Home Birth – What to Consider

Home birth is a controversial topic in today’s litigious society. The debate around home birth continues. There are risks involved involved in a home birth, but there are also benefits.

Those who support home births claim that up until the twentieth century, most women gave birth at home, even in the western world and that it has stood the test of time. Those who are against it argue that it is extremely risky because if something goes wrong, the emergency technology that is available in most hospitals, is not available at home. If there is a crisis, time is often of the essence and delays in treatment could alter the outcome of the birth significantly.

Whatever camp you are in, the most important thing you can do when making your decision is be fully informed.

Benefits of a Home Birth

There are many reasons that some women choose to give birth at home, here are some of them:

  • Comfort and familiarity: Surroundings are familiar and comfortable and it is a vastly different atmosphere compared to a hospital ward.
  • You are in charge: You can arrange the décor of the room where you will give birth, you can play music, watch the television, have a bath, eat when you feel like it. If you are having your baby at home there are no real rules to follow.
  • You can choose how many people are with you: if you want your partner, a doula, your mother and best friend with you, you can. Some women want their older children to be present. If you don’t want your children in the room during the actual birth, they can be among the first to see the new baby soon after birth.
  • You can regulate your choice of pain relief: most women who have home births only want natural pain relief, not having an epidural or pethidine available is not an issue. At home you are more likely to use breathing exercises, bean bags, or have a water birth. A midwife who specialises in such techniques will guide you on the equipment that you need, and how to use it. You can also use alternative methods of pain relief, such as hypno-birthing.
  • You lead the birthing experience: as long as you produce a coherent birth plan and dis-cuss everything fully with your midwife before the actual labour, you can be extremely independent in your choices.

Risks Associated with Home Birth

With all of the above benefits of a home birth in mind, it is still vitally important to take into account all of the inherent risks of having a baby at home. The main concern about giving birth at home is how safe it is for the mother or the child. If the pregnancy is risk free and everything goes according to plan, a home birth does not have to be dangerous, but the risks outlined below, should be considered.

  • Appropriately qualified and experienced midwife: you need to ensure that the midwife you hire is appropriately qualified and experienced, specifically in home births. A home birth is a significantly different experience to a hospital birth and it is essential that your midwife has a deep understanding of the nuances of home birth.
  • Emergency situation: if something goes wrong during the labour or birth and the mother or baby need medical attention, for example an emergency a caesarean, the delay involved in transporting the mother to hospital could be detrimental to the health or survival of both mother and baby.
  • Financial cost of a home birth: you will need to hire a private midwife if you want to have a home birth. The costs of this can be significant (and vary between $3,550 – $5,500). Some midwives, known as ‘Eligible Midwives’ are eligible for some of their fee to be claimed through Medicare. Your health insurance may also cover part of the cost. As this varies so significantly between providers and locations, it is important that you thoroughly research the costs associated with a home birth.

Insurances and Financial Cost of Home Birth

Some private health insurance will pay partial rebates for home birth, but each insurer is different, so be sure that you check what is covered. Some Midwives are Medicare Eligible Midwives, which means Medicare will rebate some of the cost associated with pre and post natal care, but not cost associated with the birth, if it occurs at home. A home birth with a private Midwife will cost between $3500 – $5500.

Private Midwives do not have professional indemnity insurance that will covers a birth that takes place at home, even if she is an Eligible Midwife. A midwife’s insurance will cover antenatal and postnatal care. It is likely that your midwife will ask you to sign a declaration agreeing that you are aware that there is no insurance cover for the birth.

If you wanted to claim damages for negligent care during the birth itself, your midwife would be required to pay the damages, rather than an insurer.

Some Questions to Ask Yourself

If you are considering a home birth, here is a comprehensive list of things to consider:

  • Do you really know what a home birth entails? It might be helpful to watch a documentary home birth as part of your research.
  • If you are set on your home birth, what kind of home birth do you want? Some women seek an unassisted home birth, which essentially means that the midwife is there as a safety net, but you do most of the work yourself. You may, on the other hand, prefer a midwife who is more proactive.
  • What are your own personal risks? If you are going through a problematic pregnancy or there is a problem with the way that your baby is lying this needs to be considered. Before booking your home birth, you are well advised to discuss this issue with your doctor to find out whether this option is realistic for you or your baby.
  • What home birth options are available to you? Contact a home birth association to discuss all your options.
  • Can you afford the cost of a home birth midwife? Cost associated with a home birth can be significant. You should factor this in to your decision.
  • Once you have found a midwife, ask to see her qualifications. Is she officially registered? Are her services covered by your health insurance? Ask her for references and speak to as many mothers who have used her as you can. If you find that she is evasive when you question her or that she refuses to provide references you should consider someone else.

On considering your options, if you are an advocate of home birth and your pregnancy is low-risk, and your health is good, home birth is a relatively safe and low-intervention way to give birth. In New Zealand, Scandinavian countries and some European countries home birth is well integrated in to the health system and is supported by the government.

The key is to be fully informed and have researched all your options. Once you feel confident of this you will be able to make an informed decision based on your own particular circumstances.

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