Bring the birth center home

There are many reasons a person might want to give birth at a freestanding birth center rather than a hospital. Most birth centers are owned and operated by midwives. Giving birth with a midwife has many advantages including great outcomes such as: fewer perineal tears, fewer c-sections, holistic approaches to preventing prenatal complications, extended delayed cord clamping, fewer interventions, increased autonomy in birth and the list could easily go on for a while here! According to one research study from the UK published in 2015: “Women who have a planned home birth have high rates of satisfaction related to home being a more comfortable environment and feeling more in control of the experience.”

Many individuals would rather give birth in a birth center, because to them it feels safer than giving birth at home. Well, I’m sorry to spoil that perception but it is just NOT true. When you choose to give birth at home with a midwife present, you are essentially bringing the birth center to your home!

Homebirth midwives have the same background and training that birth center midwives do. Additionally, they bring all the same supplies TO YOU that would be at a birth center including but not limited to anti-bleeding meds, antibiotics, lidocaine (for stitches), IV fluids, oxygen, resuscitation equipment, sutures, catheters, cord clamps, vitamin K shot and oral, erythromycin eye ointment, pulse oximeter, stethoscopes, BP cuff, thermometer, gloves, chux pads, gauze, sterile instruments and more! Many midwives bring herbs, homeopathy, essential oils, peanut balls, birth balls, rebozo, birth stools and have birth tubs available along with water birth supplies.

Homebirth supply setup (Medications, gloves, BPcuff, stethoscope, etc)

All the essentials at your midwife’s finger tips. You may not need any of it but it’s there for when you do!

When you give birth at home there are a number of potential advantages. I’ve created a list of some of the top benefits of having a home birth with a midwife.

1) You can give birth in your own microbiome! Meaning when you go to another location whether it is a hospital or birth center, there will be exposure to the germs, viruses and bacteria in that location. I won’t go into details about the benefits of being in your own microbiome and flora, but suffice it to say there are many benefits.

2) You don’t need to leave your space which often pulls labor people out of their labor flow. It can take hours to get back to the same place you were at prior to leaving your home. Mindset and coping are more easily managed in your own space.

3) Having attended countless births at home and in birth centers, I have noticed that staying home is less disruptive to the natural hormones of labor. Not interrupting this delicate balance has the potential to make labors shorter with less complications. That has been my experience antidotally (as a midwife) too.

Laboring with partner at home

Without interruptions that may impact the flow of labor hormones

4) When you arrive too early to the birth center, you will most likely be sent back home until you are in strong active labor. First time parents are especially likely to come in when they are still in early labor and end up going back and forth one or more times. If at the hospital you may end up staying when it is still early labor and this is also more likely to lead to interventions such as augmenting labor with Pitocin.

5) When you arrive to the birth center to check-in, unless you are clearly about to have your baby, then you can expect to have a cervical check to see if it’s time to stay. If you go back and forth several times, that might mean a few extra cervical checks. However, when you give birth at home, at least in my practice, if it seems like I’ve arrived too early then I will simply listen to fetal heart tones, take maternal vitals, set up my supplies and leave to await your call for when things have progressed to active labor. Essentially, most home birthers will have fewer or even no cervical exams in labor - it is up to the person giving birth to decide.

6) There are slightly higher transfer rates from birth center to hospital (16%) vs home to hospital (10.9%). I believe to some degree (this is only my opinion), that this can be attributed to multiple factors such as: the birthing person may have a disturbance in the flow of labor hormones, may have unwanted cervical checks, may feel “watched” if they arrive in early labor and possibly if the midwife providing care in labor puts the laboring person on any kind of time line. Some birth centers have policies on how long a client can labor at the center prior to initiating a transfer to the hospital. Ask your midwife if they have any such time limits!

7) Another advantage of home birth vs birth center is the postpartum care. When you give birth at a birth center, you will go home in most cases somewhere between 4 hours and 6 hours after birth. In both locations you will receive similar care which includes checking you and baby’s vitals, getting stitches if needed, eating something, establishing breastfeeding/chestfeeding, a head to toe newborn exam including measurements, weight and checking newborn reflexes. The main difference is that at home the midwives will tuck you into bed afterward vs you needing to get into your car to drive home. That may sound like a small difference, but I have heard of it being a downside repeatedly from those who went the birth center route.

Hopefully, this has been a helpful list in explaining some of the advantages of giving birth at home with a midwife vs giving birth at a birth center. Both are truly wonderful options and offer lower overall interventions when compared to traditional hospital care. Ultimately, giving birth at the location you feel best has a host of benefits and there is no “right” answer.