This post is not about the benefits of homebirth. It’s a guide to making a decision about where to birth. Here are some things to consider:
The first consideration for most people is health. Are any underlying conditions present that might necessitate more specialized care than a midwife can provide? This can be hard to discern, because every midwife has a personal comfort level. Some accept clients who are having a VBAC, twins, a breech baby, or have elevated blood pressure, gestational diabetes, etc. and some do not. I would suggest that you review any existing research to decide your own comfort level and then try to find a midwife if you decide to pursue homebirth. Midwives have the right to choose which risk levels they are comfortable with (aside from anything that is legally restricted), so it may be difficult to find the right fit for you if you require a more skilled attendant.
Is your family life/home acceptable for homebirth?
I chose to say acceptable rather than ideal because homebirth is still possible in many less than ideal situations. It is, once again, determined by the comfort level of you and your midwife. Some questions to serve as a launching point:
Is your family accepting of homebirth?
It is, of course, possible to birth at home without your in law’s blessing, but consider any stress the dissent would put on you. Is homebirth something you feel strongly enough about to pursue anyway? Many midwives are willing to sit down with concerned family members and answer respectful questions and concerns.
Is your home’s distance from the hospital within your and your midwife’s comfort zone?
Living very far from the hospital increases the travel time in the event of a transfer. If your home is too far for comfort, you might consider a ‘home away from home’ birth if it’s an option.
Is your home safe and sound?
Is there any safety hazard present that would make a homebirth difficult or inadvisable? Are there any restrictions specific to homebirth (apartment or assisted living rules)?
Where do you feel safest?
Even if you logically decide that a physiologically normal birth is right for you, home might not be the answer. If you do not feel safe without a medical setting, there is nothing wrong with that. Don’t ignore your own feelings. Feelings are very important when it comes to birth.
Is homebirth financially possible for you?
In an ideal world, homebirth would be available to everyone who desired it. Unfortunately, many insurances do not have coverage for homebirth. A good start is to find out if your insurance covers homebirth and if there are any restrictions. If they don’t cover it, it might be an option to just ask them to cover it. Is the deductible greater than your midwife’s fee? It may make more sense to just pay outright. Try asking your midwife for advice on dealing with insurance. She may have more information about it. If you cannot get your homebirth covered by insurance, discuss payment options with your midwife. You may be able to work out a payment plan. Some midwives are willing to accept goods or services for a portion of their fee. If you are having a baby shower or are usually given gifts by friends and family when you give birth, you could ask for money in lieu of gifts to help pay for your homebirth. If all avenues are exhausted, some midwives may be willing to reduce their fee or be even more lenient about payments. It doesn’t hurt to ask, but please be respectful. A midwife’s skills and time are not free. She has had to pay for her education, office space or transportation to your home, medical supplies, lab work processing and any expenses incurred from being available to her clients at all times. She has to alter her lifestyle for every client who is due, and may have to face serious inconveniences in order to attend your birth.
These questions serve as a good launching point to help you decide if you want to look into homebirth more seriously. Naturally, the next step is to speak directly with a midwife to learn more about her standard of care and policies.