Is A Home Birth Right For Me?

By Jill Snelson, CPM

I love home birth. I would probably be in the wrong line of work if I didn't. But I also don't believe everybody should have a home birth.

That surprises people sometimes.

Home birth isn't something I think women need to be convinced into. In fact, if I have to push you towards it, I am not the midwife for you! Birth setting is personal, and the right decision involves more than wanting an unmedicated birth or loving the idea of having a baby in your own bedroom.

A good home birth fit involves health, values, expectations, logistics, and (say it with me, now) the willingness to change course if circumstances change.

Home birth is designed for low-risk pregnancy.

The first consideration is clinical.

Out-of-hospital birth is intended for women experiencing healthy, low-risk pregnancies. Throughout prenatal care, we assess both maternal and fetal health to make sure home remains an appropriate birth setting.

Sometimes a medical condition, pregnancy complication, medication, abnormal test result, fetal concern, or another change means a family needs additional evaluation or a different level of care. That can be disappointing when someone has deeply hoped for home birth. But loving home birth means respecting its boundaries too.

My goal is never home birth at any cost.

You should actually want to be at home.

Some women relax when they imagine laboring in their own home. They like the privacy, familiarity, freedom to move, absence of unnecessary interruption, ability to eat and drink normally, and having their own bathroom, their own bed, and their own people around them.

Other women feel safer knowing an operating room, anesthesia team, and NICU are immediately available down the hallway.

Neither woman is doing birth wrong.

Where you feel safest matters because labor is an incredibly vulnerable experience. You do not earn a medal for giving birth at home. You also do not need to be afraid of home birth simply because it isn't the cultural norm.

The goal is to understand your options well enough to make a thoughtful decision.

Home birth requires flexibility.

You can prepare beautifully for home birth and still end up having your baby somewhere else. This may be one of the most important things to understand before choosing this model of care.

Sometimes pregnancy develops complications that make hospital birth more appropriate. Sometimes something changes during labor. Sometimes a mother simply reaches the point where she wants pain relief that I cannot offer at home.

Choosing home birth means choosing a plan that includes the possibility of transfer.

I want the families I care for to value physiologic birth without becoming so attached to a particular location or outcome that changing the plan feels impossible.

Sometimes wisdom looks like staying home and allowing normal labor to unfold.

Sometimes wisdom looks like getting in the car.

You should feel comfortable with your midwife.

This is a big one.

Your midwife will be invited into one of the most private, vulnerable experiences of your life. You need to trust her clinical judgment, but you also need to feel comfortable asking questions, disagreeing, expressing fears, and telling her what you need.

You should understand how she practices, what she considers outside her scope, how she handles emergencies, how she approaches transfer, who comes with her to births, and what happens when she isn't available.

You should not choose a midwife simply because she is the closest, the least expensive, or the first person who tells you yes.

And I don't want someone choosing me simply because I am a home birth midwife in Metro Atlanta. I want us to actually be a good fit.

Home birth is not about proving anything.

It isn't more spiritual. It isn't more feminine. It doesn't make you stronger than someone who has an epidural or cesarean.

It is simply one setting in which birth can occur, and for the right family experiencing the right pregnancy with an appropriately trained birth team and a thoughtful plan for consultation and transfer, it can be a beautiful option.

Ask questions. Learn what home birth actually involves. Meet more than one midwife. In fact, interview at least three!

Pay attention not only to whether someone supports the birth you hope to have, but whether you trust that person to tell you when the plan needs to change.

Then choose the care and birth setting that gives you the greatest confidence moving forward.

Your birth deserves that kind of thoughtfulness.