Homebirth Essay

Advantages and Disadvantages of Birthing at Home, Birth Center, and Hospital

Before becoming a client of Women's Health and Birth Care, we would like for you to become familiar with your options and the advantages and disadvantages of each. Please read the following and feel free to ask any questions.

Advantages of home birth...

  • Statistics show that home birth is as safe or safer than hospital birth for low-risk women with adequate prenatal care and a qualified attendant.
  • At home a woman can labor and birth in the privacy and comfort of the familiar surroundings of her own home, surrounded by loved-ones. in whatever positions and attire she finds most comfortable.
  • The laboring woman maintains control over everything impacting her labor and birth. Meeting her needs is the only focus of all those present. Nothing is done to her without her consent.
  • Labor is allowed to progress normally, without interference and unnecessary interventions.
  • Studies show that the risk of infection is reduced for both the mother and the baby.
  • During labor the woman is encouraged to eat, drink, walk, change positions, make noise, shower, bathe, etc.
  • Care-givers are invited guests in the birthing woman's home. She can have anyone she desires present: family, friends, children, etc. Her medical team (midwife and birth assisiant) do not go home because their shift has ended or because it was supposed to be their day off or because it is a holiday or because they planned something else.
  • She doesn't have to worry about when to go to the hospital since her care-providers come to her.
  • Continuous one-on-one care is given by the midwife, providing ongoing assessment of the baby's and mother's condition throughout the birth process and postpartum period. Her care provider knows her well and she knows her care provider. They have established a trust relationship.
  • Women are supported through the hard work of labor, and encouraged to realize the insights, and experience the personal growth as a human being to be derived from such a powerful, life-changing event.
  • Bonding is enhanced and includes everyone who has contact with the baby including neighbors and relatives. Breast feeding is facilitated by the baby remaining with the mother.
  • Cesarean Section and forceps deliveries are unavailable - transportation to the hospital is necessary if these interventions are required. However, rates of both, as well as episiotomy, are very low.
  • The cost of a home birth may be less than a hospital birth, and is often covered by insurance if a CNM is utilized.
  • Pregnancy and birth are viewed as normal, natural body functions and not as an illness or disease.

Disadvantages of home birth...

  • Client's must assume a greater level of responsibility for their own health: physical, mental and spiritual. This requires active ongoing participation in decision making in all aspects of their care, and a willingness to accept the consequences of those choices and decisions.
  • Since the hospital is the currently socially acceptable location for birth, choosing otherwise may result in negative judgments and lack of support.
  • Cesarean Sections, forceps deliveries and a nconaialogist arc not available at home, transport is necessary for these and other medical interventions.
  • Personal arrangements must be made for postpartum care, such as meals, housekeeping, child care etc.
  • The cost of a home birth may not be covered by the client's insurance.
  • Analgesics are not readily available with a home birth.

Advantages of a birth center birth...

  • The facility is usually only provided for pregnancy and birth events.
  • In a birth center, pregnancy and birth is considered a natural and healthy process.
  • During pregnancy and birth, women arc encouraged to take charge of their own health care.
  • It provides an alternative to parents not comfortable with home birth, yet do not want to give birth in a hospital.
  • It has many of the same advantages as home birth, such as greater parental control, non-interventive obstetrical care, freedom to eat and move during labor, and to give birth in any position, and to have any number of family and friends attend the birth.
  • The parents are usually encouraged to bring family members to their prenatal visits.
  • It offers personalized care at much lower costs than traditional hospitals.
  • In most centers, parents can meet the entire staff prior to the birth.
  • The rate ofCesarcan and forceps deliveries is less than hospital.
  • The discharge time after birth is normally measured in hours, not days.

Disadvantages of a birth center birth...

  • Rigid screening criteria often eliminates healthy mothers, i.e.; VBAC, mother over 35.
  • The mother is still moved to birth center during labor, and still labors away from the home environment.
  • Many centers have rigid rules concerning transporting of the mother to the hospital i.e.; prolonged labor, ruptured membranes. Mother may have to be moved during labor.
  • There are usually no pediatricians on staff if the baby has special needs after the birth.
  • The mother cannot remain at the birth center for a two or three day rest; discharge is usually within four to 24 hours.

Advantages of a hospital birth...

  • Many mothers feel safest laboring a hospital.
  • It is the safest environment for the mother at risk for medical complications during labor.
  • Emergency personnel and equipment is available if the mother develops complications or needs medical attention.
  • It avoids the rush of a last-minute transfer to the hospital (from home or a birth center) if medical problems arise.
  • It is the only option available in the event a cesarean section is necessary.
  • Immediate pediatric attention is available should the newborn need medical care. Baby does not need to be taken off site to be routinely examined by a pediatrician.
  • It has round-the-clock help for the mother and baby (food, diaper changes, medical assistance and information.)

