Many people feel that women choose homebirth selfishly, putting their own experiences above the safety of their babies. This simply is not true - everyone has the same priority: a healthy mother and a healthy baby. Women who have their babies at home have learned that statistics bear out the safety of homebirth for healthy mothers experiencing normal pregnancies. They also recognize that there are many advantages to homebirth for the baby as well as the mother and the entire family.
Advantages for the Baby
- He or she is more likely to be born vaginally, without the breathing difficulties often caused by cesarean section and/or anesthesia.
- There is less likelihood of infection when the baby is with the mother than the in newborn nursery.
- The baby’s experience at birth is considered important and made as gentle as possible. Routine procedures such as deep suctioning and unnecessary stimulation are avoided.
- The baby is not separated from the mother. The mother-infant bond is never sacrificed for institutional procedures.
- Breastfeeding is easier to establish when the baby can nurse on demand and is not given bottles.
- She is not subjected to routine procedures such as immobilization for electronic monitoring, IV’s, multiple vaginal exams or stirrups.
- She can eat and walk freely.
- She will have continuity of care with the same attendants, increasing safety.
- She is more likely to be treated and her progress evaluated as an individual, rather than being sacrificed to protocols or statistical averages.
- She is much less likely to request or require drugs for pain, forceps or a cesarean section when she has attendants who know that birth is a normal physiological function.
- She is comfortable in her own surroundings, relaxed and able to labor and deliver wherever she chooses.
- She has less chance of developing an infection.
- Postpartum depression is less common since there is no separation of mother and baby and the midwife relationship/support continues well after the birth.
- Advantages for the Family
- Partners are in their own homes, not "allowed" to be present; they can participate as fully as they please.
- Other children can be present as appropriate.
- The birth is an integral part of family life, which helps with postpartum adjustment.
- Disadvantages
- Requires a higher level of effort and responsibility.
- Often not supported by society or doctors.
- Access to some emergency equipment can be delayed and require transport.
- Minimizing the Risks Birth at home
- Like birth in the hospital, homebirth is not risk-free. You can minimize the risks by:
- Eating well and gaining adequate weight which can help in avoiding high blood pressure and other complications
- Finding a midwife who is skilled, confident and experienced in birth at home
- Receiving prenatal midwifery care
- Informing yourselves through reading, classes, videos and other resources
- Having adequate support during labor and postpartum
- Having a plan for facilitating transfer to the hospital, if necessary, which you and your midwife have discussed and posting telephone numbers by the phone
- From "Homebirth as the Standard of Care" By Rahima Baldwin Dancy Article copyright 2001 by Informed Homebirth, IHIBP@sbcglobal.net. Used with permission. Safety of Homebirth References and Readings Following is a list of readings and references that proves the safety of homebirth 1. Stotland N, Declercq E. Safety of out of hospital birth in industrialized nations: a review. Curr Probl Obstet Gynecol Fertil 2002; 25:134-44. 2. DeClerq ER, Paine L, WinterM. A profile of home birth in the United States, 1989-1992. J Nurse Midwif 1995;40:478-81. 3. Ackerman-Liebrich U, Voegli T, Gunter-Witt K Kunz I, Sullig, M Schindler, C et al. Home versus hospital deliveries: follow-up study of matched pairs for procedures and outcome. Brit Med J 1996;313:1313-8. 4. Janssen PA, Lee SK, Ryan EM, Etches DJ, Farquharson DF, Peacock D. et al.. Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia. Canadian J Midwif 2002;166(3):315-23. 5. Campbell R, MacFarlane A. Where to be born? The debate and the evidence. 2nd ed. Oxford: National Perinatal Epidemiology Unit, 1994. 6. Davies J, Hey E, Reid W, Young, G. Prospective regional study of planned home births. Brit Med J 1996;313:1302-6. 7. Eskes TK. Home deliveries in The Netherlands--perinatal mortality and morbidity. Int J Gynaecol Obstet 1992 Jul;38:161-9. 8. Murphy PA, Fullerton J. Outcomes of intended home births in nurse-midwifery practice: a prospective descriptive study. Obstet Gynecol 1998;92(3):461-70. 9. Northern Region Perinatal Mortality Survey Coordinating Group. Collaborative survey of perinatal loss in planned and unplanned home births. Brit Med J 1996;313:1306-9. 10. Anderson RE, Murphy PA. Outcomes of 11,788 planned home births attended by certified nurse-midwives: a retrospective descriptive study. J Nurse Midwif 1995; 483-507. 11. Walsh D. Evidence-based care series,1: birth environment. Brit J Midwif 2000, 8(5):276-8. 12. Weigers TA, Keirse MJNC, van der Zee J, Berghs GAH. Outcome of planned home and planned hospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands. Brit Med J 1996:313:1309-13. 13. Woodcock HC, Read AW, Bower C, Stanley FJ, Moore, DJ. A matched cohort study of planned home and hospital births in Western Australia 1981-1987. Midwif 1994;10(3):125-35. 14. Olsen O. Meta-analysis of the safety of home birth. Birth 1997;24(1): 4-16. 15. Springer NP, Van Weel C. Home birth: safe in selected women, and with adequate infrastructure and support. Brit Med J 1996;313: 1276-7. 16. Wiegers TA, van der Zee J, Keirse MJ. Maternity care in The Netherlands: the changing home birth rate. Birth 1998; 25(3):190-7. 17. Chamberlain G, Patel N, (Eds). In: The future of the maternity services. London: Royal College of Obstetricians and Gynaecologists Press, 1994:298. 18. Chamberlain G, Wraight A Crowley P. Home births. Report of the 1994 confidential enquiry by the National Birthday Trust Fund. Carnforth: Parthenon, 1997. 19. Governing Council, American Public Health Association. Increasing access to out-of-hospital maternity care services through state-regulated and nationally certified direct-entry midwives. Policy Database, Washington (DC), 2001. 20. College of Midwives of Ontario. Statement on home birth. Toronto, January 1994. 21. Walker J. Quality of midwifery care given throughout the world: report of the Fourth International Home Birth Conference, Amsterdam. Midwif 2000, 16(2)161-4. 22. World Health Organization. Report of the Safe Motherhood Technical Working Group: Care in Normal Birth: a practical guide. Geneva, 1996. 23. Ministry of Health, Community Health and Culture. Government position on the Kloosterman Advisory Committee. SDU, The Hague, 1989. 24. Crotty M, Ramsay, AT, Smart, R, Chan, A. Planned home births in South Australia 1976-1987. Med J Aust 1990, 153. 25. Vedam S, Kolodji Y. Guidelines for client selection in the home birth midwifery practice. J Nurse Midwif 1995, 40(6), 508-21. 26. Bailes A, Jackson ME. Shared responsibility in the home birth practice. J Midwif Womens Health 2000, 45(6), 537-43. 27. Mehl-Madrona L, Madrona MM. Physician and midwife attended home births. Effects of breech, twin and post-dates outcome data on mortality rates. J Nurse Midwif 1997 Mar-Apr; 42(2):91-8 28. Cronk M. Home birth-continuity of care. MIDIRS, September 2000, 10(3). 29. Bortin S, Alzugaray M, Dowd J, Kalman J. A feminist perspective on the study of home birth: application of a midwifery care framework. J Nurse Midwif 1994, 39(3), 142-9. 30. Anderson RE, Anderson DA. The cost-effectiveness of home birth. J Nurse Midwif 1999, 44(1), 30-5.