7 Reasons to consider an out-of-hospital birth with a midwife
When planning for where to give birth there are a few things you might not be considering but that you SHOULD consider. Unfortunately, many new parents don’t know, what they don’t know, until they are in the throws of labor. Giving birth is hard work and it’s really not easy where ever you do it. Sometimes new parents fall prey to the mentality of “the hospital is covered under my insurance and therefore is the way to go” and “the hospital has my best interests at heart”.
If you are having a low-risk healthy pregnancy, then out-of-hospital birth with a midwife might be right for you.
Read on for 7 top reasons clients have given me for choosing a homebirth or birth center birth with a midwife!
During the course of care you will have plenty of time to ask all of your questions. Most midwives schedule appointments for about an hour or in busy birth center practices sometimes 30 mins versus 5-15 min with most hospital providers. Having more time for appointments means you can ask your questions and that there is time for getting the answers you need! Your midwife will also provide some education during appointments on variety of topics that come up in pregnancy, labor, birth and postpartum. I consistently have heard from clients that they enjoy midwifery care because they don’t feel rushed and they don’t feel like they are “just another number”.
How busy a midwife is and her ability to not over-schedule is another important factor! I recommend asking her how many births she takes per month and if she takes any regular time off.Individualized care is a cornerstone of midwifery care and receiving that level of care has many benefits. If you choose midwifery care in any setting you, have a good chance of receiving great individualized care. Some hospital CNM practices with several midwives in one practice have more regimented protocols for care - that is less individualized - so if that’s not your preference, then plan accordingly. An out-of-hospital private practice midwife has a lot more freedom to provide individualized and autonomy focused care to their clients.
You will have greater access to your care provider between visits and in most cases if anything more emergent comes up you will have direct communication with your midwife. It’s a real luxury to have your midwife on speed-dial. If a problem comes up, you can get help right away. For example, sometimes I’ve have clients with an acute UTI, gallstones, taken a fall or have preterm labor symptoms - they can call for guidance early to get treatment sooner.
Midwives have lower rates of interventions across the board but if you have an out-of-hospital birth then you can expect to be monitored intermittently with a hand-held doppler and vitals taken every 4 hours with a BP cuff and thermometer. Furthermore, you likely will not be getting IV fluids (unless truly needed). This means you will not be hooked up to wires and tubes. Essentially nothing stays on you between those quick health checks - this naturally promotes more movement, changing positions and eating/hydrating during labor. All things that support normal birth.
Staying home means you won’t have to get in your car during active labor to go to the hospital or birth center. This is something many clients have told me they particularly did not enjoy when they have had a previous hospital or birth center birth. The simple process of leaving your space can also disrupt the normal flow of labor hormones, which can sometimes take hours to get back into your labor groove.
Midwives routinely follow the birthing persons lead when it comes to choosing positions to labor in or give birth in. If you would like the freedom to give birth in any position of your choosing in the moment, then an out-of-hospital birth is a great choice. There are some forward thinking OBGYNs and CNM’s (certified nurse midwives) out there that do support choosing your birth position at the hospital - with the caveat of staying on the bed.
When you choose to birth with a midwife out-of-hospital, they follow the scope of care for any credianials they have but are not guided by hospital administrators with keeping up profit margins. Policies and red tape are unfortunately part of the industrialized medical model of care for hospital based care. There are hospital administrators and legal teams in charge of making the “rules” you are supposed to follow AND worse yet, they are also making “rules” for the physicians and midwives who work there to follow as well. In essence, the care provider with great intentions may have their hands tied (so to speak) or face being disciplined for breaking hospital policy in favor of respecting patient autonomy. This sometimes means you need to “fight” for what you want and it is not automatically given. Hospitals have become corporations and they do not run based on what is best for a normal physiological birth.