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Home births & Midwifes

What is home birth?

Home birth is defined as giving birth to a baby in your place of residence. Home birth can be planned (87% of U.S. home births) or unplanned (13%). It can be attended by a midwife (62% of U.S. home births), a physician (5%), or others, such as family members or emergency medical technicians (33%).

There is a lot of controversy over who should be eligible to give birth at home. Many countries have standardized "lists" of what makes a woman a good candidate for a home birth, but the U.S. does not. The list below is taken from the criteria used in Janssen's (see sources) studies on home birth in Canada.

Women who are considered "low risk" and may be good candidates for home birth include the following (this should not be regarded as an exhaustive list):

  • A woman who is pregnant with a single baby and has made an informed choice to birth at home

  • Baby is head down at term

  • Between 37 and 41-42 weeks pregnant (researchers differ on the 41-42 weeks)

  • No serious medical conditions (heart disease, kidney disease, blood clotting disorders, type I diabetes, gestational diabetes managed with insulin, preeclampsia, or bleeding)

  • No placenta previa at the beginning of labor

  • No active genital herpes

  • No thick meconium

  • No prior C-section

  • Spontaneous labor

What are some reasons women and families decide to have a home birth?

In a 2009 study (see sources) interviewed 160 women who had a home birth in the U.S. and asked them why they chose a home birth. Reasons that the woman gave included:

(* indicates one of the five most common reasons stated)

  • The belief that home birth is safer than the hospital*

  • Desire to avoid unnecessary interventions*

  • Previous negative or traumatic hospital birth experience*

  • Control over birth decisions and choices (want to avoid strict hospital rules)*

  • Dislike of hospitals, doctors, or medically managed birth*

  • The desire for privacy and to avoid strangers

  • Trust in birth as a normal, healthy process

  • Lack of separation from baby, easier breastfeeding initiation

  • Preference for midwives as caregivers

  • Increased options such as delayed cord cutting or water birth

  • Decreased risk of Cesarean birth

  • Comfortable atmosphere

  • Family involvement during the birth (children can be present)

  • Decreased risk of infection

  • History of fast (precipitous) labor where it is difficult to get to the hospital in time

What interventions can a midwife do at a home birth?

Midwives do have a host of other clinical skills that they can use, depending on their scope of practice, training, and licensure. In general, home birth midwives can do the following:

  • Intermittently monitor baby's heart rate with a handheld Doppler and/or fetoscope

  • Monitor the woman's progress of labor

  • Perform cervical exams as requested by the mother

  • Provide physical and emotional support during labor

  • Perform a newborn exam

  • Suture any tears after birth

  • Recognize complications and transfer a patient to the hospital (most of the time, complications are recognized, and women are transferred before the situation becomes an emergency)

  • Administer oxygen and emergency medications

  • Perform adult and neonatal resuscitation

  • Start IVs and administer IV fluids (some midwives)

Whether you choose to have a home birth or a midwife, it's important to know that you are in charge of your birth experience. You are stronger than you know!!


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