The Real Pros and Cons of Home Birth
Like all things in life, giving birth at home has pros and cons. Keep reading to learn the benefits of home birth as well as some disadvantages. Plus, find out how to know if a home birth is the right choice for you!
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Choosing where to give birth is a highly personal choice. Every woman should feel that she has the freedom to choose a hospital, a birth center, or her home as the place of birth for her children.
Each location has benefits and each has disadvantages.
Today, let’s go over the pros and cons of giving birth at home.
Pros of Home Birth
I gave birth to my daughter at home and loved the experience. I think home births are a great choice for many women.
I don’t think hospitals are bad. I’m all for medicine and medical treatment when it’s needed. But most of the time, it’s just not needed for birth.
So let’s get to it – here are the benefits of a home birth.
Note: The way you experience home birth will depend, in part, on who you choose as your midwife. For that reason, choose wisely.
You are in control.
Above almost everything else, women often choose a home birth because they want to be in control of their birth. They want to determine the atmosphere they give birth in, who’s there, and what does and doesn’t happen (more on each of those later).
At home you get to decide if lights are on or off – or if you want fairy lights or candles! You get to decide what to wear – or to wear nothing at all.
You aren’t surrounded by medical machines or wires. You’re in your own space with your own things. That means you can use your favorite pillow, wander through any room, or change your clothes whenever you’d like.
In your home, you’re the boss. Whatever you say, goes.
You can eat or drink whatever you want.
Part of the “being in control” element of home birth is that no one is going to tell you whether you can eat or not. You can eat whatever you want, whenever you want.
Most hospitals have a no food, no drink policy. So once you get there, it’ll be an IV and ice chips until your baby is born.
But eating and drinking regularly is so important during labor! You are working harder than you’ve probably ever worked in your life, so you need to keep your energy and your blood sugar up.
You know your birth attendants.
One of the best things about home birth is that you know exactly who will be at your birth. By the time you go into labor, you will have a relationship with your midwife. You’ll know her and she’ll know you, and you know she’s the one that will be there when your baby is born.
You’ll also know everyone else in the room. There will be no strangers coming in and out because the only people there will be the ones you’ve invited!
You get to decide how many people are at your birth.
In that same vein, you get to choose how many people are at your home birth. In the hospital you’ll be limited to 2-3 people. But at home, you can have your midwives, a doula, your husband, your kids, friends and family…whoever you want!
Your care is more individualized.
When you give birth at home, everyone there has one focus: you. Your midwife doesn’t have to leave to care for other mothers birthing at the same time as you. You are her only client until your baby is born.
And it’s the same for everyone else there. You are the only one they are there to support and they’ll stay with you the entire time if you want them to.
You avoid medications and interventions.
This is another big one. Many women choose a home birth because they want to avoid the medications and interventions that are so common during birth in hospitals.
Medication can be helpful (think: pain relief) but it also has risks.
And interventions (like Pitocin and continuous fetal monitoring) often have a snowball effect. One leads to another and that can lead to negative outcomes for baby and mom.
The benefit of being at home is twofold, in this sense: not only are you not in a place where these interventions are readily available but you’re also not being cared for by people who may pressure you to use certain interventions.
Unfortunately, many hospital policies (and misaligned financial incentives) make it hard for doctors to set the medications aside and put the mother first.
READ MORE >> The Risks (and Benefits) of Medications During Labor
READ MORE >> The Cascade of Interventions [Explained]
You’re less likely to experience assisted delivery.
At home, you have a very low chance of having a doctor assist in the delivery of your baby. (It will only happen if you transfer to the hospital – more on that later.)
Assisted or instrumental delivery happens either by forceps – a metal device kind of like salad tongs – or a suction cup device attached to your baby’s head.
Both methods of assisted delivery help your baby to be born vaginally. They can be helpful if you are struggling to push your baby out, but they can also cause problems, such as requiring an episiotomy.
To learn more about assisted delivery, go here.
Negative outcomes are less common.
Home births (and any birth attended by a midwife) usually have better outcomes for mom. Moms who give birth at home usually experience less infection, less tearing, less hemorrhaging, and more satisfaction with the birth.
