Giving birth is a joyous occasion, for all of the pain and discomforts that go along with it. The at-home experience is preferred by women around the world for many reasons, including environmental familiarity and deeper fulfillment from the experience. Cultural perspectives surrounding childbirth differ in the United States from many other countries. In the United States, childbirth is often seen as expensive, mysterious, and better left to highly qualified physicians and other obstetrics professionals in case there are complications. A 2007 study of maternity in the Netherlands, however, showed that maternity is viewed as a "low-risk part of normal family life and is associated with modest costs, excellent maternal and infant outcomes, and a high percentage of home births attended by professional midwives." [1]
Having had three children, all hospital-based rather than home, comparing experiences with women who gave birth at home supports Johnson’s study assertion. For all of the wariness toward the idea of giving birth at home, I have more than once found myself almost jealous of friends who had their babies in the comfort of their own homes, without the antiseptic environment of a hospital. They were able to rest without being checked on every couple of hours, and they were able to eat their own preferred foods. Further, their costs were substantially lower.
There are legitimate arguments for both birthing options, which are understandable. Once the decision has been made to give birth at home, there are many tips to consider, and some seemingly unusual suggestions by women who have been through the process.
First: Research, research, research.
This cannot be over-emphasized. There are several things you will need to consider, like who your midwife or doula will be.[2, 3] What are their qualifications? How long have they been in practice? What is their experience with emergency situations? Do they provide portable ultrasound and lab capabilities, or will that be a separate cost? What does your insurance cover, if applicable? And speaking of costs . . .
Second: Budget carefully.
The average cost of a midwife is between $1,500 and $3,000. [4] This is usually paid prior to giving birth. However, this is not the only cost consideration. If your midwife provides ultrasound and labs, ask if those services are included in the total payment, or if there are processing fees from laboratories processing bloodwork. What other supplies might you need? Prenatal vitamins, maternity clothing, and post-natal items are part of the pregnancy process, regardless of whether you give birth at home or in the hospital - so remember to include them in your budget.
Third: Have a back-up plan.
How far do you live from the hospital? This was a concern of a friend who lives in rural Kansas, more than a half hour drive from the nearest hospital. Her suggestion is to discuss with friends and family members the option of using a room in their home if distance is a concern. (Note: she decided to give birth in her own home - twice - and everything was fine.) Also, be prepared for the possibility of Caesarian section, which might necessitate a hospital stay.
Fourth: A few unusual suggestions.
Invest in one or two bottles of mineral oil. The reason for this is for vaginal preparation. Do not wait until end-stage pregnancy to do this; start during the second trimester, from about the 20th week. Gentle massage and circular pressure of the vaginal opening aids in preparing and strengthening the gateway to the world. Also invest in a plastic sheet and a few "throw-away" blankets. These are not expensive items, and can be purchased at any time, though having these items on hand early is a good idea in the event of premature labor. My suggestion here is to scout your local consignment shops and Goodwill stores for possibilities. Your local church might be another place for terrific resources.
Fifth: Relax, and be kind to yourself.
When my friend said this, it seemed like an obvious suggestion. Not so. Women are often hard on themselves in the best of times. During pregnancy, sometimes it seems as though every little thing is going to result in failure for which mommy is responsible. Keep in mind that not everything is in your control, and while the majority of pregnancies and home deliveries go smoothly, not all do. That’s okay. Really. If, despite all of your planning, something happens that makes a hospital stay necessary, don’t fret over it. You are going through an amazing experience in your life, regardless, and the sweet bundle of joy is the outcome - regardless of where he or she is born.
Sources:
1. Johnson, T., et al. (2007). "Dutch Women’s Perceptions of Childbirth in the Netherlands." American Journal of Maternal Child Nursing May/June 2007;32(3):170-177
2. Midwives Alliance of North America.
4. Dian Dewi. (2009). Home Birth Guide: Promoting a Joyous Experience.
