An expectant mom has several options when it comes to where to give birth. She can choose from an at-home birth, birth centers, or in the hospital. Home births can be great for appropriate candidates with trained midwives and backup transfer plans in place if needed. But not everyone is an appropriate candidate for home birth, nor does everyone want a home birth. 

There’s been a rise in at-home births in the U.S. They’ve reached their highest level in 30 years. Increased education and awareness about childbirth options have caused the increase says LaKesha Owon Johnson, a traditional midwife at Greenwood Midwifery and Integrative Health. Additionally, the pandemic significantly influenced this shift, as many expecting parents sought environments where they could maintain control over their birthing experience amid restrictive hospital policies. 

“Families today are more informed about their rights and the comparative benefits of home versus hospital births,” she said. “At-home births give families more power and authority to make choices that are best for their family.”

Social media has also played a part in romanticizing the comforts of home birth and villainizing the hospital setting. Jessica Diggs, is a licensed midwife who explains that although she does not align with that mentality without the proper context, she agrees that parents are asking better questions about what type of care they deserve during childbirth. 

“Parents are not blind to this country’s current and deeply embarrassing Black maternal health crisis,” Diggs said. “People are scared to trust a hospital system that has not improved birth outcomes for all people.” 

Assess Your Health and Risk Factors

Johnson explains that determining if a home birth is suitable for you involves assessing your health, pregnancy risks, and personal preferences. Expectant moms should consult with a trained midwife who they trust to review their medical history, discuss any potential risks, and ensure there is a comprehensive plan in place. 

“The key is ensuring both mother and baby’s safety throughout the birthing process,” Johnson said. 

Home births are a great option for low-risk pregnant people. Diggs encourages women to ask themselves, “When you envision yourself in labor, where do you feel the safest?” The answer you give is where you should give birth.

If you are unsure about whether you are low-risk, consult with a homebirth midwife. They can review your medical records and talk it over with you.

Consider Medical History and Personal Factors

Several factors can influence the decision for or against an at-home birth. Women with certain pre-existing medical conditions are advised to give birth at a hospital, Johnson explained. These include immuno-compromised diseases, chronic hypertension, pre-eclampsia, heart issues, bleeding disorders, uncontrolled diabetes, or fetal anomalies.

If an expecting mom has had multiple births (twins, triplets, etc.) or previous cesarean deliveries, she is not automatically disqualified from an at-home birth. If she’d like to have an at-home birth, it is ideal to retain a qualified midwife. 

Additionally, women experiencing complications during pregnancy, such as placenta previa or an active genital herpes infection at the time of labor, should opt for hospital births. This is to ensure that they receive specialized and prompt care. 

“Other than medical reasons, some women simply may prefer hospitals,” Johnson said. “This is especially true if they live too far from a hospital to safely consider an at-home birth.”

Compare Birthing Options

It is best to consult your doctor when weighing the pros and cons of each birthing plan. At-home births provide a more personalized and intimate experience. Expectant moms have greater autonomy, fewer routine medical interventions, and the comfort of being in a familiar setting. 

“Midwives are trained to handle breech births, postpartum hemorrhage, shoulder dystocia, vaginal tears, other other emergencies,” Johnson said. “They have medical supplies and protocols to swiftly manage these situations or transfer care to a hospital.” 

As a midwife, Johnson says she provides comprehensive prenatal care, such as a detailed birth plan and hands-on and off approach during labor and postpartum care. 

“I make it a point to create a safe space of openness and comfort,” Johnson said. “We are all a part of one team and have the same goal.”

Most midwives (state license restrictions apply) bring the same equipment from a normal labor and delivery room. Diggs explained that her birth kit includes anti-hemorrhage medication, neonatal resuscitation equipment, oxygen, IV fluids and more. 

On the other hand, hospitals are equipped to offer immediate access to specialized care and interventions. Examples include an anesthesiologist for epidurals and an operating room for cesarean sections.

“This setting can provide peace of mind for those who might be at greater risk or simply prefer the assurance of immediate medical resources,” she added.

Why Women Choose At-Home Births 

Moms might choose at-home births to experience birth in the comfort and familiarity of their own home. At-home births free moms up from unnecessary medical interventions and give them the power to choose who is present. These moms might value a more natural birth process and the personalized care and close relationships fostered with midwives.

“From my experience, the primary reason expectant parents choose at-home births is to avoid repeating traumatic hospital experiences,” Johnson said. “Women of color also face the pressing need to ensure their safety and well-being are protected in traditional hospital settings.”

Advice for At-Home Birth

For first-time moms contemplating an at-home birth, Johnson suggests diving into educational resources and learning about each step of the process. The journey begins with comprehensive discussions with your midwife, who will be your guide and support. It’s crucial to feel at ease and trust the team that will support you during your birth.