Home Birth

Having a home birth means you give birth at home instead of at a hospital or birthing center. Home births give you the opportunity to deliver in a place that’s comfortable and familiar to you. It can also give you more control over your experience. But home births come with risks.

Before deciding on a planned home birth, be sure to understand all the pros and cons. Talking to certified nurse midwives (CNMs) and obstetricians can help you decide whether a home birth is safe for you.

What happens during a home birth?

During a home birth, a home birth midwife comes to your house to deliver your baby. It’s important to find a provider who has lots of experience with home births. Find someone who makes you feel comfortable and understands your goals for giving birth at home. You may also work with a doula during a home birth. Doulas focus on supporting you through labor.

You don’t need a special birthing room, but you should pick an area that’s spacious, clean and comfortable. Many people use their bedrooms or family rooms.

Most home birth midwives will bring all the birthing supplies with them, including things like:

• Supplemental oxygen (for both you and your baby)
• Sterile gloves, gauze pads, towels, drop cloths and other items
• Medical tools

You should also have a birth plan that you discuss with your provider ahead of time. Be sure to include things like how you want them to treat your pain, cord cutting, and positions for labor and delivery. Many home birth midwives work with hospital CNMs and obstetricians at nearby hospitals. This can be helpful if there’s an emergency or your birth plan suddenly changes. Talk to your home birth midwife about how they handle emergencies.

Your home birth midwife and your birth team will support you through each stage of labor. They’ll monitor you and your baby, offer comfort techniques and help you change positions. Once your baby is born, they’ll do basic newborn care, like making sure your baby’s breathing is OK, getting a birth weight and helping with breastfeeding. Your home birth midwife will also monitor your bleeding and vital signs.

Types of home births

There are generally two types of home births: assisted and unassisted. An assisted birth means a home birth midwife helps you deliver your baby. An unassisted birth means no home birth midwife or medical provider is present.

What are some reasons people choose to birth at home?

You may want a home birth because:

• You don’t want medication (like an epidural) or an assisted delivery (like delivery with forceps or a vacuum)
• You want more control over your birthing experience
• You want to be surrounded by your family and friends, pets or other children
• You want to deliver in the privacy of your own home
• You have specific cultural, spiritual or religious beliefs or traditions about birthing
• Your pregnancy is healthy, and you don’t have any risk factors that could complicate labor or delivery

While having a home birth is a personal decision, major healthcare organizations strongly urge you to use a certified nurse midwife (CNM). They also recommend living near a hospital and having a clear plan for emergencies.

Who shouldn’t have a home birth?

A home birth isn’t right for everyone. There are certain factors that can make a home birth unsafe. Home birth may not be a good option if you:

• Have any form of diabetes, high blood pressure or heart disease
• Are having twins, triplets or more
• Have a breech baby
• Are attempting a VBAC (vaginal birth after c-section)
• Have a history of preterm birth or are at risk for preterm birth
• Can’t get to a hospital in 15 minutes or less
• Don’t have a trained provider to deliver your baby

What are the risks?

The biggest risk of a home birth is not being able to reach a hospital if a complication or emergency arises. Even a few minutes can make a huge difference. The American Academy of Pediatrics says that even a 15- or 20-minute drive to a hospital can be too long.

Childbirth can be unpredictable. Despite your best plans and preparations, things can sometimes go wrong. That’s when a home birth can become dangerous.

When do you need to go to a hospital?

Labor and delivery complications can happen suddenly. You may need to go to the nearest hospital if any of the following happen:

• Your labor stops progressing.
• You decide you’d like pain relief.
• You change your mind about a home birth.
• You develop high blood pressure or a fever.
• You begin to bleed excessively.
• Your baby shows signs of distress.
• Your baby needs medical intervention right after birth.

One study found that hospital transport for delivery is necessary in 10% to 40% of all home births. The rate tends to be higher if it’s your first time giving birth. Only a small number of transfers happen because of emergencies. Most are due to stalled labor or a request for pain relief.

How common are home births?

Home births are becoming more popular in the United States. In 2022, there were over 50,000 home births in the U.S. Despite more interest, home births still make up less than 2% of all births. This means most still give birth in a hospital setting.

Is a home birth legal in the U.S.?

Yes, home births are legal. Still, many medical organizations don’t support home births due to safety concerns.

The American College of Nurse Midwives, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists agree that hospitals and accredited birth centers are the safest settings for birth in the United States. Additionally, these organizations are supportive of people who chose a home birth and offer clinical guidance in hopes that it leads to the best possible outcome.