Home birth is a safe, wonderful way to welcome babies into the world. I've had six babies at home myself. But it may not be for everyone. Here are a few reasons not to:
You don't want to birth at home.
I've had six great experiences birthing at home, but not every woman wants to give birth at home. That's OK.
There are some misconceptions that make people hesitate. Some are petty (like “it's messy.” Your midwives clean everything up for you. It will probably be cleaner than when you started). Some need research (like “it's illegal.” In general, you can have your kid where you want to, the law doesn't care).
But many women still want to go to the hospital, even after they know home birth statistics, even if they're low-risk, even if they know the midwives will clean everything up. That's fine. If you don't want to give birth at home, then don't!
You've developed a pregnancy complication.
There are many pregnancy complications that make planning a hospital birth the safe option for you.
First, remember that most complications are preventable. Really. You're not powerless to count only on luck for a healthy pregnancy. You can do a lot with nutrition, exercise, staying low-stress, etc. to keep yourself and your baby healthy.
But if a complication does develop, the hospital is a safe place to head. Sometimes you can have a great birth in the hospital, even if you have a condition that needs to be carefully managed by your OB, or by your OB / midwife team. Many moms with diabetes – Gestational diabetes or Type 1 diabetes (pre-pregnancy) are able to have natural births in the hospital by working carefully with their medical team.
You want pain medications.
You're reading a site about natural birth right now, so I think it's safe to assume you're at least considering natural childbirth. But should you think you'll want pain medications, don't plan to give birth at home.
Truth? The point of getting pregnant is to give birth to a baby. Your labor is the means to that end, and you can do it. You can work with your baby. Even if it hurts. Even if it takes awhile. You can do it. I know you can.
But sometimes you do want pain medication. Sometimes labor goes on a very long time, and medication can give you the rest to see it until the very end. A hospital will give you that option (you can transfer from home to hospital if this is the case, too).
You know your pregnancy is high-risk.
This is something you may know going into pregnancy – you may have a condition that means pregnancy is high-risk. I already mentioned Type 1 diabetes. Most moms with this condition work carefully with an OB, even if they also see a midwife. Heart conditions, congenital defects, drug dependence (even if you need it and have a prescription), and other issues make the hospital the right choice.
Other conditions are debatable. Some families with twins / multiples and breech babies, for instance, feel that home birth is safe. If you're in a situation that could be considered high risk it's time to do your homework. Nobody can make that call for you. You can and should consult with different professionals and get their opinions. It's important to know what position your baby is in in many of these cases. Some breech and twin positions, for instance, truly need the hospital or even a cesarean.
We have the hospital, cesarean birth, and other interventions to save lives – use them if you need them. If you do know ahead of time that you'll need a cesarean birth for health reasons, advocate for yourself and your baby to have a family-centered c-section. It's possible (check out the Birth, Baby, and Life Podcast episode 002 for more details).
You know your baby will need help.
Sometimes you're in great shape, but you know your baby isn't. Your baby may have a congenital defect, or a complication such as IUGR has developed.
In these cases you want the support of a good hospital. Don't settle for any hospital. Make sure your hospital has the appropriate level NICU to give your baby the care he or she needs. It's far better for your baby if you're able to birth at the hospital where he or she will receive care. Transport is good, even life-saving, but you'll be able to spend more time with your child if you're in the same hospital, at least until discharge.
If your baby has a terminal condition and you'd rather birth at home, talk to your doctor. Many doctors feel that home birth is a safe option for healthy mothers in this case, and it can give you more time to hold your angel baby. Ask about palliative care and pediatric hospice services during this difficult time.
You feel like you should go to the hospital.
This is true at any point in pregnancy or during labor. Sometimes, even if you've planned to birth at home and feel committed, you feel a strong sense that you need to get to the hospital.
If you're in the middle of transition and feel like you can't go on, you may just need your labor partner to help you get through the intensity.
But if you have a strong sense that the hospital is the safest choice for you and your baby, then go there.
Natural birth in the hospital may be a little harder, but it's still possible. And a respectful, family-centered birth is possible even if you need interventions. Your choices for your child's well-being (and for your own) are important even now – don't feel guilty if you make the choice for the hospital.
I believe in natural childbirth and advocate for home birth. But I also feel that every woman should make that choice for herself. If you have solid information and use that to pick the hospital, that's the best place for you and your baby.
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Photo by Daquella manera