The rate of home births is decreasing. Midwives are licensed in 11 states. While most births are uneventful, a small percentage experience unanticipated threats to mother and baby. Previous screening helps to identify some but not all problems in advance.
Takes Careful Planning
The decision for a home birth usually transcends economic and safety considerations because of a deep emotional commitment to a home birth experience. A previous, negative hospital experience reinforces that commitment. If a home birth is your choice, you need to plan carefully. Prenatal Workup
Have your prenatal workup done by an obstetrician, determine if you have any medical or health problems, your pelvis is more than adequate, and your blood work is normal. Determine the amount of time it would take you to get to the hospital in case of an emergency. Ask your doctor what is considered a reasonable time limit and if he/she would agree to provide back-up if you end up in the hospital.
If you pass the first step, you can start shopping for a birth attendant. Doctors attend fifteen percent of home births; certified nurse midwives do twenty-five percent, and lay midwives thirty-five percent. If your area allows certified nurse midwives or doctors to do home births, you’re in luck. If that option is not available to you, interview lay midwives carefully. Some lay midwives have no experience beyond giving birth to their own babies at home and decide that midwifery would be an interesting hobby.
If your area has no licensing and standards, be an informed consumer. Screen your prospective birth attendant well. What training has she had? How many births has she attended (fifty is an appropriate number). Does she have resuscitation skills? Is there a plan for complications such as bleeding, breech, or prolapsed cord?
Be sure she has a well defined disaster plan. If she’s willing to care for you even if you develop a high-risk complication such as preeclampsia or diabetes, look for another birth attendant.