You decrease your chances of a c-section.
If you give birth at home, you have a far lower chance of getting a c-section. Said another way, you have a much greater chance of having a vaginal birth.
OBGYNs are surgeons. And the average c-section rate in American hospitals is nearly 1 out of every 3 births (and it’s higher in some places).
On the other hand, independent home birth midwives are the experts when it comes to normal birth. They aren’t surgeons and they don’t have to be because they know how to help women have vaginal births.
They trust the birth process and have a different view on what’s an emergency and what’s not.
You’re more likely to have a successful VBAC, too!
By the way, this benefit of increased likelihood of vaginal birth also includes women who have had a c-section before. Rates of VBAC (vaginal birth after cesarean) are better at home, too.
There is no time limit.
If you choose to labor and give birth at home, no one is there to tell you if you’ve been in labor too long. You may feel contractions start and then stop. Your water may have broken hours ago. You may be in active labor for a day or more.
But at home, as long as you and your baby are going strong, no one will tell you it’s time to get Pitocin or have a c-section.
You won’t be separated from your baby.
At home, your baby never leaves your side. He or she will be placed on your abdomen immediately after birth. They won’t be taken across the room for washing or testing. They won’t be placed in a nursery.
Your baby will be with you from the moment they are born.
RELATED >> What Happens To Baby After Birth?
You’ll be able to sleep in your own bed.
One of my favorite things about giving birth at home was that as soon as my baby was born, I was able to rest in my own bed, in my own bedroom. It was comfortable and familiar and perfect.
You can have a water birth.
While the occasional hospital will allow for a water birth – where your baby is born in the tub, directly into the water – most will not. Usually, you’ll be asked to get out of the water when you start to push.
At home, you can choose to labor and give birth in the water, if you want to. In fact, many women who have home births have water births!
Water can provide relief from discomfort or pain and can provide a gentle transition to life outside the womb for your baby.
It may cost less.
Sometimes, a home birth will cost less than a birth anywhere else. You don’t have to pay the hospital and staff. You just pay your midwife and purchase any supplies you need or want. Because of that, a home birth may be significantly cheaper for you. It was for me.
I would have paid $6,500+ after insurance if I had followed through with my plan for a hospital birth with an OB. And that’s just the OB global fee and the cost of being at the hospital.
Instead, I paid less than $7,000 for EVERYTHING baby- and pregnancy-related, including my midwife’s fee. (My midwife’s fee in 2023 was $3,250.)
However, I know that’s not always the case. That is why you’ll also find cost on the home birth cons list below.
READ MORE >> How Much Does a Home Birth Cost?.
It’s just as safe as a hospital birth.
For most women, most of the time, a home birth is just as safe – if not safer – than a hospital birth. When a woman is healthy and she has a well-educated midwife at her birth, studies have shown that maternal outcomes are consistently better at home than in hospitals.
And a huge study found that, for healthy mothers, the risk of their baby dying is “not different when birth [is] intended at home or in hospital.”
READ MORE >> Are Home Births Safe?
READ MORE >> Home Birth Myths: Busted
Cons of Home Birth
That pros list is pretty awesome, right? To be fair, I also want to go over some of the disadvantages of home birth. This list is a lot shorter.
Some women will likely be better off in the hospital.
For a small group of women, a hospital birth is probably a better option. Usually the reason for this is a preexisting health condition such as…
- Heart or blood disorders,
- Poorly controlled diabetes or asthma,
- A history of severe placental problems,
- Cancer,
- Epilepsy, or
- Lupus.
While none of these necessarily require the medical care of hospital staff, women with these conditions are more likely to have complications or need c-sections.
I do want to point out, though, that some circumstances do not necessarily mean you have to be in a hospital, even though it’s common to hear that it is. These situations include…
- Being pregnant with multiples (twins or more)
- Having had a c-section previously
- Your baby being in the breech position (bum or feet down)
- Having gestational diabetes
- and more.
If you find a good midwife who knows her stuff, she’ll look at other factors, not just these ones, and help you determine whether or not a home birth is a good choice for you.
