What Is Home Birth?

A home birth refers to giving birth to your baby at home. While common in many countries, home birth is relatively rare in the United States, however, it has become more popular in recent years. It’s estimated that about one out of every 62 U.S. births take place at home.

Planned home births are usually attended by a certified midwife or certified nurse-midwife. An unplanned home birth occurs when a pregnant woman intends to give birth at a hospital or birth center but cannot make it in time. 

This article will provide an overview of home birth, how to prepare, and who should avoid one. 

What Is Home Birth?

A home birth occurs when a baby is born at home as opposed to a hospital or birthing center. The American College of Obstetricians and Gynecologists (ACOG) has stated that giving birth in a hospital or accredited birthing center is the safest option. However, the organization recognizes that each pregnant person has the right to make the best decision for themselves. 

Contraindications

It’s important to note that home birth is not for everyone. If you have had any complications or health problems during your pregnancy, home birth will not be a safe option for you. If you have experienced any of the following factors, it’s recommended that you avoid home birth:

• Pregnant with multiples (twins, triplets, etc.)
• History of cesarean section (C-section, surgical removal of the baby)
• Baby is breech (bottom or feet first instead of headfirst)  
• Any other contraindications (reasons it may be harmful), according to your healthcare provider 

Potential Risks 

Having a home birth comes with serious risks that need to be carefully considered. Research shows that giving birth at home doubles the risk of perinatal death and triples the risk of neonatal seizures or serious neurological dysfunction. 

Even pregnant people who are considered low risk experience a higher rate of neonatal death during a home birth than those giving birth at a hospital or birthing center. Home births also raise the risk of uterine rupture during labor and delivery.

To lower the potential risks of home birth, only consider one if:

• You have had a healthy pregnancy without complications.
• There will be a certified nurse-midwife present.
• Your healthcare provider has access to fast and reliable transport to a hospital if needed.

Purpose of Home Birth 

Everyone has their own reasons for seeking home birth. Home births have been associated with fewer medical interventions such as labor induction, regional anesthesia, electronic heart rate monitoring, episiotomy, operative vaginal delivery, and c-section.

People who give birth at home are also less likely to experience vaginal and perineal tears, as well as postpartum hemorrhage. It’s important to note that most people who give birth at home have given birth in the past and tend to be considered low-risk pregnancies. 

A 2015 study found that women choose home births for three main reasons:

• Experience of home birth: Many of the study participants chose home births because they were dissatisfied with their previous birth experience in the hospital. They cited frequent interruptions, too many staff members entering the room, and a lack of input as negatives of hospital birth. 
• Control and empowerment: Study participants shared that they felt their voices were not heard or respected by hospital staff in the past. They hoped that home birth would reduce the pressure they felt to agree to medical interventions and pharmacological pain relief. 
• Home environment: The study found that home birth has a high satisfaction rate. Participants felt that their homes were more peaceful and restful than the hospital environment. 

The study authors noted that the high satisfaction levels that participants felt with their home birth experiences were in part due to their low-risk pregnancies and complication-free birth experiences. Research shows that people who choose home birth are less likely to have known risk factors such as teen pregnancy, smoking during pregnancy, obesity, preterm labor symptoms, or low birth weight.

How to Prepare 

To safely prepare for home birth, start by talking with your healthcare provider to determine if you this would be a good option for you. A home birth should only be considered with the following criteria: 

• No preexisting maternal disease
• No pregnancy complications 
• A single fetus 
• Cephalic (headfirst) presentation
• Gestational age greater than 36–37 weeks and less than 41–42 weeks
• Spontaneous labor (does not require medical induction) 
• Safe and timely transport available 
• Midwife certified by the American Midwifery Certification Board 

Plan Ahead for Transport

When giving birth at home, it is vital to have a plan in place if complications arise. You will need a way to get to the hospital if needed. Most hospital transports are needed because of a lack of progression in labor, changes in fetal status, need for pain relief, high blood pressure (hypertension), bleeding, or fetal position. 

Financial Considerations

Another way to prepare for home birth is to make a financial plan. It’s estimated that about two-thirds of home births are self-paid. Talk with your healthcare provider about fees to expect and how you will be billed if any complications arise. 

Summary

A home birth occurs when a baby is born at home as opposed to a hospital or birth center. The American College of Obstetricians and Gynecologists has stated that the safest place to give birth is in a hospital or accredited birthing center. Possible risks of home birth include perinatal death, neonatal seizures, and uterine rupture. Those who have had a C-section in the past or are experiencing pregnancy complications are not candidates for a home birth. 

A Word From Verywell

There are several reasons why you might consider having a home birth. You may have had a difficult experience in the past or are hoping for fewer medical interventions during labor. No matter your reasons, talk with your healthcare provider before deciding to go the home birth route. It’s important to consider the risks and make a plan that is as safe as possible for you and your baby.