Is home birth safe?
For low-risk pregnant women, home birth is a safe option that results in reduced medical intervention, better outcomes, and more positive experiences.
Within the midwifery model of care, studies have shown that low-risk women who birth at home have far lower rates of episiotomy and assisted delivery, epidural, induction, infection, and significantly higher breastfeeding rates at six weeks postpartum compared with low-risk hospital-based populations. Of paramount importance, the cesarean rate for planned, midwife-attended home births is 5.2% which is significantly lower than the national average of 31% for full-term pregnancies.
These numbers reflect the low intervention approaches consistent with midwifery care and our access to higher-level support when needed.
But isn’t it safer to give birth in the hospital?
There is no such thing as a life or birth without risk. With that being said, risk factors vary and exist in any birthing environment (at home, birth center, or hospital). Home birth midwives are experts in normal pregnancy, birth, and postpartum. Midwives know what normal looks like, and have time and knowledge to help maximize health and wellness throughout the childbearing year for their clients.
If you decide to work with me for your care, our prenatal appointments are an ongoing place for connection, education, and risk assessment. To this end, you can feel reassured that if we are home for your labor and birth it is because I feel you are a good candidate to have a safe *and* wonderful home birth.
Why would I want to give birth at home?
Home birth allows for your care to be individualized to you. My care looks different for every woman – and even with the same woman, different every pregnancy! I structure my care around you and your specific values, wishes, and needs. I work to understand you as an entire person and to build a strong relationship with you and your family.
I understand that trust is foundational to safety and that the only way to have trust is to know you intimately. I believe that the most intimate relationships we have are those within our own home and that home is, therefore, the perfect setting for great maternity care. But don’t take my word for it, check out these videos from families that I’ve worked with as their midwife to learn more about why planning a home birth may be right for you and your family.
What tools do you bring to a home birth?
I carry the same tools that you would find in a Level 1 hospital. Here is a list of what we bring with us to every birth:
- Waterproof, intermittent monitoring
- Labor support tools including herbs, homeopathy, essential oils, and more!
- Anti-hemorrhagic medications including Pitocin and Cytotec (Misoprostol)
- Oxygen and newborn resuscitation equipment
- Suturing materials and numbing medication
- IV fluids and antibiotics (to prophylactically treat GBS in moms who screen positive in late pregnancy)
- Catheter equipment
My team adapts to the energy of your space. We listen to the baby in any position of your choosing and support your unique process of meeting your baby. As needed, we bring you food and drink, gently recommend different labor positions and comfort measures, and reassure you of your ability to do hard things. There are no routine vaginal exams done in my practice.
After your baby is born, we stay for several hours and don’t leave until both you and your baby are stable. In the immediate postpartum we initiate breastfeeding and do a full head-to-toe newborn exam (with Vitamin K and erythromycin eye ointment available).
What if something comes up that isn’t “normal”?
A midwife’s understanding of what’s “normal” is a significant part of our education and training to become a midwife. I have a deep respect for pregnancy and birth as normal processes AND a healthy appreciation for when medical technology is truly necessary. I am attentive if anything trends in a concerning direction and I act readily with my available tools to return to a more normal presentation. If more care than what I can provide at home is needed, I will set up consults or make referrals to appropriate care in a timely manner.
What if the cord is wrapped around the baby’s neck?
A cord wrapped around a baby’s neck is a very common variation of normal (1 in 3 babies to be exact!) Usually, all that’s needed is to gently unwrap the cord after the baby is born.
What if we need to transfer to the hospital in labor?
I understand both personally and professionally how concerning a hospital transfer is for families planning a home birth. My team works very hard to help you stay at home safely, and when a transfer is appropriate make it as seamless as possible. The number one reason that I transfer into the hospital is for a woman who has had a long labor at home and is needing an epidural to get some sleep. In this scenario, everyone is on the same page and in agreement that going in is the right decision. I am transparent with my clients about what I am thinking and why I am making any recommendations. These conversations do not catch anyone off guard. It is a non-urgent situation and there is time to gather your things at your own pace. I call ahead to your planned hospital of choice, send records, and offer to join your family there to continue my care by providing labor support and advocating for you within the hospital system. My assistant stays to clean and tidy your space for a pleasant homecoming. Once you discharge from the hospital, we resume a normal course of postpartum and newborn care together.
In a more time-sensitive situation, we may facilitate transfer with EMS. We have the tools and training to keep everyone stable till we can get to higher-level technology and support.
What about the mess?
You may be surprised to learn that your home will only look better than before by the time we leave your home birth. We work hard to avoid making messes and clean up as we go to keep things neat and tidy. We love to do dishes after serving you a meal in bed postpartum. We aren’t professional cleaners, but we are moms who understand the best way to relax and enjoy your baby is to know your home is well taken care of and in order.
How much does a home birth cost?
The total cost for home birth midwifery care is $5,500. This fee covers full prenatal, labor and birth, postpartum and newborn care. It includes a birth tub for anyone interested in water birth. We work with a billing company to get maximum coverage from your insurance plan and offer payment plans, as needed.
Check out this article for ideas to help pay for your home birth.
Is home birth covered by my insurance?
It is usually not clear what insurance plans will cover home birth and which ones will not. Many plans end up covering some part of our fee, and others the full amount. You can file a “verification of benefits” for a small fee with our biller, SLB Billing to better understand your potential coverage.
I recommend that you plan to pay for your midwifery care as an out-of-pocket expense. At the end of care, I will submit our global fee to SLB Billing and reimburse you directly for any coverage.
For tips on getting your insurance to cover your home birth, check out this helpful podcast episode.
How do I file a birth certificate for my baby?
If you are in Tennessee, the simple answer is you don’t! I file your birth certificate directly, and within days of the birth I’ll bring you a draft copy to order the amount of hard copies you’d like.
If you are in Georgia, the process is not handled by me directly. Instead, you will need to go to your county’s vital records office to submit your completed “Out of Institution Birth Packet” found on the Georgia Department of Public Health’s website within a month postpartum.