Home Birth – Pros, Cons and How to Do It

Going into precipitous labor and having an emergency birth at home is a thought that crosses the mind of all pregnant women. As giving birth is a natural process, the body instinctively knows how to do it. Women with uncomplicated pregnancies can, with a little bit of preparation, go through labor at home and have healthy babies. An emergency home birth is similar to a regular home birth, except it’s a surprise! In such moments, it’s important to stay calm and remember that the body is equipped to handle the process. Knowing how to deliver a baby at home can empower you to act confidently if faced with an unexpected situation. Having a basic understanding of the stages of labor and keeping essential supplies ready can make the experience less daunting.

What Is Home Birth?

A home birth is simply where you deliver the baby at home instead of a hospital. Up until the last few decades, when hospitals weren’t as popular, giving birth at home was common. Childbirth at home is assisted by the participation of one or more experienced midwives in the familiar and comfortable surroundings of the home. It could be attended by members of the family and friends as chosen by the mother. There is always more privacy without the interruption of hospital staff. The midwives are experienced at monitoring the mother’s physical, psychological and emotional well-being throughout the childbearing cycle. Their model of care involves the minimisation of technological interventions. It provides the mother with continuous hands-on assistance during labor and postpartum support. Homebirth is an option for women with healthy low-risk pregnancies who wish to enjoy the freedom of giving birth at their own homes and this is common in many countries.

For those with conditions such as diabetes, high blood pressure and risk of preterm labor, home birth is not recommended.

How Common is It to Give Birth at Home?

Home births/ emergency home births are common in rural areas where hospitals aren’t close by and fewer in numbers. These areas would require long journeys to the hospital and it’s not always possible for women to reach in time. In urban areas, emergency home births are rare. It is also unlikely that the labor is so short that you cannot reach a hospital in time. Still, it’s best to know the basics in case one has no option but to deliver a baby at home.

Pros and Cons of a Home Birth

Home birth is an option some families choose for a more intimate and natural birthing experience in a familiar environment. While it can provide comfort and a sense of control, it also comes with potential risks that require careful consideration. Understanding the pros and cons can help you make an informed decision about this deeply personal choice.

Pros

Home birth offers a unique experience that many families find empowering and personal. Understanding the benefits of home birth can help you decide if this option aligns with your preferences and needs.

• Comfort of being in a familiar environment.
• Ability to create a personalized birthing plan.
• Avoidance of unnecessary medical interventions.
• Greater control over the birthing process.
• Opportunity for family involvement in the birth.
• Reduced risk of hospital-acquired infections.
• Lower cost compared to hospital births.
• More relaxed and private atmosphere.
• Continuous one-on-one care from a midwife or doula.
• Immediate bonding with the baby in a stress-free setting.

Cons

While home birth can offer many advantages, there are also some potential risks and challenges to consider. Understanding the disadvantages of home birth can help ensure you are fully informed before making a decision.

• Limited access to emergency medical care in case of complications.
• Higher risk of maternal or baby distress without immediate hospital intervention.
• Potential lack of pain relief options like epidurals.
• Limited support if there is a need for specialized care or equipment.

Planning to Give Birth At Home – Important Things to Do

1. Stay Calm and Focused

Birthing is a natural process and women are well designed to go through it. If the baby is coming out a little earlier, it could be because it’s time. Immediately call your doctor and the hospital where you had planned to give birth and ask for an ambulance. Tell them your name, phone number, and address so they can get to you.

2. When You’re on Your Own

You’ll need all the help you can get while you wait for the ambulance during emergency labor. Keep your mobile phone with you at all times and call your husband, family, friend or a neighbour; whoever can reach you quickly. Try to stay close to the main door and if it is safe, keep it unlocked so the people who come to help can get in.

3. Keep Your Supplies at Hand

Make your own emergency home birthing kit and always have it ready in a place that you can access instantly. The kit should have items such as:

• Towels, tissues, and clean sheets to wipe and cover the baby.
• Clean, soft blankets for receiving the baby.
• A small blanket to protect the baby from the cold.
• A large container or bucket to discard the placenta.

