Home birth

The safest place for babies to be born is in a hospital or birthing center. A birthing center offers a more home-like, relaxed environment for giving birth than a hospital. Birthing centers have health care providers and equipment to care for you and your baby, especially if either of you need special medical care right away.

You may choose to give birth at home. You may want to be in the comfort of your own home, be in a more family-friendly setting and have more control over your baby’s birth. If you’re thinking about having a home birth, plan ahead to help keep you and your baby healthy and safe.

Is home birth safe?

While most babies come into the world healthy, problems during childbirth can happen very quickly, even for healthy women. You may need special medical care and equipment right away to keep you and your baby safe. If you’re giving birth at home, this kind of care (for example, a neonatal intensive care nursery) is not available at home.

It’s not a good idea to have a home birth if:

• You have pregnancy complications, including diabetes, high blood pressure and preeclampsia.
• You are pregnant with more than one baby (twins, triplets or more). 
• You’ve been pregnant less than 36 weeks or longer than 41 weeks.
• Your labor is being induced at home.
• Your baby is breech. This is when the baby’s bottom or feet are facing down right before birth.
• You had a cesarean birth in a past pregnancy. A cesarean birth (also called c-section) is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

Who provides care during your home birth?

Most home births are done by midwives, but some may not have the proper training in pregnancy and childbirth. If you’re planning a home birth, make sure that your midwife is a certified nurse-midwife (also called CNM). CNMs are certified by the American Midwifery Certification Board. They have special training to take care of pregnant women and deliver babies.

Your home birth also should include another health care provider whose main job is to care for your newborn right after birth. This provider can be a doctor, nurse or respiratory therapist who has training, skills and equipment to care for your baby, especially if your baby has breathing problems after birth. This person is there in case you and your baby both need help.

What kind of care should your newborn get right after birth?

Even at home your baby should get the kind of care after birth he would get at a hospital or birthing center. This includes:

• Being kept warm. You can keep your baby warm with kangaroo care or warming pads. Kangaroo care is when you hold your baby skin-to-skin on your bare chest or between your breasts. Warming pads are soft, electronic pads that your baby lays on to help keep her warm when her provider is caring for her right after birth. 
• An Apgar test. This is a test your baby gets right after birth. The test checks five things to make sure your baby is healthy: heart rate, breathing, muscle tone, reflexes and skin color.
• A complete physical. The health care provider checks your baby out from head to toe.
• Eye drops or ointment to help protect the eyes from infection
• A vitamin K shot and the vaccine. Vitamin K can help your baby’s blood clot normally and protect her from bleeding problems. Hepatitis B is a disease caused by a virus that attacks the liver.
• Newborn screening tests. These tests check for serious but rare and mostly treatable conditions at birth. It includes blood, hearing and heart screening.

Your baby’s health care provider should check your baby again within 48 hours from your baby’s first checkup after birth.

What if something goes wrong?

If things don’t go as planned, you and your baby may need special care that you can’t get at home. Here are some things you can do before your baby’s home birth to plan ahead:

• Talk with your health care providers about what to do if an emergency happens. What hospital will you go to? How will you and your baby get there? Will you call 911 for an ambulance or will you have other transportation available? 
• Notify the hospital that you’re having a home birth so that its staff knows you’re coming if you have an emergency.
• Make sure you have a working telephone in your home. If you’re using a cell phone, make sure it’s completely charged.
• Check the weather so you know what to expect if you need to get to the hospital.

Last reviewed May 2013

See also: Newborn screening