The Home Birth

Dear Parents,

Where you birth is a special and important decision to make. This location is known as your “birth space” and can be your home, a local birthing center, or a hospital. As your doula, the scope of our serveices to you remains the same, no matter what birth space you choose. We are here to serve you, love you, and help you be empowered to take charge of your birth.

Let’s dive into what a home birth looks like, and how this differs from a traditional hospital or birth center birth:

Birth has occurred in the home since the beginning of civilization. Since the normalization of hospitalized births in the late 1900s, home births have been on the decline. However, this is beginning to change due to the education of parents on the pros, and cons, of home births. In 2021, home births in the US rose to 12% of all births, the highest level since 1990. Let’s explore the pros and cons of home births:

*Pros of a Home Birth:*	Cons of a Home Birth:
– Comfort and Familiarity: Birthing at home allows you to birth in a comfortable and familiar place. This helps significantly in balancing the birthing woman’s hormones and protecting her emotions.	– Limited Access: At a home birth you have a limited access to pain medications or other medical advantages of the hospital. Monitoring the baby is also somewhat limited, though it varies between midwives.
– Control Over the Process: At home you have the freedom to create a birth environment and plan that is best for you, and without the stress of needing to transfer to the hospital.	– Increased Risk: Because of the distance from hospitals, the fetal and maternal mortality rates do go up, though remain low overall. Studies show that neonatal mortality rate in the US for hospital births is around 0.033%, and around 0.137% for home births.
– Low-Cost : Home births also cost less than the average price of a hospital vaginal birth.	– Supplies: At home, you are also responsible for providing most of your own supplies and birthing tools (we will discuss this in more detail shortly)
	– Not Suitable for High-Risk Pregnancies: Certain complications would disqualify you from having a home birth. Some of these risks include preeclampsia, breech baby, preterm labor, placenta previa, placental abruption, infection, or gestational diabetes.

Water Birth

Let’s take a quick detour to explore one way of birthing that is primarily used at home births. Most hospitals will not conduct water births because of the potential risks of aspiration, hypothermia, and infection. However, despite these risks, if the water birth is conducted safely and by a trained professional (such as a midwife), then a water birth can reap huge benefits for both mom and baby. One of the greatest concerns surrounding a water birth is that of aspiration(breathing fluid into the lungs). Let’s explore what causes baby to take his first breath:

The Physiology of the First Breath: In an infant or adult’s body, the heart pumps blood into the lungs to get oxygenated, then the oxygenated blood is pumped to the rest of the body. However, during pregnancy and most of labor, your baby’s lungs are filled with amniotic fluid. The heart bypasses the lungs and instead receives oxygenated blood from the placenta, and pumps that blood throughout the baby’s body. There are a few factors that trigger your baby’s first breath outside the womb. The first is stimulation (by air or coldness) on the trigeminal nerve, which is around the nose and mouth. During this time, an increased blood volume also helps to expel amniotic fluid from lung tissue, which is why delayed cord clamping is extremely beneficial.

The Midwifery vs. Medical Model: The midwifery model of breathing emphasizes the dive reflex. This reflex states that babies will automatically hold their breath when their faces meet water. Because of this, the baby will not take their first breath until exposed to air. But instead, will still receive oxygen via the umbilical cord while underwater. The Medical model, however, emphasizes that babies will take their first breath in response to the lack of oxygen in their blood. If baby is in distress or has low oxygen levels, it is believed that the baby will attempt to breath, even if submerged in water. However, it is important to note that as labor progresses and even after baby is born, the placenta is still actively pumping oxygenated blood back into baby.

*It is important to note that vigorous crying is not an indication that your newborn is not breathing. Newborns are often able to regulate their systems and begin breathing when there is nothing interfering or disrupting the baby’s natural instincts.

Home Birth Supplies

One of the most common questions when planning a home birth, are what supplies should you get? – Often your Midwife will provide all medical supplies that are needed, as well as some comfort measures. This can include: monitoring equipment, TENS unit, sterile bandages and instruments, newborn care supplies.

– Your doula will focus on your comfort and bring tools such as a rebozo, heating pad, birth ball, cooling cloths, snack and drinks.

Here are some supplies that you might want to keep on hand for your home birth:

Towels and Washcloths
Clean sheets and bedding for after the birth
A large bowl for your placenta
Your own comfort items! You know what you enjoy
Some of your favorite easy-to-digest foods and drinks
A postpartum kit: Sanitary pads, perineal spray
A comfortable change of clothes

The benefits of a home birth are truly remarkable. While it differs from birthing in a center or hospital, remember that you are designed to birth, momma! You’ve got this!

With Love,

Pearl

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