Tip: modern home birth is nothing like your grandmother's 50 years ago.
When it comes to home birth, many women still envision the 1950s scenario: a woman giving birth in distress, screaming her lungs out, while someone rushes on horseback to fetch a chubby midwife with warm, damp cloths from the ends of the earth.
But the world has changed a lot, and so has childbirth! Nothing could be further from the reality of home birth today than the home birth of 50 years ago!
I had a home birth in Brazil, in 2014. I heard all sorts of comments, from the classic “you’re crazy” to dreadful stories about unknown women who had died giving birth at home in the middle of nowhere. Some of my neighbors even organized prayer circles to pray for me (thanks, Maria!).
It was just me, my niece, my doula, the obstetric nurse (midwife), and the neonatal nurse. And, of course, all their necessary materials — including a huge oxygen cylinder, scale, and so on.
After that experience, I could never imagine giving birth in a hospital again. I also decided to take a Doula of Birth course to help more women have the experience I had. I accompanied that same niece in her own home birth a year later and a few more “doulas” in their planned births, which I remember fondly.
I shared this firsthand to demystify any image you may have about home birth. Now I will directly answer your questions.
What is a Home Birth?
Home birth is a childbirth that takes place in a domestic setting, i.e., at home. It is also called “planned home birth,” as it is carefully prepared and planned, with rigorous care and usually accompanied by a specialized multidisciplinary birth team.
As you can tell already, nothing like our grandmothers’ home births with a midwife, hot water on a bucket, and some heated cloths.
Although there are many myths about giving birth at home, scientific evidence is favorable, and the benefits of well-assisted planned home birth can be significant for the mother, baby, and the entire family.
A good example is the literature review of scientific studies conducted by researchers at the University of Technology Sydney, Australia (country, by the way, where you have public funded homebirths available for women!) which concluded that there is no added risk to home birth compared to hospital birth.
The same study also found no significant difference in the number of fetal and neonatal deaths between home births and hospital births. Therefore, the idea that “it’s safer in the hospital because anything might be needed” is not scientifically accurate.
The many benefits of Home Birth
According to the study, some of the benefits of home birth compared to hospital birth are:
- 65% less chance of ending in a cesarean section;
- 15% more chances of going through birth with an intact perineum;
- 43% less chance of suffering severe perineal lacerations;
- Reduces the risk of postpartum hemorrhage by up to 23%;
- Reduces the chances of medical interventions during childbirth by up to 63% (such as forceps);
It is worth remembering that many complications during childbirth in America are related to poor assistance and excessive medical intervention, not something unpredictable that naturally went wrong.
In addition, it is important to note that caesarean section rates in the United States have been on the rise in recent decades, currently accounting for more than 32% of births (compared to the 10% recommended by the World Health Organization). In addition, the country has one of the highest maternal mortality rates compared to developed countries… and these are not from homebirth!
Are home births legal in the US?
Yes, home births are legal in the United States, and many families choose this option for childbirth. However, it’s important to note that the legality and regulations surrounding home births can vary by state. Each state has its own laws and regulations regarding home births, and some may have specific requirements or restrictions.
In some states, certified professional midwives (CPMs) or certified nurse-midwives (CNMs) may attend home births, while in others, it might be necessary to have a physician present. Additionally, some states may have specific licensing or certification requirements for midwives attending home births.
Who can have a Home Birth?
Only pregnant women considered low-risk can opt for home birth. That is, it must be a full-term pregnancy without diseases developed during pregnancy or indication of pathologies (preeclampsia, gestational diabetes, placental abruption, etc.). Additionally, the birth team generally establishes as a prerequisite that there is a hospital near the home where the birth will take place in case a transfer is needed.
How much does a home birth cost?
Generally, the costs range from $3,000.00 to $10,000.00, depending on the state, what is included, and the birth team involved. In practice, the values are similar to those of a normal birth or cesarean section in the private healthcare system.
Is home birth the same as humanized birth?
Not exactly. Hospital births can also be humanized. The term “humanized” does not depend on where the childbirth will take place (at home or in a maternity care) but on the assistance provided to the birthing woman and the baby during childbirth. It is assistance based on current scientific evidence, with respect and dignity for the woman’s sovereignty and attention to the woman’s protagonism in childbirth.
Is the doula included in the home birth team?
Not always, that entirely depends on the birth team you hire. It is possible to hire a home birth team that already includes a doula, but more frequently the doula is an individual service provider selected by the pregnant woman. Ideally, personally talk and consult directly with the home birth team to answer these questions.
Is home birth included in the national health system?
No. Unfortunately, America seems resistant to follow the practices of more advanced countries in the field of humanized childbirth and obstetrics. In some countries, it is possible to have a home birth through the national health system or funded by the state, as is the case in the Netherlands (where 20% of births were at home in 2014) and Norway.