There are many decisions that you need to make when it comes to planning your birth. But, choosing your birthing environment is one of the two most important decisions, the other is choosing a care provider that shares the same views on birth as you do. Both can influence many choices and decisions that you may encounter during your birth.
I have birthing clients describe fear even at the thought of being in a hospital, perhaps because of a previous experience for themselves or a family member. Others describe how hospitals have saved their lives and feel most comfortable being surrounded by doctors and life-saving equipment. Yet some feel most comfortable in their own home, resting on their bed or taking a bath in their bathtub.
Your birthing environment can help to set the mood, affect how safe you feel and perhaps how your labour progresses.
Homebirth is not right for everyone, but it can be a beautiful choice for some. Ultimately, you should take time to explore where you think you will feel most comfortable and where you will be able to focus on your relaxation and allow your body to relax and open, because that is the place where you should plan to give birth in.
Here are some evidence-based facts and a few other things to consider:
Being low risk makes you an ideal candidate for giving birth at home
You should always discuss your unique situation with your care provider, but you are probably considered low risk if you are carrying only one baby, he/she is head down and growing normally, and if your pregnancy has been healthy and not showing any signs for obstetrical complications.
Your home will be equipped with the equivalent of a level 1 community hospital room
Your midwives are well trained to deal with obstetric emergencies including neonatal resuscitation and will arrive in a car full of all the equipment that is needed for your birth. Their birth equipment bags include things to check your and your baby’s vitals plus sterile instruments, oxygen, neonatal resuscitation equipment and medications to treat postpartum hemorrhage.
You will also be given a birthing kit ahead of time that includes many birthing supplies such as disposable blue underpads, medical gloves and a basin for the placenta.
Planning a homebirth has been shown to have lower rates of interventions
If you are hoping to have a more natural birth experience, you are more likely to have one if you plan a homebirth. This includes more likely to have a spontaneous vaginal birth and less likely to have postpartum hemorrhage, a cesarean birth, an episiotomy, an assisted vaginal birth (vacuum or forceps), or the use of pitocin for augmentation.
Planning a homebirth has been shown to have lower rates of use of pain medications
This includes the use of an epidural or spinal anesthesia, narcotics and nitrous oxide gas.
If you have skills and support that can help with pain management this is the time when they come in handy. Comfort measures like using breathing and relaxation techniques, trying different positions, having your birth companion do acupressure, counter pressure and hip squeeze, or opting for water immersion can be combined for added benefit.
And don’t forget that using a doula has also been shown to reduce the need for pain medication!
Planning a homebirth was found to have similar use of interventions and health outcomes for baby
When compared to babies that were planned to be birthed at the hospital, babies that were planned to be birthed at home have similar rates of neonatal resuscitation, NICU admissions and APGAR scores.
Most cases of transfer to the hospital are non-urgent
The most common reasons to go to the hospital are for prolonged labour, pain relief, meconium and fetal heart rate concerns. After the baby is born, the most common reasons to transfer are post partum hemorrhage, perineal repair, and neonatal health concerns such as respiratory distress and small for gestational age.
You should consider your home’s distance to the hospital and always have a back up plan ready in case you need to transfer to the hospital.
Things that you might need to gather for a homebirth
Things to keep you comfortable:
- plenty of pillows, a birthing ball and a yoga mat for labour positions
- Light snacks and fluids- juice, electrolytes, ice cubes/chips
- Water bottle and bendy straws
- Heating pad and ice pack
- Comfortable clothing options and menstrual pads
- Non-essentials- dimming lights, camera, music, birth pool, affirmation cards, essential oils, homeopathic remedies
Things for cleaning:
- large heavy duty garbage bags, 2 large laundry baskets
- a shower curtain and old sheets to cover your mattress
- lots of old towels and face cloths
- hydrogen peroxide to remove blood stains
- A bucket in case you need to throw up
- Paper towels
Things for baby:
- 2 infant hats
- Receiving blankets
- Newborn diapers, onesies and sleepers
- A thermometer
- Oven tray and freezer bag for the placenta
- An extension cord and a bright lamp
- Meds- Tylenol, Advil and Gravol
- A packed hospital bag
So, if you are confident in your ability to give birth and you feel most comfortable and relaxed in your home, perhaps giving birth in your living room or having a shower in your own bathroom might be the right choice for you. As long as your partner doesn’t mind cleaning up a bit of mess…
- Hutton EK, Reitsma AH, Kaufman K. Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study. Birth. 2009 Sep;36(3):180–9.
- Hutton EK, Cappelletti A, Reitsma AH, Simioni J, Horne J, McGregor C, et al. Outcomes associated with planned place of birth among women with low-risk pregnancies. CMAJ. 2016 Mar 15;188(5):E80–90.
- 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. CMAJ. 2002;166(3):315–23.
- Janssen PA, Saxell L, Page LA, Klein MC, Liston RM, Lee SK. Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ. 2009 Sep 15;181(6-7):377–83.
- Rossi AC, Prefumo F. Planned home versus planned hospital births in women at low-risk pregnancy: A systematic review with meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2018 Mar;222:102-108. doi: 10.1016/j.ejogrb.2018.01.016. Epub 2018 Jan 31. PMID: 29408739.