Are You a Good Candidate for a Home Birth?

Giving birth at home is gaining popularity, but it might not be right for you.
pregnant couple

This spring, the American Academy of Pediatrics (AAP) reported that home birth is on the rise in the United States. The official guidelines from the AAP state that, "The AAP concurs with the recent statement from the American College of Obstetricians and Gynecologists (ACOG) that the safest setting for a child's birth is a hospital or birthing center, but recognizes that women and their families may desire a home birth for a variety of reasons."

In 2009, the Centers for Disease Control and Prevention (CDC) released a 19-year study on homebirth and concluded that although at last count, less than 1% of births in America occur at home, its popularity still rose about 29% from 2004 to 2009 alone. Kathryn Hulett is a mother of three who chose a homebirth for her first delivery and claims she felt "safe and supported" with her midwife. "I enjoyed being at home in peace and quiet, not being bothered or bullied, letting my body do its job," she says.

Sherill Sedillio is a certified practical-midwife who believes home birth is a personal choice by a mother and her family. Sherill performs home birth deliveries alongside three other midwives at Tender Touch Midwifery in Orange County and believes home birth is a safe option for healthy, low-risk women and their babies.

Proponents of home birth, like Kathryn and Sherill cite a long list of benefits to home delivery, including a more positive empowering and bonding experience for the mother, lower rates of infection for both mother and baby, less unnecessary medical intervention, a more one-on-one relationship with the care provider, and higher rates of breastfeeding success.

Of course, there are also risks to consider with homebirth itself, such as a baby that turns the wrong way, a dip in heart rate, or a postpartum hemorrhage. Studies about the risk of homebirth are worrying. A 2011 study in the American Journal of Obstetrics & Gynecology found that although complications such as lacerations, hemorrhage, and infections were reduced in home births, the rate of infant mortality occurring within 28 days after birth was tripled in homebirths.

Experienced home birth practitioners know that there are extremely strict guidelines that must be followed for a woman to be a good candidate for a home birth delivery. As Leah Outten, a blogger and mother of four who chose a homebirth for her fourth birth commented, "A skilled midwife will sees signs of issues before it is a life threatening issue in most cases to be able to transfer to hospital."

Home birth care providers also rule out medical indications that would disqualify a woman from being a candidate for a home birth, such as:

- High blood pressure
- Preeclampsia
- Low or high amniotic fluid levels
- Fetal malpresentation
- Preterm labor
- Twins or multiples
- Positive HIV
- Anemia
- Any medical conditions, such as diabetes, neurological disorders, or heart, lung, or kidney disease
- Substance abuse
- Past OB complications

In addition to the care and considerations for the mother choosing homebirth, the AAP stresses the importance of taking precautions to ensure the health of the newborn, which include "at least one other person present at delivery" solely to care for the baby, along with proper medical equipment, a working phone, weather monitoring, vitamin K administration, blood sugar testing, comprehensive documentation and follow-up with the child's primary health care provider.

With experts still debating and studies still pending, right now the choice for a home birth is a very personal one that requires a lot of thought and consideration for parent-to-be.

For parents wondering if home birth is right for them, Sherill recommends talking to other couples who have had birth experiences in both a hospital and at home.

"The most important thing I can advise couples to do," says Sherill, "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."

Labor & Delivery: Homebirth
Labor & Delivery: Homebirth

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