The best to date study, based on data collected by Midwives of Alliance of North America from 2004-2009, included 17,000 midwife-supervised out of hospital births and is referenced below. Maternal and neonatal outcomes for this data set were excellent and intervention rates were of course very low. Most notably only 5.2% of mothers ended with a surgical birth in comparison to 32% national average. In addition the rate for successful VBAC was 87% compared to 13% in hospitals.
This article from The Journal of Midwifery & Women’s Health goes into greater detail on the statistics of home birth outcomes.
Bottom line: No one can guarantee how your birth or any birth will go. There is always a small but real chance that a serious complication may materialize. It is the midwife’s responsibility to watch for any indications of a problem and refer for other care appropriately. While it is possible but rare that a situation may develop where hospital resources are needed but not available, it is highly likely that hospital interventions that cause harms minor or major will occur in any hospital birth.
The third party payer system as it stands is not set up to support midwifery care. Insurance payments are based on codes and huge systems that seek to categorize individuals in ways that make them easy to manage and control. Most medical offices employ full-time staff just to handle insurance billing and insurance company mandates are what force doctors to meet quotas on patients seen per day, giving them just a few minutes with each person.
If insurance did cover home birth midwifery at any scale it is certain regulation and requirements would come along with the benefit. The insurance company would dictate much of your care just as they do in the medical model. Unnecessary procedures may be encouraged while individualized care and independent decision making is discouraged. Most midwives are resistant to this potential change and feel they can serve their clients with more integrity by remaining autonomous. The old Celtic adage “he who pays the piper calls the tune” applies—if you are the one paying for your care you are the priority and not the system.
Most or all “health sharing” groups reimburse for home birth midwifery. Health shares are not insurance and are a way to plan for medical needs without supporting insurance companies. Each health share organization has its own rules regarding reimbursement. As a member you will need to thoroughly understand your plan.
Sometimes Health Savings Accounts and Flexible Spending Accounts can be used to pay for midwifery services. Again you will need to be informed of the rules applying to your individual account.
Several firms offer loans for medical care. Two are United Credit and Care Credit.
Bottom line: Most young couples happily spend a lot of time and money planning their wedding, and rightly so! And while it provides lovely memories, the success of the one day event will not determine the success of your marriage nor measurably affect your life going forward. On the other hand, experiencing trauma or physical damage unnecessarily from your birth may alter your childbearing future and can impact your health for the rest of your life. The risk of both is greatly reduced by making the choice for home birth.
Doula:
Midwife:
In essence, a doula offers emotional and physical support without providing medical care, while a midwife is a trained healthcare professional who can deliver babies and provide comprehensive prenatal and postpartum care, including medical interventions when necessary. For many families, a birth support team includes both roles. Doulas are especially helpful for mothers having their first unmedicated birth.
A Certified Professional Midwife is a healthcare professional specializing in providing care to women during pregnancy, childbirth, and the postpartum period. CPMs are trained to offer midwifery care outside of the hospital setting, typically in homes or birthing centers.
Here are some key characteristics and aspects of Certified Professional Midwives:
Certified Professional Midwife (CPM) and a Certified Nurse Midwife (CNM) are both types of midwives but with differences in their education, training, and scope of practice.
The majority of CNMs attend births in hospitals; the majority of CPMs attend births in homes and birth centers. In Virginia, CPMs are licensed to provide care for normal newborns up to 6 weeks of age. CPMs and CNMs can be regulated differently, even in the same state.
Social media is rife with ethereal scenes of shimmering water and twinkling fairy lights, but it’s not all about aesthetics. The purpose of laboring in a pool or tub is mainly comfort. The warm water can feel so good, especially if you are a person who has found relief with water in the past. On the other hand, some women dislike the pool. For the baby to be born in the water, it must be quite warm, and some moms find it too hot. Trying to find a comfortable position in the pool can be hard.
Many homes don’t have a water heater that can fill a pool in one go. Plan B is heating large pots of water on the stovetop. Timing can be tricky as you need it full and warm at the right time, and it needs to stay warm until baby comes. Good planning and a coordinated birth team are a must. If your home has a large bathtub, it’s usually much easier to fill, keep warm, and drain!
I provide inexpensive one time use pools to my clients who want to try waterbirth, with the caveat that the plan can change depending on how you are feeling and how the labor is going. There are times it’s best to deliver the baby out of the pool.
Babies won’t be stimulated to take their first breath until their bodies sense air, and they’re just moving from one water environment to another in a waterbirth.