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Midwife Talks

Homebirth: A Gentle Option for Low-Risk Pregnancies

- Sep 5th, 2023

We are all unique beings, with our own beliefs and experiences in life that help to guide us in making decisions. These decisions also include the type of care we desire during pregnancy, birth and beyond. There is a reason why we have all these options for care. I don’t think that these options are superior or inferior to each other but rather a spectrum of choices that every person decides where they feel most comfortable and safe. These choices obviously need to take into account the person’s health history and the level of care they need.

Yes, the lives of birthing people and their babies are of utmost importance, but does that always mean that being in a hospital setting is the right choice for everybody. There are studies that show that this is not the case for low risk folks who wish to plan a homebirth under the care of a qualified midwife. Au contraire!

The data shows that the perinatal mortality and morbidity is unchanged when you look at two similar groups of low risk pregnancies, where one chose to birth in a hospital setting and the other in a home setting. What you do find is that the hospital group is more likely to experience interventions such as pitocin augmentation, artificial rupture of membranes, more vaginal exams, episiotomies and so on. It’s unfortunate that knowing all this, the number of families that choose homebirth is currently around 1% in the US. The scare tactics and fear mongering needs to stop! The homebirth option needs to be integrated into the system, to optimize the relationship between in hospital and out of hospital healthcare providers. This option needs to be made more accessible to families so that health equity can be achieved.

This is why I wanted to dive deeper into a topic that often sparks spirited discussions in the world of pregnancy and childbirth - homebirth. Specifically, I want to address the safety of homebirth as a viable and gentle option for those with low-risk pregnancies.

In the world of midwifery, where I have devoted years of my life, I've witnessed and personally experienced the profound beauty and safety that homebirth can offer. While it may not be the right choice for everyone, it certainly deserves thoughtful consideration.

Understanding Low-Risk Pregnancies

First, let's clarify what is meant by "low-risk pregnancy." This term refers to pregnancies where the birthing parent and baby have no significant medical conditions or complications that would necessitate continuous medical intervention during labor and birth. Low-risk pregnancies typically involve:

  • No pre-existing medical conditions such as diabetes, high blood pressure, or heart disease.
  • No history of previous cesarean sections (unless it was a low-transverse incision).
  • A singleton pregnancy.
  • A baby that is in a head-down position (although that can be argued, and a topic for another post , for sure!).
  • No known fetal anomalies or complications.

With this in mind, let’s discuss what you get with the home birth experience:

  • Personalized Care: Homebirth allows for personalized, one-on-one care from a midwife who is dedicated to your well-being. This close relationship fosters trust and ensures that your specific needs are met throughout the pregnancy, labor, birth and postpartum. There is a strong emphasis on family-centered care. Siblings and partners can be more actively involved, creating a supportive and intimate atmosphere that promotes a sense of security and well-being.
  • Familiar Environment: The comfort of your own home can significantly reduce stress and anxiety during labor, leading to a more relaxed and efficient birthing process. This is your safe space, where the only people there are those who were invited in. You know that they are there to support you.
  • Lower Risk of Infection: Hospitals can expose you and your newborn to various infections. Homebirth minimizes this risk, as you control your environment.
  • Fewer Interventions: Homebirth often results in fewer medical interventions such as inductions, epidurals, and cesarean sections, episiotomies, instrumental deliveries (vacuum/forceps) which are more commonly used in hospital births. There’s a lower risk of 3rd/4th degree tearing and other complications.
  • Reduced Risk of Medical Errors: In a homebirth setting, the risk of medical errors, such as medication mix-ups or miscommunication among healthcare providers, is virtually nonexistent. And yes we do carry medications with us to homebirth, in case a complication does arise, such a hemorrhage.
  • Respect for Your Choices: Homebirth empowers you to make informed decisions about your birth, ensuring that your preferences are respected and honored.
  • Faster (but more importantly Healthier) Recovery: Mothers who give birth at home often experience quicker postpartum recoveries due to the peaceful and nurturing environment. Homebirth clients receive a more comprehensive postpartum care plan, instead of just one 6 week postpartum visit.

Homebirth is a beautiful option for low-risk pregnancies, offering a safe, nurturing, and personalized experience. While it's not the right choice for everyone, it's crucial to consider it as a valid option for those who desire a gentle and empowering birth experience in the comfort of their own home. Choosing your birth place and your birth team should never be done out of fear or out of pressure and bias that people around you carry. Some of these are so deeply ingrained it’s hard to even notice them and can sometimes lead to a skewed perception of safety.

This is why choosing this option should be a conscious and informed choice that you make. It’s your body and your baby. We do proper research before picking a surgeon for a procedure, before choosing a daycare for our kids, before buying a car… I could go on and on. The same should be done when choosing the team who will support and care for you during one of the most beautiful and transformational times of your life.

As always, consult with a midwife/healthcare provider to determine if homebirth is the right choice for your unique circumstances. Your safety and the well-being of your baby are of the utmost importance, and with the right support, homebirth can be a safe and rewarding journey into parenthood.