Photo: Shea Long, Coastal Lifestyles Photography
Just whisper the words “home birth” and you’ll get opinions that range from the absurd to the alarming. Hospitals are still the far more popular choice. (Less than two percent of births in Canada happen outside the hospital.) But despite what your father-in-law’s neighbour’s sister has to say, as long as you’re having a healthy pregnancy, where you deliver your baby is 100 percent your call. Knowing the facts (and common myths) may help you decide whether delivering your baby at home is right for you.
Actually, a planned home birth with a certified, licensed midwife is just as safe for your baby as a planned hospital birth. Studies from Ontario and BC have shown that the same number of babies are born healthy, no matter where their parents planned to have the birth. Midwives are regulated medical professionals who carry everything they need to deliver your baby, as well as to manage a medical emergency: oxygen, neonatal resuscitation equipment, and antibiotics and other medications. “We are coming to people’s homes with a fully stocked small hospital in our car,” says Hava Glick, a midwife with Kensington Midwives in Toronto. A little less than half of women delivering their first baby who planned to give birth at home end up moving to a hospital—but it’s usually for pain relief or because labour is lasting too long. The number drops to 15 percent for those who’ve given birth before. And only about eight percent transfer to the hospital in an ambulance or emergency vehicle.
While midwives don’t administer epidurals, they do have many soothing tricks up their sleeves. Showers, baths, heating pads and massage can all make a difference, as can keeping your fear response to a minimum—the coaching of an experienced midwife can help immensely in this area. Laughing gas, or nitrous oxide, may be an option at home, depending on where you live. There are also techniques that aim to “distract” your nerves so they’re too busy to send pain signals to your brain; TENS machines, sterile water injections and acupressure work on this theory. And even if you planned a drug-free labour, moving to the hospital for an epidural during labour is often still an option.
People who choose a “free birth” or an unassisted birth are “opting out of the medical system,” says Glick. “There is no one at the birth to assess risk and deal with emergencies.” These types of births are controversial and considered unsafe. A home birth is attended by trained midwives and does not mean you’re going to deliver alone in a meadow or a backwoods cabin—or whatever TV would have you believe.
In movies, a lot of fluids get thrown around, says Glick. “The reality is midwives tend to be careful and clean.” Most of the mess from a home birth can be managed with a plastic sheet and a few disposable underpads. When all is said and done, the midwives will likely leave you with just one bag of laundry and one bag of garbage (and a baby!). Your home doesn’t need to be sterile; in fact, the risk of infection is much higher in a hospital, says Glick.
All sorts of parents choose to have their babies at home for a variety of reasons. Members of the LGBTQ2+ community might take a pass on the hospital to avoid discrimination. Parents without medical insurance often choose home births in provinces where midwifery is funded by the government. Indigenous communities are reviving midwifery and home births as part of reclaiming Indigenous knowledge. But anyone who wants more control over who gets to attend the birth, what they eat during labour, how long they are allowed to labour, how they are dressed (or undressed), whether they get to move from room to room, and what positions they try during contractions should consider a home birth.