The pros and cons of home birth vs hospital birth

As you begin to plan your birth experience, you may be wondering if a home birth is right for you and what the fors and againsts of having a home birth or a hospital birth are. Depending on your pregnancy situation, your healthcare provider may strongly recommend a hospital birth, particularly if your pregnancy is considered high-risk, you are expecting multiples, or there are complications during your prenatal journey. In these situations, it’s important to weigh up the information and discuss with your midwife / doctor any questions you have, as they have your best interests at heart for the safety and wellbeing of you and your baby. If this is the case, it may mean giving birth in a medical facility with healthcare providers, equipment, and interventions readily available to assist in your labour and delivery. Remember even if a hospital birth is planned you can spend your early labour at home until you feel that the labour is established and you need to get to the hospital.

With that in mind, if you have been given the green light by your healthcare provider to choose your birth setting, there are many reasons why you may opt to deliver your baby at home. These include:

• Wanting to deliver in a familiar, home environment with as many or as few support people –including your other children –with you.
• Wanting to deliver in an environment with less medical interventions and with use of birthing balls, pools, and/or bathtubs.
• Access to a hospital with a maternity wing is some distance away.
• Desire to use a private or known midwife.
• More freedom of choice to move, rest, etc. and more control during your labour and delivery.
• Cultural and/or religious factors.

Whatever the reason behind considering a home birth or hospital birth, it’s important to remember that there may be situations during labour, which necessitate the need to support your labour and birth at a medical facility. If labour isn’t progressing after many hours, your baby is showing signs of distress or is breech, your blood pressure gets very high, there is excessive bleeding, or you reach a point where you wish to have stronger pain medication, you may need a medical facility.

When writing your birth plan and discussing a home birth with your midwife, be prepared for the possibility that you may need to go to hospital, especially if you choose to have a planned home birth so that you can have family and siblings there. Though these emergencies are certainly not guaranteed to occur, it is important to be prepared for any situation and to have a back-up plan in place in the event that you are taken to the hospital.

How to prepare for a home birth

The most crucial aspect of planning your home birth is selecting the right healthcare partners. Often, this is a certified midwife or certified nurse-midwife, who performs home births but it can also be your community doctor. Some parents-to-be also wish to have an additional birth partner, siblings, a family member or doula present during the labour and delivery. Discuss with your midwifery team their experiences of supporting women to birth at home and together you will create a birth plan to support your labour, have an idea what to expect, plan a water birth if that is your choice and get the delivery experiences that you desire.

If you plan to have a birthing pool or the like, be sure to order them for purchase or rent as soon as possible to ensure their availability ahead of your due date. Some items, like birthing pools or tubs, usually require assembly, so make sure your partner or another support person can pitch in to ensure it is operational in the days or weeks before. Other items, such as birthing balls, plastic sheets, towels, and postpartum essentials, should also be purchased ahead of time, so you can rest assured that everything will be ready for you (and your baby!)

What will your home-birth team bring?

Your healthcare provider will prepare a birthing pack and may leave it with you, (usually about 2 weeks) prior to your due date. On the day, your midwife may come with a colleague to support you during your last stages of labour and delivery. They will support and provide pain relief medication such as gas and air, so if you need a little help with your labour pain, they will be able to meet your needs. Talk with your midwife and discuss labour pain management in the weeks leading up to your due date. As part of the midwife / doctor medical kit for a home birth they have a prepared pack for supporting your baby if he needs a little help at birth; they think of everything! They will bring these when you call them to say that your contractions have started and how close and strong these are.

Having a back-up plan in place is important in case of any unexpected situations that may require a hospital transfer. When having a home birth vital signs like pulse, blood pressure, and your little one’s heart rate will be intermittently monitored. Your midwives will encourage you to be mobile, try different labour and birthing positions

Many women are worried that a home birth may be messy and you will have to dispose the placenta and do the laundry. Many health providers take the placenta and soiled items away with them to dispose safely in the hospital. So with minimal tidying up to do, you can rest and just focus on breastfeeding and holding your baby in skin-to-skin.

Top tip:

• When you prepare to birth, use darkly coloured towels or bedsheets, especially if you have your children excited to welcome their new baby brother or sister. On dark coloured laundry the colour of your waters / fresh blood is not so striking and frightening for those around you.

After the birth of your baby it is an expected practice that your midwife, doctor or paediatrician carries out a full health check, also known as ‘newborn medical neonatal examination’. This usually takes place within the first 24 hours after birth.

There is certainly a lot to consider when deciding between home birth or hospital birth, but these decisions are yours to make! Your birth team, including healthcare professionals, family members, spouses or partners, and other support people are in your corner and can help you to make the right choices for you and your baby.