Vaginal birth

• Most women give birth through the vagina (birth canal).
• Labor occurs in three stages and feels unique to everyone.
• If you’re healthy, wait for labor to begin on its own.

Most pregnant women choose to give birth in a hospital setting. Other pregnant moms wish to deliver their babies in their own homes. If you're thinking about having a home birth, here are some helpful guidelines to consider.

The American College of Obstetricians and Gynecologists (ACOG) doesn't support programs or individuals that provide home births. According to ACOG, most women experience children without problems, but complications can arise very quickly, even in the healthiest of women. If this occurs, special medical care is needed right away to protect the health of mom and baby. This kind of care is not available at home.

Wherever you choose to have your baby, it's important that the person caring for you is medically trained in pregnancy and childbirth. This professional can be an obstetrician/gynecologist (OB/GYN), a family physician, or a certified nurse-midwife. Some women who face complications throughout their pregnancy may also see a maternal-fetal specialist (a doctor who specializes in high-risk pregnancies).

Certified nurse-midwifes
Most home births are done by midwives. There are several different kinds of midwives. It's important to choose one with the proper training in pregnancy and childbirth.

A certified nurse-midwife is a registered nurse with advanced, specialized training and experience in taking care of pregnant women and delivering babies. Certified nurse-midwives are licensed to provide care before, during and after delivery.

Thinking about home birth
A home birth may place you and your child at increased risk. You may consider a home birth if:

• Your health provider believes your pregnancy is unlikely to face any complications during labor.
• You’ve worked with your health provider to create a plan for birth at home and transfer to a hospital, if needed.
• Your health provider is properly trained in pregnancy and childbirth.
• You live close to a hospital, should an emergency arise.

When you should not have a home birth

• You've had a complication during pregnancy.
• Your pregnancy is considered high-risk.
• Your prenatal care was incomplete.
• The person attending your birth lacks proper training in pregnancy and childbirth.
• The person attending your birth does not fully support home births as an appropriate option in some cases.
• There is no hospital nearby.
• You don't have a way to get to a hospital quickly if something goes wrong.
• You may want to use medications to help cope with labor pain.

Things to consider

• Most women with low-risk pregnancies have healthy home births. But there's no way to really know if this choice is safe for you and your baby until after the baby is born.
• A low-risk pregnancy can quickly become high-risk in a matter of moments. When this happens, you'll need to go to a hospital immediately. Each passing minute counts.
• If something goes wrong during a home birth, you won't have quick access to the special medical care that can save you or your baby's life.
• Too much focus on having a "natural" childbirth may lead to a delay in recognizing signs of trouble.

January 2010