Home Birth Pros and Cons (a realistic comparison)

When you are pregnant, one of the many decisions you will need to make is where to labor and deliver your baby. Here are the pros and cons of having a hospital or home birth for your pregnancy #naturalearthymama #pregnancy #homebirth

Choosing to birth at home is a decision that pregnant women do not take lightly. It is uncommon for women to choose to home birth and so to choose to go against the cultural norm takes some thought, planning and a willingness to stick to your decision. When you are making a decision whether to birth at home or a hospital, it is helpful to look at both the positives and the negatives of both options to help inform your choice, so here are the home birth pros and cons compared with a hospital birth.

Please read: This information is provided for educational purposes only and is not intended to treat, diagnose or prevent any disease. We encourage you to make your own health care decisions in partnership with a qualified health care professional.

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What is a home birth delivery?

A home birth is exactly what it sounds like – having your birth at home. Women since the beginning of the history of humanity have been birthing babies at home. In many cultures most, if not all, babies are still born at home.

In the US, 99% of babies are now born in the hospital or a specialized birthing center. There is a growing resurgence of women choosing to birth at home.

When you are looking at statistics of home births, it is important to note the difference between a planned, full term home birth, a surprise full term home birth and premature home births as there is often little differentiation made between these when looking at statistics.

Many woman that choose to birth at home like the idea of using a birth pool. And if you have the space to set up a birthing pool, it is a wonderful natural pain relief!

Can I choose homebirth?

Different parts of the world have different rules around the legality of having your baby at home. In some places a certified midwife can legally assist, in other places they have to work “under the table” or “off the books” to attend a birth at home.

Homebirth is best and safest for women who have no pregnancy complications and are considered a low risk pregnancy.

Choose your birth team wisely, and choose a midwife that has experience birthing at home, and knows when to transfer to hospital if there are complications developing before they become an issue.

You can choose to transfer to hospital at any time during your labor or delivery, you are in charge and you can decide this at any point.

Most low risk women can birth at home without issue, some risk factors are best monitored in a hospital setting, so talk at length with your prenatal care provider about your birth plan, and follow their expert opinion on your situation as health care is as individual as you are!

Home birth vs Hospital birth statistics

Planned home births are associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery.

Home birthing women are less likely to experience lacerations, hemorrhage, and infections.

Neonatal outcomes of planned home births revealed less frequent prematurity, low birth weight, and assisted newborn ventilation.

Although planned home and hospital births exhibited similar perinatal mortality rates, in some studies planned home births were associated with elevated neonatal mortality rates, but the overall rates are very low ( 1 ) .

Interestingly, some studies, when removing all the surprise, very premature home births from the statistics, they have found no difference in the rates of infant death ( 2 ).

Planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician. ( 3 ).

Healthy women, with low risk pregnancies are perfectly safe to birth at home with a competent midwife or doctor. It is your fundamental right to decide where you will birth your baby, but you do need to take the advice of the professionals on board and make a case by case decision.

Risks of home birth

There are some risks associated with home birth. These are significantly reduced in a healthy women, with a healthy pregnancy. It is important to listen to both your instincts and your attending lead maternity caregiver when making decisions.

You can choose to go to hospital at any time during your pregnancy, labor and postpartum time.

Your individual risks depend on your health, the experience of who will be at your birth, and how far you are away from the nearest hospital.

Overall, a home birth has less or the same amount of risk for most common labor related issues as the table here shows well.

The top 10 benefits of laboring at home. Having a homebirth is lovely, and there are many benefits to mother and baby to having a home birth. Check out the top 10 reasons to deliver your baby at home #pregnancy #birth #homebirth #naturalearthymama

Top 10 home birth benefits

1 A higher chance of a natural vaginal birth.

This then has flow on benefits for your baby‘s breathing and long term immunity. The baby is born with the mother’s antibodies, passed through the placenta and her microbiome passed via her birth canal. These include her immunity to the family’s household germs.

