When expecting to give birth, moms often feel nervous about not only controlling pain during labor, but nervous about the ultimate outcome. Will they feel comfortable with the doctor or staff? Will they feel their needs were met and their birth plan followed? These are legitimate concerns and well worth the discussion about the location you will birth in.
Recently, I met a mom who had two prior births in the hospital, only this time, she was birthing at home. She had okay deliveries at the hospital, but she felt uncomfortable, she couldn’t relax, she didn’t feel her needs were met, by her standards. This time, she had decided to birth in the comforts of her home. She wouldn’t have constant monitoring, beeping of machines, outside noises from others, and staff she was unfamiliar with. She hired a midwife team to come in and help create a relaxing atmosphere, quiet and serene. She said that this experience has made all the difference. She is less apprehensive about her care team and feels the natural approach has made a tremendous impact already.
When having a home birth, the atmosphere is your own. Often, your doula and midwife has been to your home to become familiar with your space. We ask about how we can set up, where supplies are, how you want your room, including sounds, visuals, and smells. Your senses are on high alert, so these are very important. If it is at home, I enjoy setting up candles for the evening, to set the mood. I recommend families have a song playlist ready, also the use of essential oils can help relieve stress in the atmosphere.
Your home is often quiet and the midwife will check on mom occasionally, with fetal monitoring and assessment. You can feel free to move about your home, leaning over counters, sitting on a ball, sitting on your toilet (yes, it is comfortable), or even taking a shower. While some of these can be accomplished in the hospital, you often need to wear uncomfortable hospital gowns, and don’t necessarily feel comfortable laboring in the hall with other mothers, so moms often retreat to their room and limit good movement.
Having access to your things also helps alleviate stress. Many families forget items at home and can feel on edge about the surroundings. When you are at home, having access to food during labor greatly assists mom, because she is able to keep energy longer, whereas hospitals discourage food in labor, often leaving mom weak and can cause her pain to increase.
The presence of a birth tub also helps sooth mom. More hospitals are offering this feature, but not all are tub ready. Birthing at home requires you to buy a birth kit. A birth tub is optional, but recommended. Otherwise, it is challenging for moms to give birth in a bathtub, because it is usually a cramped space for midwife, dad, doula, and any other birth assistants.
The cost of having baby at home is very comparable to hospital costs. Many insurances do cover midwifery care, so you just might have a deductible. They usually have a flat fee that includes prenatal and postpartum care. Hospital births can range between $6000-15,000 or more, depending on medications, complications, surgeries, etc. In southwest Washington state, midwives charge around $5000-7000.
Unfortunately, if you have a high-risk pregnancy, a midwife will have to refer you to an OB at the hospital, to oversee your care. Some midwifes can still assist with the delivery, depending on their connections to the hospital. For any other procedures or surgeries, she will step back and have the OB take on the rest, but can help with postpartum care after delivery.
If you are still considering and weighing your options, think about what makes you comfortable. If having baby in a hospital, near doctors and in case of emergency, that is completely understandable. I recommend a doula, either way, so that she can help you manage stressors and help advocate for your needs and wants. For homebirths, make sure you ask your midwife what her procedures are if the birth doesn’t go as planned. What hospital does she transfer to? Will she be able to continue care there? Always ask the “what if” questions, so that you feel comfortable with your decisions. Be informed and consider your goals and make sure you have others to surround you on your special day. Having the best care team will make the biggest difference.