Childbirth = Home
This equation may appear incorrect since 99% of North American babies are born in a hospital. However in actuality, home births more reflect the norm around the world and for the other 1 percent of babies here. In Canada, if you are healthy and have a normal, low-risk and uncomplicated pregnancy, choosing to birth your baby at home poses no more risk than choosing to birth your baby at a hospital (and vice versa). Of course, where you choose to birth your baby is your (and your baby’s) choice, but for those of you who would prefer or are considering a home birth, I hope to provide some useful information in this article.
When I was pregnant, there was no question that we wanted a natural home birth, specifically a water birth using HypnoBirthing techniques. This choice came from our own beliefs about what birth should be like for the baby – undrugged, peaceful and welcoming. Fortunately for us our friends, family and health professionals (mid-wife, family doctor) were very supportive of our ideas and we met with no resistance or argument. I suppose being a naturopathic doctor myself helped – they knew that I knew what I was getting myself into! And, I knew friends who also had home births, in some cases all their children were born at home!
When Keira was born, her birthing day unfolded more or less as we hoped … she was born at home, without drugs and with me in the birthing pool. And most importantly she was healthy and I was OK.
If you are choosing or considering a home birth, I wish you the same kind of positivity around your decision and situation as we received.
Things to consider when choosing a homebirth:
Do you want a natural, drug-free birth? Most drugs and procedures administered during labour (epidural, oxytocin, forceps, vacuum etc) can only be done at a hospital with an OBGYN and other medical professionals. This may be a good thing if you REALLY want a natural birth, because at home, you don’t have that option. It is still possible of course to have a natural birth at a hospital, but when the medications are available and offered, it may be easier to accept them in the heat of the moment.
Do you want an OBGYN or a mid-wife? In Ontario we are fortunate to have the option to choose between an Obstetrician (OBGYN) or mid-wife (given that your pregnancy is healthy and uncomplicated). Who you choose depends on what kind of birth you plan. OBGYN’s don’t do homebirths. Mid-wives can’t do C-sections. OBGYN’s are specialists in complicated pregnancies and births. Midwives are specialists in normal pregnancies and births. Midwifery is a regulated health profession in most provinces in Canada and covered by the government in those regulated provinces. The things I really liked about our midwife care were the longer appointments and home visits after the baby was born. We also had 2 midwives: one attending to mom and one attending to the baby.
You will need to gather supplies, prepare your home and clean up after. Unlike the hospital, where you just show up and then leave, you will need to equip your home for the birthing day. Midwives DO NOT clean up! Your midwife will provide you with a list of supplies (such as extra bed sheets, towels, pads etc) and you’ll need to keep them handy and ready. That part is easy. The clean-up … well, we didn’t even think about the clean until we needed to clean up. The honest truth: Birth is messy. There is blood. There is body fluid. There is the placenta. That said, Dad had the condo spotless by the end of the next day (and we don’t forget we had a birthing pool to empty and clean up too!).
Who do you want at your baby’s birth? Most hospitals limit you to 2 people in your hospital room. At home, you could have a family reunion if you really wanted. You can even have pets and other children present.
Also, whatever you want to create a soothing and relaxing atmosphere, you can have it – candles, videos, music, incense whatever. Birthing equipment such as a birthing pool, birthing stool, birthing ball etc are other options too.
Are you considering cord-blood banking? This decision may affect your home birth plan altogether. If you are planning to bank your baby’s cord-blood, then you must birth your baby at the hospital.
UPDATE: A mid-wife (from Toronto) kindly informed me that cord-blood collection CAN be from home! Please check with your care provider of your options.
So, you have decided that “yes, we’re having our baby at home!” and you share this information with your friends and family. What if their reactions are not supportive? What if they start talking about the “what if’s”? What can you tell them?
First, take comfort in knowing that your midwife is a highly trained professional, providing you and your baby with proper care and medical advice and doing what is in the best interest for you and your baby. On your birthing day, the midwife brings with her the necessary medical equipment to monitor you and the baby as well as other supplies that may be needed in an emergency (such as oxygen). If at any time your pregnancy or birthing moves away from being normal and low-risk, she will recommend and take the appropriate actions in order to address any medical needs, that may mean moving your birthing to the hospital or transferring care to an OBGYN.
Multiple studies comparing the outcomes between hospital and planned home births show no difference in terms of the amount of risk to mother or baby. Healthy babies are born at home and at the hospital. In fact, for a healthy, normal pregnancy and childbirth, home may be a safer place. Some people may not think there are risks in hospital births, but there are – drug-resistant infections, unnecessary interventions that can lead to side effects and complications. The safest birth for a healthy low-risk pregnancy is one without any interventions. Birthing at home affords you the time you need to birth your baby, so situations such as a long or stalled labour can be managed safely and on your and your baby’s schedule, not the hospital or staff’s schedule.
There are many benefits to birthing your baby at home:
Mom is usually more relaxed, therefore allowing her to better manage or even avoid unnecessary discomfort.
Rates of post partum depression are lower in moms who had a home birth
You have better access to resources: food, drink, clothing, shower/ tub, people, TV/radio ec
Those who choose home births generally delay umbilical cord cutting. Delayed cord cutting allows more blood, oxygen and immune cells to reach baby.
There is more room at home for mom to change positions as she choose or for emergency purposes (such as the baby is not in the proper position)
Mom and baby bond and recover in the privacy of home, rather than in a shared room.
What About “Emergencies”?
Contrary to what is depicted in movies and TV shows, birth is generally a slow process and there is usually ample time to get to a hospital even in the case of a true emergency. And while there is small a risk that a medical situation could happen which could possibly be better handled in the hospital (such as umbilical cord prolapse, uterine rupture, abrupted placenta, postpartum hemorrhage) the midwife monitors the labouring woman carefully for potential problems.
Excessive bleeding (postpartum hemorrhage) can be managed at home by breastfeeding immediately to stimulate oxytocin production and uterine contractions or by doing uterine compressions. The midwife may carry IVs or an injection of Pitocin for these circumstances.
For true emergencies that require going to the hospital, those living 20 minutes from the hospital have the same access to emergency services as women birthing at that same hospital. Many hospitals cannot prepare for an emergency surgical delivery in less than 20 minutes. The standard is “30 minutes decision to incision” for all non-scheduled cesarean sections.
The experience of birthing at home is very different than in a hospital. It feels calm, relaxed and familiar. Even looking at home birth pictures brings about a different feeling compared to looking at hospital birth pictures. And even though birth itself can be unpredictable, birthing at home can give you a secure sense that you can control some things. And when it’s all done and you meet your baby, you’re already home!
I wish you a happy birthing day!