ice
A bulb syringe
Clothes and diapers for your newborn baby
Clothes for you during and after giving birth
Lots of snacks (including some rich in protein)
Favorite teas or beverages
Plenty of water
Home Birth Checklist
When your labor begins, it’s important that you and your support team are able to focus on making sure you and your baby are safe and comfortable. That means preparing sufficiently in advance so you don’t end up having to run out and buy supplies or feeling unsure of what to do next. As you prepare, it can be helpful to keep a home birth checklist to ensure you’re ready for each step of labor and delivery when it arrives.
Each person’s home birth checklist will be unique to them and their specific situation, but here are a few items to consider adding to yours:
Gather all labor and birth supplies in one easy-to-access location.
Prepare any environment-tools (such as lighting, music, candles, or other items) for comfort and relaxation.
Determine where the labor and delivery will take place in the home (or where it will begin).
Develop a plan for photography/videography.
Plan how to contact support-team members when labor begins.
Discuss what will happen in the event of an emergency or the need for medical intervention.
Pack a hospital-transportation bag, in case of the need for transfer.
How to Get a Birth Certificate for a Home Birth
An essential part of planning is making sure you know how to get a birth certificate for a home birth in your state. Obtaining a birth certificate is essential, as it ensures your child will receive a social security number. If you work with a trained midwife they can assist you in the process of obtaining a legal birth certificate.
The process following a home birth differs between states (Oregon has its own specific forms and requirements). Generally, you need to visit your local Vital Records office to provide the following:
Proof of your baby’s birth date
Proof of residency
One witness of the birth
Water Birth at Home
A water birth means you spend part of your labor and/or delivery in a tub or pool of warm water. Water births take place at hospitals, in birth centers, and during home births. Especially for people who’ve chosen natural, non-medicated childbirth, water birth can help ease the pain of labor and delivery, shorten the duration of labor, and help prevent the need for anesthesia. Water birth is especially helpful during the early stages of labor, when you’re experiencing the pain of contractions.
If you choose to plan a water birth at home, you’ll need to make sure you have access to a wading pool or clean bathtub and warm water. It’s also helpful to add a few extra towels to your home birth kit.
Home Birth Tub
Some expectant parents choose to use their bathtub or a small wading pool for their home water birth. You may also consider purchasing a home birth tub specifically designed for giving birth at home in water. These birth tubs can be ordered through Amazon and other online retailers and are designed to provide ample space for your body to move during labor. They also sometimes come with sanitary liners, water pillows, heaters, and other accessories that can make giving birth more comfortable.
Home Water Birth Videos
Home water births are the subjects of some of the most intimate, natural, and beautiful birth photos and videos. Home water birth videos can capture the moments of pain, connection, emotion, relief, and joy that you and your family experience as you go through labor and delivery. If you’re planning a home water birth, it can be helpful to look for birth photographers and videographers who have experience with capturing births in water.
Looking for unbiased information or advice about home birth?
We’re trained comprehensively to provide physical, emotional, and educational support to pregnant and birthing people. We’re here to offer you guidance and evidence-based help, wherever you choose to give birth. Contact Wildwood Birth to speak with a Portland-based doula and get your questions answered.