For almost all of human history babies have been born at home. Over the last 100 or so years however, birth has begun to move into the hospital in industrial countries that practice Western-style medicine. In America, hospital birth has become so ubiquitous, that homebirth is not well understood by our generation, or our mother’s generation. However, since the 1970’s there has been a small, but growing movement to promote homebirth as a valid and safe choice for healthy, low risk mamas. While this movement has drawn criticism from some American medical groups, today I want to explore the sustainable side of homebirthing. Is homebirth a Green Idea? And is it worth it?
Note: this review is intended to explore the GREEN side of homebirth. I do not want to begin a debate on the safety of homebirth. Numerous studies have show equivalent safety rates when comparing home and hospital births (source). Of course, it is YOUR responsibility to do your own research and decide if homebirth is right for you. I will delete any comments debating the safety of homebirth, only because this is not the right forum for that discussion.
- Better for you – women who birth at home have lower rates of vaginal tearing, episiotomy, pharmaceutical drug use, and surgical intervention
- Better for baby – babies born at home (to healthy, low risk mothers with a certified midwife in attendance) have similar outcomes as babies born in a hospital, but also get more skin to skin time with their mother, allowing them to initiate breastfeeding much more easily.
- Better for the Earth – homebirth is a very environmentally low impact process, focusing on the body’s natural processes. Use of electronics, disposables and pharmaceutics (which enter the waste stream) is minimized, and the clean up is limited to a small bag of trash plus one or two loads of laundry.
- Saves time – no need to wait for child care, or pack-up and ride to the hospital while in labor. Everyone you need comes directly to you.
- Saves money – homebirth can offer out of pocket savings of up to 60% or more depending on the area of the country you live in and your health insurance situation.
- Comforts of home – homebirth allows you to labor in a comfortable and familiar environment, to sleep in your own bed after delivery, and have 100% control over who is coming in and out (medical professionals and potentially unwanted well-wishers).
- Great customer service – at the hospital you are another vagina with a baby coming out of it. At home you are a real person who has a name other than “mom”. More on this later….
- No pharmaceutical pain relief available – you need to be prepared to manage the pain of an unmedicated labor. If you can’t handle it, you must transfer to the hospital.
- Not all births can happen at home – even in healthy, low risk mamas, the homebirth to hospital transfer rate is around 10%. Hospital transfer (even for good reason) can be super disappointing if you were planning a homebirth.
- No break from home and family life – some mamas really enjoy the alone time they get at the hospital, where meals are brought to them and they don’t have to get up for anyone other than themselves. It is hard to get this kind of atmosphere at home where everyone is used to you being the mom, regardless of the soreness of your lady bits.
- Insurance coverage is hit or miss – depending on your type of health insurance, the type of midwife you use, and how the birth is billed, you could be stuck paying for the whole thing out of pocket.
- Your family and friends will not understand – and their range of reactions will include questions about your sanity, hilariously ill-informed comments, concerned requests for more information, or even harassment and fear mongering in order to get you into a hospital with a “real” doctor.
I was born in a typical mid-western hospital. So was every one in my family for the last three generations, as far as I am aware. Homebirth was not something I was “raised” with or knew anything about. Except there was this one lady at church…
She was (is) one of those fun, super chill, always creative mamas with six or seven kids. One summer when I was a teen, she delivered a baby at home and I went with a bunch of youth group kids to visit her and wish her well. She was tucked into her own bed at home, cuddling her sweet newborn, and with her husband attending to everything. She told us about a very calm labor where she read portions of the Psalms out loud during contractions. It was all serene and natural and beautiful. That short visit made a huge impression on me.
After that, I tucked away homebirth as an option in my mind. During those early married but no kids years, I mentioned it to my husband once or twice as something I was interested in. I don’t remember him ever questioning, or pushing back. He just always responded with something like “as long as insurance covers it”.
My first pregnancy was a big surprise. We had experienced fertility issues, and instead of addressing medically, had set the dream of a family aside and moved cross country so my husband could chase a dream career instead. Needless to say, having a baby was NOT part of our first year in L.A. plans, and I panicked at the sight of a positive pregnancy test.