Disadvantages of a hospital birth...

  • The parents are not on "home ground" and do not have the same control they would at home.
  • Hospitals are primarily associated with illness.
  • Hospitals can seem impersonal and intimidating.
  • As a large institution, the hospital has rules, policies and red tape; they are rarely altered to accommodate an individual.
  • Less privacy is available.
  • The father is often less actively involved in a hospital setting, and may fell like an "outsider".
  • The mother's birth is usually managed by experts trained in pathology, not normal births.
  • The risk of iatrogenic complications and infection to the mother and baby is greater among mothers who deliver in hospitals, than among those who give birth at home or in a birthing center.
  • The mother is at a significantly higher risk of having an unnecessary cesarean section.
  • Some routine separation of the mother and baby is almost unavoidable.
  • Most hospitals do not allow the mother much rest.

Why Having A Home Birth Was The Best Decision For My Family

Words: Angela Johnson

A painful hospital birth made this mom consider other options the second time around.

For as long as I can remember, I’ve fantasized about becoming a mom. I envisioned pregnancy as a blissful nine months filled with prenatal yoga classes and eating ice cream without guilt. Unfortunately my reality was far less romantic.

In the fall of 2009, my husband and I were delighted to learn that we were having a baby girl. But just as we started picking out names and strollers, we received some startling news four months into my pregnancy: I was diagnosed with an “incompetent cervix.” My OB warned me that I might not be able to carry my little girl to term and ordered me to spend the rest of my pregnancy on bed rest. I was afraid even the slightest movement would have dangerous consequences for my baby; I decided to leave nothing to chance, and complied with my doctor’s suggestion to stay put.

Confined to my bedroom, I read, watched a lot of television, and even taught myself how to knit, but mostly I lived in fear that I would lose my baby. After months of tests and confusing “doctor talk,” a routine ultrasound revealed a low level of amniotic fluid; two weeks before my due date, I endured a painful labor induction. The only thing worse than the Pitocin-induced contractions was the fact that the epidural did almost nothing to help ease the pain. And as if that weren’t bad enough, my parents and my OB missed out on the entire thing. At the end of the ordeal, we were blessed to have a beautifully healthy baby girl, but I’d be lying if I said I enjoyed what it took to bring her into the world.

I lived in fear that I would lose my baby...

A year and a half later, when my husband and I learned that baby number two was on the way, I was terrified. The pain of my first pregnancy was still extremely raw. I didn’t want to relive that experience, but I had no idea how I could avoid it. Once an incompetent cervix, always an incompetent cervix, right?

After watching The Business of Being Born, a documentary about home birth, my husband and I decided to consider alternatives to another hospital birth. This time, we wanted more control over our birth experience: He didn’t want to be confined to visiting hours and hospital policies, and I wanted the freedom to eat, move around, and dress as I pleased (no more hideous hospital gowns and ice chips for me!). For us, home was the best place to make all of our childbirth dreams come true.

But as excited as we were, my husband and I had a hard time finding others who shared our enthusiasm (“Is it safe?” and “Are you crazy?” were the most common reactions we got from friends and family when we shared our news). We tried to reassure everyone that women have been having babies at home for centuries and that midwives were more than capable of handling emergencies, but there was also a little part of me that was uneasy. Could I, the woman who could barely tolerate a paper cut, handle natural childbirth?

It didn’t take long for us to find a pair of local midwives who made us feel comfortable. Both had a gentle demeanor, and were mothers who had experienced home birth firsthand. Their cozy office walls were lined with photos of women holding their beautiful, healthy babies—all born at home. They reviewed my medical records and gave me the green light to maintain my normal routine, encouraging me to allow my body to be in control of the pregnancy. As far as they were concerned, I’d already proven I could carry a baby to term.

“Is it safe?” and “Are you crazy?” were the most common reactions we got from friends and family...

For the next nine months,  I looked forward to my monthly appointments, which were more like therapy sessions than medical checkups. I used the hour to vent about everything from piles of dirty laundry to painful hemorrhoids. The midwives even helped me find a doula who worked with me on natural pain management techniques to use during my labor.

With our team in place, there was nothing left for us to do but wait and wait. My due date came and went with little more than a flutter in my belly. My midwives monitored me closely, but resolved to rely on my body to decide when the baby should be born. “The baby will come on his birthday,” one of them joked. I tried every natural labor-inducing tactic out there—spicy food, long walks, acupuncture—but my little guy chose to stay inside and cook.

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