First-time moms have a higher transfer rate.
If you are a first-time mom, you absolutely can have a wonderful home birth experience. (I’m living proof!) It’s common to hear that home births are more risky for first-time moms, but that statement needs further explanation to be totally accurate.
What is true is that first-time moms trying for a home birth do transfer more often than moms who have given birth before.
But WHY do they transfer?
The most common reason for transfer, even in first-time moms, is NOT emergency – it’s slow progress in labor.
But if you look at almost any description of the stages of labor, you’ll read that first-time moms naturally labor for longer than moms who have had babies before (generally).
That, combined with fear of the unknown, is likely the reason first-time moms transfer more often than experienced moms – not because it’s more risky.
Emergencies do happen at home.
Emergencies during home birth are rare (accounting for only 5.4% of transfers, at most). But they do happen. In the case of an emergency, you’ll have to drive to the hospital. That takes time and can be uncomfortable and stressful.
Most of the time, mom and baby will be okay, though.
Transferring to the hospital also makes your birth more expensive – not only do you pay your midwife, but now you also pay a doctor and the hospital, too.
I do want to point out that many midwives carry Pitocin and oxygen. Pitocin can be used to stem the flow if you experience heavy bleeding after birth. Oxygen can be used if your baby struggles to breathe.
Most midwives will also carry suturing tools, in case of a perineal tear.
Medical pain relief isn’t an option.
Obviously, if you’re at home, you can’t have an epidural. You won’t have any painkillers at your disposal either. Some midwives carry nitrous oxide (laughing gas) but other than that, you’ll need to rely on natural comfort measures.
It may cost more.
One frustrating reality of the US healthcare system is that many insurance companies don’t cover home births.
It’s a bit silly, really.
When you compare the actual costs, there’s no contest. A hospital vaginal birth without insurance can cost about $14,000, depending on where you live. In contrast, even a high-end midwife’s fee for a home birth is usually around $9,000—and many are less.
But with insurance, that hospital birth could cost a mom only $2,500, with the rest covered by insurance.
Sadly, this means some women find it harder to afford a home birth, even when it’s what they really want.
READ MORE >> How Much Does a Home Birth Cost?
You’ll probably have to pay upfront.
While we’re on the topic of cost, it’s important to note that with a home birth – that is, with a midwife – you’ll likely need to pay in full before your baby is born, not after.
No matter where you give birth, it’s a good idea to save and set money aside beforehand. But that’s especially true with a home birth, since most midwives want you to pay in full several weeks before your baby is born. (You might even pay less the sooner you pay!)
Postpartum care will be up to you.
If you give birth in the hospital, you’ll probably stay for a few days and have nurses to care for you. That’s not the case at home. Your midwife will stay for an hour or so after your baby is born, but she won’t be with you after that.
It will be up to you to arrange any help you need.
You’re in charge of gathering supplies.
Since it’s your home, you’re responsible for having the necessary supplies on hand by the time labor begins. This will include some logistical things – like garbage bags and old towels – and some fun things – like the birth pool and any decorations or labor props you want.
You can find a full list of supplies you’ll need in The Ultimate List of Home Birth Supplies.
You’ll have to deal with some negativity.
Finally, if you choose a home birth, you will come in contact with naysayers. Home birth is far from the social norm, so you’ll need to find ways to deal with the negativity and horror stories that people are bound to send your way.
This can be done. But it definitely presents an extra challenge when planning a home birth.
How to Decide If a Home Birth is Right For You
So there it is. A long list of pros and cons of home birth. But how do you know if it’s really the right choice for you?
Easy! Download my FREE guide: Is a Home Birth Right For Me?.
This guide walks you through 6 questions you should ask yourself before choosing a home birth. Each one will help you determine if a home birth is a good fit for you and your unique circumstances.
You can get the guide for free in the box below.
If you’re considering a home birth, I’m stoked for you. I want you to have a wonderful birth experience, and choosing a home birth might be the first step towards that for you.
Until next time,
Allison
READ MORE:
Is Home Birth Messy? Not With These Tips!