2 There is a lower chance of infection at home than in hospital environment for both mum and baby.

Because mothers and babies are never separated, the baby‘s immature immune system is able to function optimally. Hospitals have unfamiliar bugs and microbes and a mother isn’t able to offer herself or her baby the same degree of immunity as she can from home.

3 Bonding with Mom AND Dad.

There is a possibly for consistent skin to skin contact that is not broken for institutional routines and procedure.

4 Easier establishment of breastfeeding and higher levels of breastfeeding success.

Continuous bonding time and connection promotes successful breastfeeding. Mothers feel more relaxed in their own environment and are less likely to struggle with breastfeeding anxiety.

5 Individualized and responsive midwifery care

Home birth midwives provide continuity of care and comprehensive care which differ vastly from the shift work nature of a hospital.

6 Control over your decisions, mind and body.

Your home, your choice. Having a good relationship with your midwife, and being informed and clear about your birth intentions, give you the best chance of retaining control over your body, birth and baby.

7 Increased chance of natural, active labor without unnecessary interventions.

In your home you are able to relax more deeply, and move more freely. This allows you to relax and let the natural dance of birthing hormones to work the best.

8 Emotional and physical comfort after birth.

After you’ve given birth you can sleep in your own bed, eat your own food and listen to your own music. There is no pressure to engage in further checks, move to another room or consider the next process of packing up to go another facility or home. Your visitors and family can be there whenever you want, there are no set visitor hours.

9 A Physiological third stage (the natural birthing of placenta).

Delayed cord clamping can give your baby a full 10-20% more blood than clamping and cutting immediately. Experiencing a natural third stage has significant health benefits for both mum and baby, and the risk of postpartum bleeding is less when the placenta is allowed to come away naturally.

10 Have who you want, when you want, around you.

Birthing at home means self selected support people, and as many or as few as you choose. There is the ability for siblings to be present for as much or as little of the labor as you like, and you can decide when to have visitors and make your birth announcement.

Can I have a home birth?

Anyone can have a home birth but the choice of whether you should have a home birth is something you should make with your midwife, support team and yourself.

RELATED POST: Preparing for a successful home birth

Is home birth cheaper than hospital birth?

It does depend how your maternity care is paid for, in some countries all labor care is free, in others, you have to pay. In the USA a home birth is cheaper than a hospital birth.

Are home births covered by insurance?

It is worth checking with your own insurance company. Generally, home birth is covered by your insurance, but additional associated costs may not be. You should contact your insurance company and ask for a list of what is and is not covered for your insurance.

Hospital birth Benefits

1 Close monitoring

When admitted to the hospital, you’ll be placed in a hospital bed with fetal monitoring, IVs, and a transducer to measure contractions to make sure everything is running smoothly from start to finish.

2 Fully covered by insurance

Depending on your medical coverage, your entire birth may be covered by insurance.

3 Pain medications

Pain medication is readily available for those who desire assistance through delivery including pethidine, gas and air and an epidural

4 Can be intervention-free

It is absolutely possible to achieve a natural birth in a hospital setting.

5 You can use a midwife

Most hospitals allow you to use a midwife and/or doula throughout labor and delivery.

6 Postnatal help around the clock

You have assistance from trained nurses to help care for your baby, while you heal and rest after giving birth for the first 1-3 days. There is also on-site lactation help.

7 Free formula in some hospitals

For those who do not wish to breastfeed, hospitals supply formula for baby during your stay and enough for the first few days after returning home.

8 Immediate medical assistance

If complications should arise, you have immediate medical assistance with the most advanced technology.

Hospital birth Cons:

1 You will be starved

Your food and fluid intake will be limited to ice chips, this is in case you need a c-section.

2 You are on a time limit

Hospitals often set a time limit on how long they will allow a woman to labor or push before using intervention.

