Is Homebirth a Safe Choice for Me and My Baby?
Updated: Jun 30, 2022
Here's a resource for the part of you (and your family) that likes statistics: https://mana.org/healthcare-policy/homebirth-study-fact-sheet
And then, remember - safety is also a feeling (as in, 'I feel safe here with you') and an experience (as in, 'I arrived home safely). When you feel safe, your nervous system is in a state of resilience, responsive to the faces and gestures of those around you, and shifting healthfully between sympathetic and parasympathetic activity so that you can be playful and/or restful. When feeling threatened or in danger, the more extreme sympathetic activities of fight-or-flight and even parasympathetic freeze response can be triggered. A labor and birth that are safe for the baby and birthing person involve a sensitive cascade of hormones dependent on the birthing person feeling safe. Contractions will be more effective, labor more efficient, more oxygen will go to baby, and all body systems will be better regulated in an environment of hormones released with maternal feelings of safety. Remember also, that feelings can be contagious - a calm and confident partner, doula, and care provider create a lovely holding space within which the birthing person can relax, sensing that all is well and taken-care-of. Of course, fearful presences can also stimulate fear in the birthing person and wreak havoc with the labor process. (Read: hire a doula!).
Another factor in safety is how risk-factors are handled. In the midwifery model of care, we strive to prevent risk factors before they arise and mitigate those that do using all the non-invasive tools at our disposal. By cultivating relationships with our clients and getting to know all we can about their diet, exercise and sleep habits, stress-reducing practices, and other lifestyle factors, we get to collaborate in setting our clients up for safety, health, and success. Alternatively, sometimes pregnant people experience exacerbation of risk factors by well-meaning care providers and others who scare them into a 'better safe than sorry' approach, which often leads to more intervention than could have been necessary. As my teacher Whapio says, "We can do better than better safe than sorry."
Some of the questions we get most often from partners are around 'what happens if... xyzzy emergency arises.' Please know that homebirth midwives are trained and equipped to handle emergencies at home such as baby getting 'stuck' on the way out, baby needing help breathing right after birth, birth person bleeding too much, need for I.V. hydration therapy, shock, and so on. We are also monitoring for signs that transfer might be necessary to prevent an emergency. Additionally, the way we handle emergencies at home is a bit different from how things are handled in the hospital. We utilize the resources of a mobile birthing person, in the case of a dystocia, and the ability to keep baby attached to the placenta in the case of a resuscitation, for example. Most of our transfers are due to maternal exhaustion and/or a desire for pain medication. (So rest, drink, and eat in labor, please!)
If you can see yourself giving birth at home, if you and your partner are both on board, if you feel confident and connected with your (possible) home birth care team, then you have a lot going for you when it comes to a safe home birth experience for you and your baby.
If home birth just doesn't feel like a good idea, if giving birth without pain medicine is not what you deeply and truly want, if your partner is totally freaked out by the idea and does not even want to meet with a midwife or watch a movie about it, if you have a bad feeling about it, then please listen to yourself and your partner. Home birth is an all-in commitment that requires preparation and real trust in yourself and your team. Of course, emergency services can be activated, and non-emergency transfer by choice is always an option. But being clear within yourself is the first step towards safety - in feeling and in outcome. I trust you to make the right choice for you and your family, for now and for always.