I was also so naive. After seeing that no homebirth midwives were listed in the Blue Cross Blue Shield directory (haha, as if), I made an appointment with a random OB. Our first meeting (that one where you’re supposed to interview your provider to see if they are a good fit for you), I asked questions like “so do you like delivering babies”, and “I was thinking homebirth could be cool”. So naive. I was totally unprepared for the OB and type of care she provided, mostly because I was totally unprepared to be pregnant. It didn’t take too long, however, for me to get up to speed with what was going on versus what I really wanted to be happening…
Most OB visits were a series of urine tests and blood draws for reasons that were never explained to me. I would get 5, maybe 10 minutes with the actual doctor, who always offered more testing to check on all the things that could potentially be going wrong. She told us we should get all the testing done so we could “terminate the pregnancy” if test results were unfavorable. This conversation did not sit well with me, especially after we had it multiple times. When I told her I wanted a natural birth, she shrugged her shoulders and said, “sure, whatever you want”. We never talked about things I should be doing for optimal health, or to increase chances of natural birth (good nutrition, special exercises, etc). We never talked about what to expect, or what options for treatment were available during birth. As the weeks went by I was feeling more and more uneasy about the OB and what may be waiting for me at the hospital.
We decided to hire a doula to increase our chance of natural delivery in the hospital. Frankly, I was afraid of delivering at the hospital. Afraid that things would be done to me without asking that I didn’t feel comfortable with. (The hospital standard of care is anything but “natural”). Afraid that I would not be in a place to make truly informed decisions while laboring. Afraid of the cascade of interventions. Afraid that I would be just another vagina with a baby coming out that no one really cares for personally. As I interviewed a very wise doula she pointed out that it sounded like I would be much more comfortable at home than in the hospital. Then she encouraged me to MAKE IT HAPPEN!
We are very fortunate that in California, and especially in Los Angeles, there is a large network of independent home birth midwives that practice legally and have good relationships with back-up OBs. I was able to find a Certified Nurse Midwife who lived only about 20 minutes away. She had space for me, and at 20 weeks we made the switch. Yay! (Would you believe the OB’s office never contacted me after I stopped making appointments? You would think they would at least check in to make sure everything was okay if I abruptly stopped coming. I guess I was not very important to them at all!)
My midwife appointments were much different than with my OB. Appointments lasted about 45 minutes – all of the time with the midwife. I did my own urine dip tests and weight checks. We spent lots of time getting to know each other, taking about nutrition, exercise, what was happening with baby this month. As the birth grew closer, we talked about test and care options available (i.e. GBS swab, vitamin K drops, eye ointment after birth, etc). The choice to do any of these was mine with no pressure, and she was very good in spending time talking about the pros and cons of each choice. We talked about what was happening in life, and how I was doing emotionally. By the time the birth came, we were good friends, and I KNEW she cared about me personally.
I have now had three home births with the same midwife, and I couldn’t be happier! The midwife and her assistant arrive at my home within about 30 min of when we let her know we need her. She has left me to labor alone with my husband’s support, only checking in with intermittent electric fetal monitoring as necessary. She has done minimal, but necessary interventions when required (pitocin injection for a post delivery hemorrhage, artificial membrane rupture followed by immediate delivery for fetal distress). These interventions were only done, however, after true informed consent was given.
After the baby arrives and is stable, the midwife leaves my husband and I alone with the new babe for at least 30 minutes just to cuddle and bond. This is before the cord is cut, and even before baby is measured or cleaned! Then the baby gets a full physical exam while laying on the bed right at my feet. Afterwards, the midwife and her team clean up any mess, make the bed up fresh, and start a load of laundry. Meanwhile, the midwife’s assistant helps me to the bathroom and bathes me (literally cleaning blood from between my toes if necessary), dresses me and tucks me back into bed. I feel so special and pampered!
In summary, Homebirth has been a great choice for my family! Now, I know I promised to discuss more about the environmental impact of homebirth. However, as I approach 2000 words on this post, it seems I have a lot more to say than I realized. Stay tuned for Part 2, when I will go further into the case for homebirth, the green factor, and answer some frequently asked questions about homebirth. I am by no means an expert on homebirth, but it is something that is important to me, and I want to spread the word about this GREAT option for women with low risk, healthy pregnancies!
Have you had or considered a homebirth? Why do you think it is something that the “crunchy granola” crowd seems drawn to?
Reminder: I do not want to begin a debate on the safety of homebirth. Numerous studies have show equivalent safety rates when comparing home and hospital births (source). Of course, it is YOUR responsibility to do your own research and decide if homebirth is right for you. I will delete any comments debating the safety of homebirth, only because this is not the right forum for that discussion.