The Trainwreck Myth: Home Birth vs. Hospital Birth

The choice between home birth vs. hospital birth often speaks directly to parents’ desired family culture.

make a more informed birthing choice and Realize this culture by learning more about each setting.

A common question I get from clients and potential clients centers on the safety of a home birth vs. hospital birth. It’s a great question, and there are some key considerations to think about. However, know that the research is clear that home birth is as safe as the hospital for most pregnancies.

In this article, I’ll explore the safety, benefits, and other important considerations of each setting for you to compare. Hopefully, this empowers you to best make an informed choice that aligns with your preferences and values.

Is home birth safe?

Safety is often the primary concern for expectant parents considering a home birth vs. hospital birth. The myth of the “trainwreck” home birth is a powerful one, so this is evident and understandable. Even though most pregnancies can safely progress at home, it’s important to remember that it’s not suitable for every pregnancy. High-risk factors, such as gestational diabetes, preeclampsia, or certain medical conditions, might necessitate a hospital birth or a transfer-of-care. Hospital births unquestionably have their place, and hospital support is never far away. These and certain other complications are generally outside the scope of a safe home birth. Clients suffering from these conditions may be referred to a nearby supporting hospital if conditions don’t improve.

Research shows that, for low-risk pregnancies, home births attended by qualified professionals are as safe, or safer, than hospital births.

Cheney, et al.

However, when carefully planned and discussed with a trained provider like a certified professional midwife (CPM) or certified nurse midwife (CNM), home births offer an ideal environment to facilitate normal, physiologic labor and birth. Research shows that, for low-risk pregnancies, home births attended by qualified professionals are as safe, or safer, than hospital births. This is because the laboring person often feels more secure, engaged, and emotionally supported in their home over anywhere else. This makes a vulnerable experience just a little easier.

Hospital Births: The Medical Model of Care

The primary advantage of hospital births is that they allow access to medical interventions and advanced equipment. This is important in the unlikely event they become necessary. For pregnancies with pre-existing medical conditions or complications, a hospital birth might be the safest option. Medical staff are on hand to address emergencies promptly, ensuring the well-being of both the birthing person and the baby.

Hospitals also afford pain management strategies that aren’t possible in home births. This peace of mind can be an important psychological safety net for when birthing becomes difficult or intense.

However, hospital births can sometimes involve more interventions than necessary, sooner than they might be needed. This can lead to a less natural birthing experience. A clinical environment might also contribute to increased stress for some individuals, which may interfere with labor progression. It’s important to consider your comfort level with medical surroundings and interventions when making the decision on where you’d like to birth.

Key Benefits of Home Births

CPMs and CNMs are specially trained to monitor maternal and fetal well-being during labor. CPMs are exclusively trained in out-of-hospital birth, becoming experts in birth physiology. This training helps them swiftly respond when things veer outside of normal physiology, often non-medically. Whereas obstetricians are often only briefly present to “catch” the baby, midwives engage in the difficult work of sitting and listening. They are equipped with a wide variety of equipment, techniques, philosophies, herbs and holistic treatments, basic medications, and a deep expertise in physiologic birth. Midwives offer in-depth, on-call, personalized care, and the expertise needed to navigate any unexpected developments.

Another significant benefit of a home birth vs. hospital birth is the familiar and comfortable environment it provides. Being in the comfort of one’s own home can reduce stress hormones, allowing the laboring person to relax and be hormonally optimized for the complex hormonal dance of labor. Additionally, family members can be more present and involved, creating a supportive atmosphere that contributes positively to the birthing experience.

Another benefit of home birth vs. hospital birth is individuals planning home births have lower intervention rates. Interventions such as cesarean sections, epidurals, and episiotomies are less frequent for those planning home births, promoting less maternal morbidity.

Finally, since the aforementioned interventions can sometimes minimize the autonomy of the birthing person, midwives who specialize in home births prioritize informed consent, returning to these individuals the freedom to make decisions aligned with their birth preferences and values.

Home Birth Planning

If you find yourself choosing a home birth, know that it does require some planning and preparation. A birth plan outlining preferences, such as pain management techniques, birthing positions, and postpartum care, is essential. Discussing emergency protocols, medical equipment availability, and proximity to a hospital in case of emergencies are all integral components of the planning process.

Midwives who offer home birth services will then conduct several thorough prenatal visits to monitor the pregnancy’s progress and ensure its suitability for a home birth, referring often to your plan to make sure current realities align with your wishes. Midwives make the birthing person’s experience central to the entire process, and concern themselves with making this experience exactly as desired as long as it’s safe to do so.

Make an Informed Choice

Ultimately, the decision between a home birth and a hospital birth should be based on a thorough assessment of your health, preferences, and values. Home births offer a unique opportunity to welcome your child in a familiar and relaxed setting, with personalized care and minimal interventions. Hospital births provide medical expertise and interventions when needed, ensuring the safety of both mother and baby.

Before making your choice, consult with qualified midwives, obstetricians, and other healthcare providers. It’s great to process the experiences of those you know as well as seeking independent research sources. Discuss your options openly, ask questions, and voice your concerns. Whether you opt for the intimacy of a home birth or the medical security of a hospital birth, remember that your comfort, well-being, and informed decision-making are at the forefront.

The choice between a home birth and a hospital birth is deeply personal and should be made after careful consideration of safety, benefits, and your individual needs. Whichever path you choose, the journey towards welcoming your little one into the world is a remarkable and transformative experience.