HOME BIRTH: IS IT RIGHT FOR ME?

You can see listings for home birth providers in the Chicago-area by choosing “I’M LOOKING FOR A HOME BIRTH PROVIDER” in the drop down menu here.

The information on this page will help you think through whether home birth is the right choice for you. The more you learn about your options, the better you’ll feel about the choice you finally make. There’s a lot to consider, including the practical and emotional advantages and disadvantages of each setting, the scientific evidence on outcomes, how to find a provider, and what other options you have.

OVERVIEW

While still uncommon in the US, more and more American women are choosing to birth at home. If you are low-risk and if natural childbirth is a high priority for you, you might want to consider home birth. When you plan a home birth, you are much less likely to have any interventions than low risk women who plan hospital births — including cesarean birth, induction, episiotomy, epidural and other pain medication. A home birth could also be a good choice if you would feel more relaxed laboring in a familiar place with the people you have chosen to be there, since feeling relaxed can help you labor more effectively.

There are other practical and emotional advantages and disadvantages of home birth that you’ll also want to take into account as you decide whether home birth is right for you. (Scroll down to see Considerations.)

In particular, you need to understand what the scientific evidence says about home birth safety so you can weigh the risks and benefits of a home birth for yourself. The evidence on home birth safety in the US is not conclusive. None of the studies meets the highest standards for scientific evidence. And while some studies suggest that home birth attended by a Certified Nurse Midwife (CNM) is as safe as hospital birth, others suggest that hospital birth is safer. (Scroll down to The Research Says to see a summary of the research. You can also go directly to a more in-depth discussion of the evidence by clicking here.)

If you decide you might be interested in home birth, take the time to find a provider who is right for you. There are several licensed home birth providers in the Chicago area and most of them serve a fairly wide area, so you should have several providers to choose from.  (Scroll down to see Choosing a Home Birth Provider.)

And finally, if you decide home birth isn’t quite right for you, you have other good options. (Scroll down to see Alternatives to Consider.)

CONSIDERATIONS

Each birth setting has advantages and disadvantages. Different people will weigh those differently. You need to sort through what matters most to you. Here are some considerations that may help you decide whether home birth is or isn’t right for you.

THE RESEARCH SAYS . . .

The evidence on the safety of home birth in the US is not conclusive. Some studies show that hospital birth is safer for low-risk women than planned home birth. Others show that home birth is as safe as birth in the hospital IF:

  • you are low-risk,
  • you choose a well-trained, licensed provider (in Illinois, that means a CNM or a doctor),
  • you have ready access to back-up care if complications arise.

Because the safety of home birth in the US is controversial, it’s important that you understand the research and take responsibility for balancing the risks and benefits of a home birth in your own case.

You can learn more about the research here.

 

CHOOSING A HOME BIRTH PROVIDER

Once you decide that you’re interested in having a home birth, plan to meet face-to-face with a few home birth providers. You are looking for someone you trust. This is also a good way to test whether your choice holds up as you begin to learn more.

Here are some prompts you may find helpful before and after your appointments. Pick the ones that seem important to you.

General questions for your provider:

  • What kind of birth do you see the most often?
  • What part of your job do you enjoy the most? What are you best at?
  • What do you think makes pregnancy and birth safer?
  • How likely is it that you would be the one actually attending my birth, and who else might end up being there?
  • How would you handle the situation if you recommended something to me and I ended up choosing a different option?
  • What kind of prenatal testing do you require? Recommend?
  • What do you do if I go past my due date?
  • Will a tub be available and do you ever use it for labor? For delivery?
  • What is your cesarean birth rate?
  • What can I expect to pay out of pocket?

Questions specific to home birth:

  • What is your certification, education and legal standing in the state where I live?
  • What kind of health conditions would exclude me from delivering at home?
  • Do you ever attend VBAC, multiple or breech deliveries? Why or why not? (These conditions are higher risk and have a significantly increased neonatal mortality rates for home birth.)
  • Where would we go for a non-emergency transfer to the hospital? And in an emergency? How long does it take to get there?
  • What kind of arrangement/relationship do you have with the physicians at the hospital where you transfer?
  • How often have you transferred and how has it gone in the past?
  • Do you have prenatal visits at home or in your office?
  • Who else comes with you to births, and what is their training?
  • If you could not attend my birth, who would deliver my baby? How often does that happen?
  • What happens if I go past my due date?
  • How long will you stay after the baby arrives?

Questions to ask yourself after an appointment:

  • Did you feel at ease?
  • Did you feel rushed?
  • Did you feel listened to?
  • Were your questions answered?
  • Did the provider ask your permission before touching you?
  • How did your partner feel?

 

It can take awhile to get to know and trust your provider. If after several months you start to have doubts, don’t hesitate to make a change.

ALTERNATIVES

If you’re attracted to the idea of a home birth but you or your partner are anxious about safety, a good alternative for you might be a midwife-led birth center. You could also consider having your baby with a midwife in the hospital.