Who can have a home birth?
Most women. Home birth is a safe choice for anyone experiencing a normal pregnancy, who desires birth with minimal intervention, including not using medication for pain relief. A normal pregnancy means one baby who is head-down, at 37-42 weeks of pregnancy, without complications like high blood pressure or diabetes that require medication. The decision to have a home birth involves commitment to learning about pregnancy and birth, healthy choices to nourish yourself and your baby, and gathering a support team which may include family members, friends, or a doula.
What does a home birth look like?
A licensed midwife and a trained birth assistant come to your home to support you through labor, birth and the first hours after birth. We provide you with all of the necessary medical supplies, you provide your own comfy pillows, towels, robe, etc (we know how to protect the things you love or clean them before we leave). When your support team arrives, we check on your well-being and your baby. If it is helpful to plan your care, and after discussing the pros and cons with you, we may perform a vaginal exam to learn more about your labor. This is much more than how many centimeters your cervix has dilated, and may help you know where to direct your energy- resting vs activity, certain positions, etc. As your birth progresses, we will be as close to you as needed, sometimes very hands on and nose-to-nose with you for hours, or if you prefer we may spend most of our time quietly observing from a corner, or waiting patiently in a nearby room and just popping in occasionally to check on you and baby and offer assistance. When the time of birth is near, we are by your side, along with whatever support people you have chosen. You are welcome to birth your baby wherever you are most comfortable. This means standing, sitting, leaning, in the tub, in the bathroom, on your knees, on your side, even outside if that’s your dream! Your midwife will follow your cues and offer gentle encouragement to make pushing as easy as possible for you and the baby. The safest place for a newly born baby is against its mother’s skin, so that’s where your baby goes immediately. In the first moments after birth your midwife and birth assistant will assess you and the baby thoroughly, but you will barely even notice as you look into those tiny eyes and absorb what you just accomplished. Your midwife and assistant help you and Baby get settled and fed, and remain in your home for 2-4 hours. We start that first load of laundry, make sure you can walk and use the bathroom without any trouble, give Baby their first head to to exam, and give you the info you need for the first days with your little one. The day after your birth, we come to see you at home to be sure all is well, and that Baby is transitioning well to life on the outside. We are infinitely available to you by phone or for home visits for the first weeks after birth, and we will schedule two additional routine visits with you and Baby in the first four weeks after your birth.
Is home birth safe?
Research shows that when home birth is integrated into the healthcare system, meaning a midwife and birthing family can move to more advanced care when needed, home birth is as safe or safer than birth in a hospital. When compared with healthy women birthing in a hospital, home birth results in fewer cesareans (5-10% vs 30%) and less than 1% of babies being admitted to the NICU vs 4% of “low-risk” babies born in hospitals. For more info on the most recent prospective data (prospective means the births were counted as home births if the original planned place of birth was home, even if they transferred to the hospital), see here: https://mana.org/blog/new-studies-confirm-safety-of-home-birth-with-midwives-in-the-us
Can I vbac at home?
Unfortunately, due to malpractice limitations, Primrose Midwifery does not attend vaginal birth after cesarean (VBAC) at home. We gladly provide midwifery care during pregnancy and will help you plan a hospital birth with the physician or midwife of your choice if you have had a cesarean birth in the past.
How does payment work?
Midwifery is a profession, and home birth is a vital service to our community, but of course we have to talk a little about keeping both sustainable which means talking about money. Sadly, most insurance sources do not pay for home birth. Primrose Midwifery is dedicated to making midwifery and home birth accessible to as many families as possible, so we offer discounts based on income and family size, and also provide documentation to submit to insurance, but most of the cost will be out of pocket. Please contact us to learn more about our fees and what options you may have so that finances aren't a barrier to your care. There are creative solutions including health savings accounts and asking for contributions toward your home birth as baby gifts. A great way to think about it is to compare the cost of home birth to the cost of a wedding or a vacation. What would you invest to have one memorable day or an amazing trip? Do those impact your physical and psychological health and the health of your baby for the rest of your lives? Until we get home birth covered by insurance for all (which I have worked on for over 10 years- if you want more info let me know!), we all can continue to make it work for both midwives and families with creative solutions.
What if something goes wrong at home?
It would be great if birth was perfect every single time, but that is not the world we live in. We are grateful that medical help is available when needed, while also grateful that we can provide an experience without medical interference when it is not needed. Our goal for you is not to keep you out of the hospital at all costs, and our primary goal is not actually to have a candle-lit water birth in your living room. Our goal is for you and your baby to be healthy in every aspect. Thankfully this usually means minimizing medical intervention. But when that is not the case our team is trained to respond quickly and effectively. This includes being certified in adult and newborn resuscitation and continually polishing our skills, carrying the same meds that are used in hospitals in emergencies, and having multiple plans in place for transferring from your home to a hospital if needed. The most common reason to go to the hospital during labor is that mom is exhausted and needs medication to help birth be successful. This is not an emergency and may mean you drive to the hospital of your choice in your own vehicle. Other rare but more urgent issues that occur during birth include the baby’s heart rate falling, mom bleeding more than usual after birth, or a baby having trouble breathing on their own after birth. These would require transport by ambulance to the nearest hospital. Your midwife will accompany you to the hospital and continue to support you regardless of the reason for transfer.