It’s no secret that I’m a huge advocate for natural births, and for home births in particular. With the fear and the number of coronavirus cases rising in New York and throughout the rest of the country, many women are now considering a home birth as they search for alternatives to the hospital births they had planned. I don’t blame them. Hospitals are overwhelmed with testing and severe COVID-19 patients, and many of them have begun restricting the support that a birthing mother can have with her during labor. There’s also the very real fear that newborns may be taken away from their parents while awaiting test results.
However, I wouldn’t recommend throwing out your birth plan just yet. Although a home birth may sound like the perfect solution, there’s a lot to consider before you make that decision–and as with most decisions around birth and labor, it shouldn’t be made lightly. Here are six questions you should ask before you decide to have a home birth:
Do I want medication?
It probably goes without saying, but if you’re birthing at home you’re birthing without drugs. Like, NO drugs. No epidural, no Demerol, no laughing gas. For some people, that’s totally cool, and for some, that sounds like the worst thing in the world. If you’re already planning on asking for “something for the pain” upon arrival, then a home birth is not for you.
Am I high-risk?
Certain populations need to birth with additional medical support because they or their child are at increased risk. While midwives are capable and licensed medical professionals, there are certain kinds of equipment that they just won’t have access to in your home, including a functioning operating room. If you’re at risk or may need a cesarean, the hospital is your safest bet.
Does the thought of birthing at home scare me?
No matter where you choose to labor or deliver, the most important factor for success is that you feel safe. An open letter from Robina Khalid, of Small Things Grow midwifery, to the birthing community states:
“People choose to have a homebirth because they seek autonomy in their pregnancy and birth, because they believe home is the safest place to give birth, or because they desire to experience all that homebirth offers, from the intense and challenging to the joyful and transcendent. Fear and panic do not lend themselves to an empowering homebirth. This is true generally and it is true now during what is unequivocally a scary time for so many of us. If a pregnant person originally chose a hospital because they believed it to be the safest location in which to give birth, that belief continues to make the hospital the safest place for that person to give birth. Birth is a physiologic process that is greatly impacted by one’s environment and one’s emotional state. For most people, the two are inextricably linked. Homebirth with a client who does not fundamentally trust their location of birth place is unsafe for both client and midwife.”
If you’re considering a home birth, it should be because you want to give birth at home. It is not advisable for you to switch simply because you don’t want to be in the hospital, particularly if you are far along in your pregnancy. Stay where you feel safe. If knowing that all the benefits that modern medicine has to offer are right down the hall makes you feel more secure, then the hospital is one hundred percent the right place for you to be.
Will I need to switch providers?
Most women in the United States see ob/gyns for routine obstetrical and prenatal care. Obstetricians do not perform home births. If you are considering a home birth, you will need to switch providers, and generally you will not be able to see your ob again until after delivery. Because birth is an emotionally and physically vulnerable process, you should only undergo it with someone you literally trust with your life. If you don’t have time to build that rapport with your midwife, you should stay with someone you know. Additionally, many midwives are being swamped with home birth requests, and they can’t support an unlimited case load.
Will insurance cover it?
Most insurance plans do not cover home births, and many of those that do will only cover them under certain guidelines or partially. I decided I would have a home birth when I was about eight or nine weeks pregnant, and had to switch health care providers in order to have it covered. My insurance company would only cover the full cost if care was initiated in the first trimester, and due to some fun administrative snafus, my insurance was not finalized for three months. On the other hand, hospital births are always covered by insurance. If the cost of a home birth would be prohibitive, you may want to consider giving birth at the hospital.
Do I have any other options?
One of the best things about home birth is the immense flexibility and control it gives you over your birthing environment. You get to say who is there, what you eat, how you labor, and (my favorite) sleep in your own bed after delivery. But you can have a beautiful, empowering hospital birth, too. Look into hiring a doula (many of them are now offering virtual services) if you need continuous birthing support and take a childbirth class. If you’re low risk, you also may be able to deliver at a birthing center, where exposure to infection and unnecessary intervention will be less of a concern. Most importantly, know what your rights are as a birthing person. Reach out to a professional if you’re not sure.
I loved my home birth, and would always choose to birth at home if I could. An empowering birth experience is about having the freedom to choose. Don’t allow fear to scare you into birthing in a way that doesn’t feel right to you.