What Is the Cost of a Home Birth?

The home birth cost can vary widely depending on several factors, such as location, the experience of the midwife or birthing team, and any additional services or supplies needed. On average, the cost of a home birth ranges from $2,000 to $5,000, though it could be higher in certain areas or if special care is required. This amount typically covers the services of a midwife, prenatal visits, and postnatal care. However, some families may incur additional expenses for equipment, doulas, or necessary medical interventions if complications arise. It’s also important to note that health insurance coverage for home births may vary, so it’s advisable to check with your provider to understand what is covered.

How Likely Is It That You’ll End Up Delivering at Home Before the Ambulance Arrives?

There are signs such as strong contractions that are spaced three to four minutes apart and your water has broken with a strong urge to push. Even though first-pregnancy babies take a long time from this point on to actually be delivered, a second or third one can come out surprisingly quickly.

1. Be Prepared

Wash your hands and vaginal area clean with soap and have a bucket of warm water at hand. Get the room’s temperature up to a comfortable level. If it’s cold outside, close the windows to make it cosy. The baby needs to be kept warm as soon as it is born.

2. Resist Any Urge to Push

Despite the instinctive and natural urge to push, try not doing it for as long as you can. Pushing can risk the baby being squeezed out too quickly and damaging the delicate tissues surrounding your vagina. Panting helps to overcome this feeling by relieving the pressure generated by your natural urge to hold your breath. Pant in three quick successions and one long blow. This can delay the arrival of the baby by a few minutes. If the urge to push is still strong and persistent, just go with it. Bring your buttocks near the ground and put a folded cloth beneath in case the baby starts coming out.

Steps for Delivering a Baby at Home

Emergency labor can be turned into a normal delivery of the baby at home if you’re well prepared for it. The steps to be followed if delivery is inevitable are as follows:

• Try to stay as calm as possible and find a comfortable place where you can lay down or sit propped up. If there’s time, use some clean shower curtains to keep the floor or your bed safe from the blood and fluids. Place some clean folded towels near your bottom so in case the baby lands, there’s soft and clean padding below.
• Reach your hands down to the bottom to feel for your baby’s head, go with the contractions and do not push. When the baby’s head is out, check if the umbilical cord is around its neck. If so, slip your finger underneath the cord and ease it over its head. This only must be done if the cord is loose enough to be lifted without snapping. If it is not loose, do not pull on it. Leave it until the baby is fully out and untangle it afterwards.
• Place your hands on the baby’s head to slow down the delivery and help guide it down during the next contraction. Once the baby is out, it is normal for it to appear bluish and be covered in blood and slippery amniotic fluid. Have a towel in hand to secure it.
• Once in your hands, quickly dry the baby using a clean towel to keep it from getting too cold. This action should also prompt the baby to breathe and cry. Most full-term babies cry within a minute after being born and have a good heart rate. Wrap the baby up with a fresh towel or blanket to keep him warm.
• If the baby is still not crying and looks purple or grey all over, he may be having breathing difficulties. Run your finger on his nose to clear it of any remaining amniotic fluid and blow on his face to stimulate breathing.
• If the baby still doesn’t respond, lay him on his back, cover his nose and mouth with your mouth, and give him a few rescue breaths for two or three seconds at a time. Check for movement in the chest with each breath. This works with most babies who start inhaling and exhaling soon after.

What to Do Once the Baby is Out

• It’s important for you and the baby to stay warm above all else, as they are susceptible to hypothermia.
• Hold the baby to your tummy or breasts, his skin against your skin to keep him warm and let the baby nuzzle against your breasts. Whether you plan to breastfeed or not, this step is important to trigger the release of oxytocin, which will help to contract the uterus to shed the placenta.
• If you’re wondering how to cut the umbilical cord at home; don’t. Allow emergency services to take care of it once they arrive.

How Is the Placenta Delivered During Home Birth?

The placenta normally comes out about 20 minutes after the baby but it can sometimes take as long as sixty minutes. Holding the baby skin to skin helps trigger contractions that release the placenta. It comes out in a couple of contractions and has a slippery yet soft texture.

