You may have heard about women choosing to birth babies at home without the care of a medical team. This practice is called unassisted home birth, or unassisted childbirth. The idea can sound appealing, especially if you’re anxious about giving birth in the hospital setting.
But is unassisted home birth safe for mom and baby? Here’s what you need to know.
What Is Unassisted Home Birth?
Laura Shanley, author of “Unassisted Childbirth,” explains that during unassisted home birth, the mother is in complete control of the experience. She chooses everything about the pace of her labor. This includes what positions to birth in, and even when to push. A woman may choose to birth totally alone, or to surround herself by friends and other people for support.
Unassisted means that no medical personnel are present at the birth.
Lynn Griesemer, author of “Unassisted Homebirth,” coordinated the first husband and wife home birth conference in 1998. The last two of her six children were born through planned, unassisted childbirth.
She shares several reasons for why she chose to birth at home without a midwife. Mainly, she wanted the birth to be private, she didn’t want to use medical intervention, and she wanted the experience to be free of distractions.
Unassisted home birth may seem appealing, especially if you’ve had bad hospital experiences in the past. But is unassisted home birth safe?
Is It Safe?
The American Congress of Obstetricians and Gynecologists maintains that hospitals and birthing centers are still the safest settings for birth. That being said, the group recognizes that women and families have the right to be medically informed about their options.
Keep in mind, there are risks associated with home birth. Most notable? A twofold to threefold increased risk of infant death compared to delivery in a hospital setting.
In 2011, an estimated 25,000 births took place at home in the United States. That represents less than 1 percent of all births. Just 1 in 4 of these births were unattended, whether intentionally or unintentionally. This number of home births is growing each year, but there’s little unbiased information about safety.
Studies surrounding home birth are limited. It’s important to understand that existing reports in favor of home birth are often focused on healthy women with no pregnancy complications. More research needs to be done to assess safety, benefits, and risks.
The safest recommendation? Consider hospitals and birthing centers. If you still want to give birth at home, do so with the supervision of a certified nurse midwife (assisted home birth), and understand the potential for various risks. You should always have transportation available if you need to transfer to a hospital in an emergency.
Assisted Home Birth
Planning an assisted home birth takes a good amount of time and attention. Birthing at home is an option in many locations, but you may need to do research to find a certified midwife or doctor who will perform births outside of hospitals and birthing centers.
Prior to your home birth, your caregiver will keep careful track of your pregnancy and any complications that might interfere with your plan. On the big day, your caregiver will likely monitor you occasionally (versus constantly) to watch as your labor progresses. After birth, you will receive instructions on follow-up care for both you and your baby.
The rest is up to you, within reason.
Benefits of assisted home birth include:
- a familiar setting, like your home
- freedom to wear your own clothing, eat your own food, etc.
- control over birthing positions and methods (water birth, for example)
- birthing without drugs or other interventions
- lower cost
- expertise of a medical team in case of complications
The American Academy of Pediatrics has also published guidelines intended to protect babies born at home. They recommend that at least one person at delivery be entirely focused on the baby’s health. They should have the skills and training to perform full resuscitation on the baby in an emergency.
Risks and Complications
Even the best birth plans sometimes need to change last minute. You may have certain conditions that make birthing at home unsafe, even with the help of a midwife. These conditions may change as the trimesters roll on, so keep up with regular healthcare visits throughout your pregnancy.
Your doctor will monitor your health to track any of the following complications, including:
- other chronic medical conditions
- previous cesarean delivery
- having multiples
- breech, or other position that’s not head first
- premature labor (before 37 weeks)
- postdate labor (after 41 weeks)
Even if everything looks perfect at the start of your labor, there are still events that may lead to a hospital transfer for the safety of you and your baby.
Transfers typically happen if:
- labor isn’t progressing
- meconium (fecal matter) appears in the amniotic fluid
- placental abruption
- umbilical cord prolapse
- excess bleeding
- placenta delivery problems
- baby or mother are in distress (fever, abnormal heart rate, etc.)
Discuss any risks and complications with your doctor, as well as any concerns you have over whether or not an assisted home birth is a possible option for you.
There are many ways to bring your child into the world. The choice isn’t simply between unassisted childbirth and hospital birth.
Birth centers offer an alternative to a hospital setting, but with many of the same benefits. If you have a healthy pregnancy, a birth center may be a solid option. They are a good option if you don’t feel entirely comfortable giving birth at home. Midwives and doctors deliver at birth centers, and some centers are even located within hospitals.
The environment is typically less sterile than a hospital. Instead, it’s warm and relaxed. You may also be able to return home more quickly after birth in a center, if that’s important to you. The benefit here is that you have the freedom to have a natural birth (less monitoring, no induction, no drugs) all while being in the safety of a facility that is equipped to handle emergencies on site, or with a quick hospital transfer.
Don’t have a birth center in your area? Don’t worry. Traditional hospitals have also come a long way in recent years as the demand for natural childbirth has grown.
Many hospitals now feature tubs for pain relief and other tools that help with a drug-free birth. Communicating your desires for natural childbirth to your doctor early and often will help you plan the best experience possible.
Writing a birth plan is another good way to let everyone know how you’d like to deliver. You can make your birth plan as simple or elaborate as you wish. Include what interventions you’re comfortable with, and what you’d like to avoid.
Also include any instructions for baby after birth, including:
- delayed cord clamping
- immediate skin-to-skin contact
- delayed shots
No matter how you choose to bring your child into the world, the goal should always be a healthy mom and healthy baby. The key in any situation is to remain flexible and understand that sometimes birth doesn’t go according to plan.
Whether you give birth at home, in a birth center, or at a hospital, make sure you do your research. Consult a medical professional, and choose the option that feels right for you and your family.