Homebirth pros and cons!
Definitely save this post if you’re considering but undecided about a home birth down the road!
*disclaimer: I’ve had them all— 1 birth center, 2 hospital, 1 home— and I’ve done all four naturally without drugs with very little opposition. So I definitely think there’s more than one right way! No judgment here. We are in “personal preference” territory. Giving birth wherever YOU feel safe is gonna be a key factor to having a safe birth!
Also: Lumping *all* hospital experiences in together is just irresponsible, just as lumping together all midwives or homebirth experiences. I’m not attempting to do a comprehensive overview, nor am I going to run down safety stats or percentages. This is just a personal testimony from my own experience!
My mom is an ICU nurse and so I grew up around hospitals. They actually <gasp> feel semi homey to me! So an aversion to hospitals was never a factor in my decision!
Some consider homebirth not as safe, but if you could see all the prevention and screenings that go on ahead of time and behind the scenes, you’d be amazed! I sure was. This is one time where I would actually get ahold of the data and statistics and see for yourself. Emergency transfer during labor would be super rare as a result (most transfers occur with first time moms who get stuck in pre-labor!) but my midwives also had 3 giant suitcases of medical supplies that could have handled any issue I’ve dealt with so far in my labors (including my retained bits of placenta!). They also have resuscitation equipment fired up and ready. We also knew that the nearest hospital was only two stop signs away. Midwives like to know this distance ahead of time before they approve a client.
Anyways, after my research, I felt plenty safe! Home is identical to a birth center, in this category.
- Getting to be in my own home
Labor is never a straight line! It was so nice to be in my own home and not have to worry about going to the hospital too soon and being sent home. I guarantee with this last one, he would’ve been born on the road as my active labor was only 90 minutes long, if that. The hospital I had Thomas at, for instance, won’t admit until active labor. Cars also speed up labor so that 90 min could’ve easily been less. Knowing that they were driving to ME instead of the other way around (have you ever labored in a car before?? 😵💫) was huge peace of mind and I wasn’t distracted by any logistic other than texting the midwives. No admittance papers, no driving, no having someone come get the kids, no walking to the right wing.
Anyways, timeline pressure is a real thing. I’m so glad I never felt any of that this time around. Everything was so peaceful, with my body and my baby calling all of the shots, and it made for a much gentler birth than my first and second and third (yes, I lump my birth center birth right in, I had a terrible midwife who induced me Bc she wanted to go home!).
I was also very well rested even though I had him at 3:30am because I had been able to nap and labor in my own bed, on my own pillow, etc. . I believe this contributed to a much healthier outcome for me!
- Recovery at home:
This is such a huge one! I thought I’d be nervous about getting my stuff dirty, but we had tarps and chuck pads everywhere. You make your bed with two sets of sheets with a mattress protector in between. I delivered the placenta on an old set of sheets (and chuck pads), and when I came out from my herbal sitz bath, my own soft linen sheets were waiting for me. ❤️ They delivered my placenta so gently that I didn’t struggle with excessive bleeding like I did when they hurried it out with AJ and Thomas. Not every OB or hospital would be rough, I’m just stating that I used to think it was me, when in fact it was the method that was contributing. I had almost no bleeding/complications this time around due to how gentle. Again, just my experience.
There was a lot of noise in the hospital after both of my births there. It was hard to get sleep and I left pretty ragged (not to mention Jesse had to sleep on a cot for 2 days! So he was sleep deprived as well). I was also woken up for tests and monitoring every 1-2 hours both times. The first couple hours after birth, the newborn typically sleeps 5-6 hours just once, so it’s key to use that to your recovery! I really enjoyed that this time around. It made the sleep deprivation the next two nights much easier to bear!
Comparing this to a birth center: most let you stay for 4-6 hours after birth, depending. But then you have to drive home! I remember that was so hard on us with Gregory’s birth. We had just been up ALL night!! Driving that 20 minutes after pulling an all nighter was very hard on Jesse.
We also didn’t need to pack! No forgetting things. Everything we needed was right at hand.
- Individualized care
It’s just a fact. Midwives take on fewer clients. Some only take on 6-8 clients a year! They hardly need your chart because they are so involved in every step of your health and care and don’t need reminders. I can’t tell you how nice it was to be able to text my midwives questions, whenever, wherever! No reaching an on-call person or waiting for a call back. Direct access for same day/hour prescription call-ins, no question too silly.
The day I went into labor with Eliot, a friend of mine experienced the tragic loss of her own baby, and it had me freaked out. My midwife called me in just to listen to the heartbeat for peace of mind. She had a cup of chamomile tea waiting for me. This kind of care contributed greatly to my confidence!
I chose midwives for both of my hospital births, and while they did a good job, they also saw hundreds of other clients as well. Both times it was a team of 4 midwives who rotated, so I never knew who I was going to get. Having this surety of who would be there was huge for my confidence.
Side note for HG sufferers— some midwives have the ability to do IVs in the office and prescribe meds. It was a lifesaver to just text my midwife and say I needed an IV for dehydration, and then sitting on a couch getting one less than an hour later. 🙌 No urgent care, no IV clinic, no wait.
Samaritans covered my birth, and I paid for super affordable labs and ultrasounds out of pocket. So all in all I was out less than $1k for the birth.
Most home births cost $6-8k if your insurance won’t cover, which is often still less than a copay at the hospital! We were on state insurance for both of our hospital births, but I remember seeing those bills and thinking yikes!
6. The Sibling Factor
Man I could write a book about this one! But I’ll keep it brief. We really wanted our kids to be involved this time around. Jesse was there for his sister’s birth when he was around 12, and he says it impacted him greatly. In fact, I know this is why he’s always been such an eager and active coach and supporter in our births.