The baby is still connected to the placenta at this point, so if you have some help, let them put the placenta into a bowl or a container nearby while you hold the baby. The placenta’s detachment is accompanied by some blood loss, which can be a frightening sight, but it is totally normal.

Things to Do After Home Birth

• Take some time to relax while your baby nuzzles against you. Try breastfeeding, which would relax both you and the baby.
• When in doubt, do nothing. Your instincts can take care of things on its own.
• Talk to your doctor about how you managed your delivery so he can offer further advice.

Home Birth Essentials

The following supplies must be part of your emergency home birth kit to help you through your labor:

• Clean towels and sheets
• Clean and soft receiving blankets
• Tissues and large sanitary napkins
• A bulb syringe to clean the nose if necessary
• A soft hat for the baby to keep it warm
• A large bowl

You could also buy a commercially available emergency baby delivery kit which features a lot more than the basic supplies mentioned above.

FAQs

1. Can a home birth be safely planned after a previous cesarean section?

In some cases, women who have had a cesarean delivery may choose to attempt a vaginal birth at home. This is known as a VBAC (vaginal birth after cesarean), but it requires careful consideration of factors like the reason for the previous cesarean, the type of incision, and the support of experienced healthcare providers. It’s important to have a detailed discussion with your provider about the risks involved.

2. How does a midwife handle unexpected complications during a home birth?

While midwives are trained to manage many situations that may arise during a home birth, unexpected complications can sometimes require quick action. Midwives typically have emergency protocols in place, such as having access to medications, equipment for resuscitation, and the ability to transport to a hospital if necessary. It’s vital to have a backup plan with a nearby hospital.

3. Is it possible to have a home birth with twins or multiples?

Home births with twins or multiples are generally considered high-risk and are not recommended by most healthcare providers. However, in very specific cases, if both babies are positioned appropriately and the pregnancy has been uncomplicated, some families choose to pursue it under the care of an experienced midwife who specializes in multiple births. It requires careful planning and close monitoring throughout the pregnancy.

Many families prefer the intimate and personalized experience of delivery at home of a child, where they can create a comfortable and familiar environment for the birth, as long as the pregnancy is uncomplicated and appropriate care is in place. Home birth may seem like the worst-case scenario, but we must remember that women have been doing it throughout the ages. With the right kind of preparation and a little bit of luck, an emergency home birth will be easy and smooth.

References/Resources:

1. Home birth: Know the pros and cons; Mayo Clinic; https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/home-birth/art-20046878

2. Home Births; American Pregnancy Association; https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/home-birth/

3. Maternal and Newborn Care in the United States (Birth Settings in America: Outcomes, Quality, Access, and Choice); National Library of Medicine; https://www.ncbi.nlm.nih.gov/books/NBK555484/

4. Cheyney. M, Bovbjerg. M, Everson. C, Gordon. W, Hannibal. D, Vedam. S; Outcomes of care for 16,924 planned home births in the United States: the Midwives Alliance of North America Statistics Project, 2004 to 2009 (Journal of Midwifery & Women’s Health); National Library of Medicine; https://pubmed.ncbi.nlm.nih.gov/24479690/

5. Grünebaum. A, McCollough. L, Orosz. B, Chervenak. F; Neonatal mortality in the United States is related to location of birth (hospital versus home) rather than the type of birth attendant; American Journal of Obstetrics and Gynecology; https://www.ajog.org/article/S0002-9378(20)30067-3/abstract; August 2020

6. What happens when you give birth in a hospital?; NCT; https://www.nct.org.uk/information/labour-birth/planning-birth/what-happens-when-you-give-birth-hospital

7. Planned Home Birth; American College of Obstetricians and Gynecologists; https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/planned-home-birth

Also Read:

Stages of Labor & Delivery
Giving Birth Alone at Home
How to Deliver a Baby in Water?
How to Give Birth to Baby in Natural Way?
How to Have a Safe Unassisted Home Birth

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