The number of women planning home births, and birth centers, has increased in the United States over the last decade. According to a 2015 study, led by Ruth Zielinksi from the Western Michigan University School of Nursing, there is evidence to suggest that more women would choose this option if it was readily available. The study found that most women in developed countries choose to give birth in hospital simply because this is what their mothers and grandmothers did, however, studies show low-risk women have excellent outcomes with out-of-hospital births.
One of the examples it cited was from a community in rural Pennsylvania. In circumstances where the birth attendants were certified nurse-midwives, the pregnancies were low-risk, and the midwives had a good relationship with nearby medical facilities, the outcomes were incredibly successful: 99.25% of deliveries were successfully conducted at home, with no need for a hospital transfer, and the rate of neonatal death was just 0.4%, which was attributed to fetal anomalies.
Pregnancy and birth are a normal part of life that rarely requires medical management. We’re here to give you the information you need to experience a safe labor and delivery the way you choose.
Have questions about out-of-hospital births? Call or email us today.
What is a low-risk home birth?
The key to safe home births, and other out-of-hospital births, is that the expectant mother must be low-risk. That doesn’t mean you have to be the healthiest person alive. Medically speaking, low-risk means you meet certain criteria – for example, your body mass index (BMI) is 32 or less, you’re eating a relatively healthy diet, you don’t have diabetes, you’re not overly anemic, your blood pressure has remained normal throughout your pregnancy, your baby is growing at a healthy rate, and so on. As long as these criteria are met, most deliveries are very successful.
Research shows that for low-risk pregnancies, out-of-hospital births have the same outcomes for moms and babies, because they’re less likely to require medical intervention. A 2009 study led by Eileen K. Hutton, from the Midwifery Education Program at McMaster University in Canada, compared outcomes for low-risk women planning home births with low-risk women planning hospital births. It found that all measures of serious maternal morbidity were lower in the home birth group, and that these women also had a much lower risk of needing medical intervention, such as a cesarean section. It concluded that midwives with good access to emergency services provided a level of care that resulted for favorable outcomes for women in both groups.
Midwife training is critical to safe home births
As you can tell, a common theme that runs through these studies is the level of training the midwives have. Midwives are highly trained in managing complications that can happen during labor and delivery and recognising potential problems early so they can be resolved early. A 2009 study, led by Patricia A. Janssen from the School of Public Health at the University of British Columbia in Canada, noted that planned home births attended by registered professional attendants did not face an increased risk of adverse perinatal outcomes in Norther America.
At Birds and Bees, Jennifer Hoadley is a certified nurse midwife, and Jennifer Cave is a certified professional midwife. We each have more than a decade of experience, and between us we’ve attended more than 3000 births. When we say we’ve seen it all, we mean that literally. We’re both up-to-date in both adult resuscitation and newborn resuscitation, and we brush up our maternal emergency medicine skills quarterly. We’re here to make sure you get the care you need.
We also recommend that first-time moms consider working with a doula. A 2000 study, published in the Journal of Perinatal Education, reported that a doula’s support is associated with a decrease in length of labor, incidence of caesarean birth, epidurals, and the need for interventions such as labor-inducing drugs and forceps. This is also associated with decreased pain and anxiety in labor.
What if an emergency happens during a home birth?
Emergencies can happen, and there are some circumstances where we will organize a hospital transfer immediately. For example, if your water breaks and the umbilical cord comes out first, for example, or if your baby’s heartbeat drops and doesn’t come back up, we’ll make sure you and your baby get the intervention you need. Informed consent is a really important aspect of this. A 1995 study into home births, published in the Journal of Nurse-Midwifery, found that a discussion of unusual circumstances – including potential risks and solutions – was critical to patient care. You should ask your midwife as many questions as you like and ensure you have a plan in place.
Safe and successful home births have excellent outcomes for low-risk women, where the births are attended by highly trained midwifes and care is taken to develop a plan. Pregnancy and birth are a normal part of the human experience, and they rarely require medical management. We’re here to we’re here to help you through this special and unique time, and ensure you give birth your way.
Want to talk to a midwife about an out-of-hospital birth? Call or email us today.