3 The very real risk of a cesarean section

Hospitals have a high C-section rate, up to 50% in some hospitals. The World Health Organization has stated that hospitals should have a rate of under 15% and many practices that observe natural birth have a cesarean section rate of under 5% ( 4)

4 Limited labor choices

Not all hospitals allow or can accommodate the desire for a water birth or even walking or moment during labor.

5 Augmentation (speeding up labor)

If intervention is required, doctors may administer Pitocin/Cyntocin (a medication to help speed up contractions), which some view as “rushing” the body’s natural process. See below with the cascade of interventions.

6 Poor privacy and very little dignity

Privacy is minimal, as doctors and nurses are walking in constantly to check statuses, take vitals, etc. Bodies might just be bodies to them, but the feeling of exposure can be perceived as a threat and can slow your labor.

7 Separation from baby

You may be separated from your baby throughout your stay due to bathing, screenings, and vitals.

8 Limited by policies and procedures.

Hospitals have strict policies, protocols, and procedures that they must follow, which means you will, too. If you want to go against these, you will have to sign waivers and really stand up for yourself. This can be hard when you are in the throws of labor.

9 Pretty pricey

Paying for all that medical care around the clock comes with a steep price tag. If you are uninsured you may need to prove that you can pay for the visit before they will admit you.

The Cascade of Intervention in Hospital Births

The cascade of intervention refers to the likelihood of one medical intervention leading to another, to another and so on.

Many women are unaware of the increased chances of further interventions when accepting an initial intervention.

Interventions include many common and routine medical pregnancy and birth interventions.

This can begin with testing, working up to an induction, fetal monitoring, pain medications and epidurals, assisted births (such as forceps and ventouse and episiotomy) to Caesarean Section operations.

A common scenario is a women in labor arrives in hospital and is told to lay on the bed and is hooked to monitors. This decrease in ability to move can increase a womans perception of pain and decrease her ability to cope with the discomfort of labor.

As a result a woman is more likely to ask for pain relief, including an epidural.

Epidurals increase can slow down labor, which increases the likelihood that you will have some chemical augmentation to speed up your labor.

Speeding up labor increases the chances of the baby getting distressed, which then makes it much more likely that you will need surgical intervention including forceps or a c-section. An epidural increases your chance of a caesarean by 160% ( 5 )

Many antenatal tests have high rates of false positives which can lead to additional testing and monitoring and often recommended induction.

For this reason it is suggested that all antenatal tests and interventions are carefully researched, considered and justified in your individual circumstance.

The in-between option – A Birth Center for labor and delivery.

A birth centre is a place that focuses on birth and women in labor. Birthing centers are usually run by midwives (usually certified nurse midwife), but some are also staffed with obstetricians and nurses.

A birth center focuses on the pregnant woman and how they want their birth experience to go, while also providing extra staff on site if they are needed. Women that need medical intervention including a cesarean section will usually need a hospital transfer.

A birth center birth is best for a healthy woman with an uncomplicated pregnancy – these are considered low risk women, the same that are thought of as safe to have a home birth.

If you have a low risk pregnancy and would like to use a birthing pool for labour, a birth center might be a good choice. They usually have built in pools for you to use, and the luxury of having meals cooked for you and a certified midwife on site 24/7 until you are ready to go home.

At a birthing center natural childbirth is the aim, and most have much less interventions than birthing in a hospital does.

Home birth vs Hospital birth pros and cons

The truth is that there’s no such thing as “safe” or risk-free birth in any setting. For each of us, “safety” and “risk” are complicated calculations made within limitations of our individual circumstances and the options we are given to choose from.

For mothers and families making these important decisions, statistics are helpful, but statistics alone are not helpful. You need to look at you and your partners belief around labor and birth, what options you have available to you, and whether you can get a suitably qualified person to attend your birth.


Do you labor at home or the hospital? Thinking about having a home birth? Here are the good, the bad and the ugly about having your baby at home vs the hospital #naturalearthymama

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Disclaimer: The information on Natural Earthy Mama is provided for educational purposes only and is not intended to treat, diagnose or prevent any disease. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dana and her community. We encourage you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.
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