More women choosing home births

An interesting phenomenon has been occurring over the past decade – births outside of hospitals have risen by 72% since 2007.  Giving birth outside of a hospital setting has become more popular and common in the U.S., especially for white women, with almost 60,000 out-of-hospitals births in 2014.  Whether a woman is choosing to birth her baby at a birthing center or an actual home birth, many couples are looking for a more natural, less invasive birth experience to bring in the new life they have created.

Why the rise in home births?

One of the main factors driving this trend is the fear couples have of wanting to avoid a cesarean section.  There is the perception that if a woman goes the way of having her baby in a hospital, there could be a higher chance of intervention such as having a cesarean.  Although cesarean rates have declined slightly in the past couple of years, first-time rates remain high at 20%.  The total cesarean rate is more than 30% of births or basically one in three women now give birth by cesarean section.  Compare this with the fact that in 1965 the national U.S. cesarean birth rate was just 4.5 percent. 

While cesareans are generally considered safe, there are serious risks of complications from this major surgery such as blood loss and respiratory problems for both the mother and baby.

The seven-fold dramatic rise in cesarean births is due to many reasons: the average age of the expectant mother is higher, the rising obesity rate among moms-to-be, an increase in multiple birth deliveries and in increase in induced labors

Women who want to avoid a cesarean, whether a first or second one, or attempt a more natural birth might feel they would be better supported to do that in a home setting. 

Is a home birth for every woman?

Delivering a baby at home is not for every woman.  There are always certain considerations that have to be made such as location (if complications were to occur, is the woman located within a short distance from a hospital), has she had a previous cesarean and is this a high risk pregnancy. 

Home births do present a slightly higher risk for some women than others.  Home births are often better suited for women who strongly desire an un-medicated, vaginal birth and a woman who feels she can achieve it.  Research shows that women at the lowest risk for any problems are generally women who have given birth before without a cesarean section, and their baby is not in a breech position.

Women who are probably not good candidates for a home birth are any woman who has a medical condition disqualifying her such as:

·      High blood pressure

·      Preeclampsia

·      Low or high amniotic fluid levels

·      Fetal malpresentation

·      Preterm labor

·      Twins or multiples

·      Positive HIV

·      Anemia

·      Any medical condition such as diabetes, neurological disorders, or heart, lung, or kidney disease

·      Substance abuse

·      Past OB complications

Things a couple should consider when thinking of a home birth

If wanting to deliver a baby at home, a couple needs to research for trained home-birth providers also known as a midwife in the area they live in.  Questions to ask are what is the provider’s experience, training and reputation, and do they have an established relationship with a physician who can offer backup if needed?  Does the provider have a good relationship with the hospital?

Most women considering a home birth usually find a midwife.  Two types of credentialed midwives are available – certified nurse midwives (CNMs) and certified professional midwives (CPMs).  CPMs can practice midwifery in 31 states.  Most offer home – or birth-center births.  All 50 states recognize CNMs but fewer CNMs deliver outside of hospitals. 

The other important consideration as stated earlier is the distance to the nearest hospital in case of an emergency. 

Making the decision

For soon-to-be parents wondering if a home birth is right for them, it is crucial the couple talks to other couples who have had birth experiences in both a hospital and at home.  Most hospitals do allow a totally natural birth but it is important for a woman to discuss this wish with her doctor. 

The most important thing a couple can do is to research all of their options so that they are able to make an informed choice about what kind of environment and care they want for their pregnancy and birth.