It’s easy to get lost in the swirl when deciding between a home birth or hospital birth. And, unfortunately, statistics can feel like they hurt - rather than help - your decision-making process. You can drive yourself crazy reviewing the studies, because there is “conclusive evidence” on either side of the home birth or hospital birth debate. While it’s true that research and fact finding are an essential part of making this choice, ultimately - you need to quiet the outside noise and honor your own instincts because it’s your choice.
Deciding whether to have your baby at home or in a hospital is a great practice for all of the decisions you’ll have to make as new parents with a tender infant, a rambunctious and wily toddler, and the rebellious teen down the road. Taking others’ opinions into consideration has its place, but working as a newborn photographer over the years, I’ve come to the strong conclusion that parents know best.
Also - if you or your partner are on the fence, start touring the Bay Area’s wealth of birthing center options. Birthing suites can feel just like home, and those that implement midwives and welcome doulas can provide the happiest medium of all for mothers and couples who are torn between the two options.
Carefully Review High-Quality Studies
Of course, you’re going to want some facts and figures on your side. But that can be challenging and confusing, too!
Depending on what studies you look at, infant mortality rates can appear much higher for home births than hospital births - but then you learn those studies included unassisted or DIY deliveries without a licensed midwife. On the flip side, other studies show that overall, there are fewer complications, dramatically less interventions and better, overall mother and baby outcomes for home births attended by licensed, certified midwives.
Make sure you’re reading valid, clinical research studies from the past five years or less. Don’t use blogs or random websites but cull the internet for .org, .gov and .edu sites where information is more regulated and is more trustworthy than someone else’s translations of the data.
Be prepared to find that reading studies is not as helpful as you hoped, which throws your inner-compass into a spin. If that happens, consider the more general risk factors involved and listen to those instincts. Your body is very wise!
Only work with a licensed, certified midwife or nurse midwife
As with most certifications, there are “ranks” amongst midwives. These include:
Certified Professional Midwife (CPM)
Certified Midwife (CM)
Certified Nurse Midwife (CNM)
The last two, Certified Midwives and Certified Nurse Midwives have college degrees and a tremendous amount of medical education and training behind them.
If you’re going to pursue a home birth, a CM or CNM are the way to go, ensuring your midwife is trained to handle all of the most common complications or immediate medical issues (such as a baby who isn’t breathing, or a mother who is hemorrhaging), and are qualified to use all of the tools in their birthing kits.
Is Your Pregnancy High Risk?
If your pregnancy is considered high risk you are best off in a hospital (or the aforementioned birth center). While midwives have amazing resources at their fingertips, women and babies who make it through a high risk pregnancy are typically safest in a hospital, where surgical interventions and acute neonatal care teams are only seconds or a few minutes away, rather than an entire drive.
High risk pregnancies include things like:
Being 35-years or older
How Far Are You From the Hospital?
I’ve had clients that live as close as five to 10 minutes away from a hospital with a full-neonatal team, and I’ve had clients who live more than 30 minutes away from emergency medical care. Most experts agree that if you are considering a home birth, you should live no more than 15-minutes away from an adequate hospital.
If you do need a C-Section (which even a Certified Nurse Midwife is not qualified to provide) or your baby needs immediate surgery or NICU support, you don’t want to worry that your decision to have a baby at home negatively impacted your/his/her outcome.
What’s Your Current Medical Status?
When reviewing the studies comparing success rates of home or hospital births, the majority of the “worst case scenario” home births were linked to mothers not adhering to the high-risk factors listed above, or because there were things associated with their own health/wellbeing that weren’t ideal for home birth.
Women with existing medical conditions or risk factors such as high blood pressure, diabetes, heart disease, etc., should have their babies in their hospital or birthing center of choice.
Do you have medical phobias?
An NPR article comparing home births and hospital births summarized the thoughts of UCSF Ob-Gyn, Dr. Robyn Lamar, who says, “a mother is more likely to dilate and embrace difficult contractions if she feels comfortable and supported in her surroundings. In other words, feeling safe can not only lead to a more positive emotional experience, but also a faster delivery.”
If you are afraid of giving birth in a hospital or medical center, you live within a 15-minute drive from a hospital and you have a low-risk pregnancy, your labor and delivery outcome may, indeed, be more positive than if you succumb to pressure and give birth at the hospital.
My desire is for every woman and baby to experience a positive, healthy and empowering labor and delivery experience. Doing what’s best for you - regardless of what friends and family say - is the best way to achieve that.
And, afterwards, I’ll be here to take incredible newborn photographs that will capture the magic of your newfound transition on print, via artful poses, props and imagery. Contact me, Marcela Limon of Lemonshoots, to schedule your maternity or newborn photography session.