The midwives answered so many questions for the boys! Having them in our home a few times made it feel normal. The boys thought of them as friends.
In addition, we didn’t need to worry about sending the boys anywhere, or coordinating with anyone. Their routines were only slightly disrupted vs. if we’d stayed in the hospital without them. We made so many sweet memories the next morning, just our family. I will cherish these times most out of all.
I think they also have a greater bond with their brother! They often recount their experience of that night, and the awe factor is still there. They’re also super gentle and loving with me, because his birth isn’t a story to them, it unfolded right in front of them. Kids can handle a lot! My oldest can’t stand to see a cut or a bug, but he handled this easily. (We did have one family member assigned per kid to be there for them, just in case however!).
Lastly, I remember how hard it was to be trying to bond with my baby while missing my other kids at home! I underestimated both times how emotionally difficult this would be— especially when they made us stay an extra day for jaundice concerns. I just sobbed and sobbed Bc I missed my older babies so much. I was miserable until I got home with them.
I have used tubs for both of my hospital births and for my home birth. Not every hospital provides them or is comfortable with them— I identified only 2 in the DFW metroplex (some actually have tubs here but refuse to let you use them!).
When they say the tub is nature’s epidural, they aren’t kidding! I don’t know how I would’ve made it through my last three births without that hot water prize waiting for me.
The advantage of homebirth, however, is that you can actually give birth in the tub! With my two hospital births, I had to sign papers saying that I would get out of the tub to push, no matter what. I even signed that they were allowed to forcibly remove me if I was in too much labor pain to move.
I cannot overstate how safe and how much easier it was to birth Eliot in the tub vs. a bed! Walking from the tub to the bed in the hospital while in transition was literally the hardest thing I’ve ever done. It brought on the contractions harder and faster and more painful. Birthing in a tub is just as safe as on a bed, IF you’ve been trained in it (you have to think upside down and know what to look for in terms of cord, head, etc).
- No epidurals
Guys, epidurals are not the enemy when done right. I have heard many cases of it being just the thing to allow a mom to relax and get her baby out safely! I’ve never had one, so I can’t speak to it on that personal level, but I’ve heard many stories of it being just the thing that progresses labor.
Without proper support, the proper environment, and some prep, I believe that a natural birth without drugs is really hard and almost near impossible. My first labor lasted over a day and crossed a line from pain into genuine suffering. It wasn’t an experience I’d wish on anyone. If someone doesn’t have the ability to labor in whatever position they want, however they want, with someone right there at their side at all times, I can see why having the epidural option is key. I know I would’ve chosen it with my first if I could have!
2. Access to more complete care
Again, this is a difficult one. Many emergencies/complications are created due to a domino effect of interventions, and it’s difficult to know whether they would’ve happened with different care. I have my own example with my hemorrhaging and placenta— I used to think I was safer in a hospital because AJs placenta came out shredded and caused significant enough bleeding that I almost needed a transfusion (but even with that situation, everything they ended up doing could be done by a midwife at home as well! Same tools, same drugs.) Turns out, the rough treatment I got with his birth was NoT normal (but I didn’t know any better!). In addition, there was a fire drill right after I had him, and I didn’t get checked by any nurse for over an hour! By then we had a semi emergency on our hands. With #3 at a hospital, they were semi gentle in removing the placenta, and while I still bled a lot, it wasn’t even close to an issue. With #4 at home, they were even gentler and I have had the easiest recovery of all. So was it safer to be in the hospital? In that instance, not really. But if the hemorrhaging had been caused by something more rare that wasn’t caught earlier in the screening, then yes.
Midwives are very careful to refer anyone with certain factors (history of preterm labor, high blood pressure, diabetes, etc.) so that the chances of needing a higher level of care are super slim in a homebirth. But some people prefer to eliminate that risk altogether.
And again, wherever someone feels safest is probably best! I know, for instance, that if I was a NICU nurse or had a complicated previous birth, it would be difficult to get some of the “what ifs” factor out of my head during labor, and I just wouldn’t relax, no matter how many safety stats I saw. Likewise, if someone has had a bad Hospital experience, I can see why it would be near impossible to relax and go into labor. The body blocks certain birthing hormones when we feel unsafe!
3. Newborn Care
My second and third babies had severe jaundice! It was nice to know that right away and start treatment (that being said, my midwife this time was on standby to prescribe me a bilirubin blanket designed for home use!).
If Eliot had failed any of his newborn exams, we could’ve been referred to a hospital which is a huge inconvenience. I can see why having more immediate access to this would be helpful! (Side note: Jesse was tasked with taking our temperatures every 2 hours! And he had a list of other screening factors to look for before the midwives returned in 2 days).
4. Postpartum Care
I did really appreciate having a nurse and lactation consultant ready to help at the push of a button! I had to change my own underwear and pads this go around, and made a complete mess of the bathroom the first time (Jesse and baby were sleeping 😝). That being said, I got the hang of things pretty quickly. It’s just a perk I want to mention.
I also really liked having meals and snacks delivered at the push of a button! Jesse and my mom and sister had that mostly covered, but sometimes it’s easier when you know you’re not inconveniencing a family member who is also sleep deprived from being up all night at your birth! (Side note: our insurance never covered Jesse’s meals, so he would say this was actually not a big perk, since he still had to leave to find or buy food for himself for those 2 days).
I hope this overview of my experience helps anyone! I loved both hospitals I had my #2 and #3 at (French Hospital, San Luis Obispo CA, and Texas Presbyterian Allen, TX) and would still recommend them if someone is considering a midwife in hospital! Call around because just as with anything, there is a lot of variety, good and bad, out there!
That being said, I’m so grateful I got to experience the magic that is home birth with my midwife Amy at Swiss Avenue Birth and Wellness.